标题：强迫症患者脑内环路磁共振波谱成像研究

      作者：陈 峰，郭 敏，刘 涛，郭骏成，蒋湘玲
    (海南省人民医院科教处，海南 海口 570311)

      卷次： 2014年25卷4期

      【摘要】 目的 应用磁共振波谱成像（MRS）研究首发强迫症患者脑内环路物质代谢，探讨其发病机
制。方法 对 20例首发强迫症患者及20例健康志愿者行常规磁共振及三维磁共振氢质子波谱(1H-MRS)检查，测
量双侧前额叶、眶额叶、尾状核头部、前扣带回、丘脑的N-乙酰天门冬氨酸(NAA)、胆碱复合物(Cho)与肌酸(Cr)的比
值，对两组之间各部位的比值分别进行两独立样本 t检验。结果 首发强迫症组患者丘脑的Cho/Cr比值(1.37±0.11)
明显高于对照组(1.17±0.09)，差异有统计学意义(P<0.01)；而前额叶、眶额叶、尾状核头部、前扣带回的Cho/Cr比
值与对照组间差异无统计学意义(P>0.05)。首发强迫症患者尾状核头部、丘脑的NAA/Cr分别为(1.22±0.15)、
(1.22±0.11)，明显低于对照组[分别为(1.47±0.17)、(1.35±0.11)]，差异有统计学意义(P<0.01)；前扣带回、眶额叶的
NAA/Cr分别为(2.92±0.15)、(2.78±0.23)，均高于对照组[分别为(2.76±0.21)、(2.57±0.18)]，差异有统计学意义(P<
0.01)；而前额叶未见明显变化(P>0.05)。结论 首发强迫症患者皮质-纹状体-丘脑-皮质环路的功能存在障碍，
该神经环路在强迫症发病机制中可能起着一定的作用。

      【关键词】 强迫症；脑；磁共振波谱

      【中图分类号】 R749.8 【文献标识码】 A 【文章编号】 1003—6350（2014）04—0512—03


Study of neuroanatomical circuit in first-episode obsessive-compulsive disorder by magnetic resonance
spectroscopy.
CHEN Feng, GUO Ming, LIU Tao, GUO Jun-cheng, JIANG Xiang-ling. Science and Education
Department, People's Hospital of Hainan Province, Haikou 570311, Hainan, CHINA

【Abstract】 Objective To find the characteristics of metabolic changes in neuroanatomical circuit in patients
with first-episode obsessive-compulsive disorder through 1H-MRS. Methods Twenty patients with first-episode ob-
sessive-compulsive disorder (the study group) and twenty gender- and age-matched normal controls (the control
group) were involved in the study. The neurochemical abnormalities including the levels of choline (Cho)/creatine
(Cr), N-acetylaspartate (NAA)/Cr were measured respectively in prefrontal lobe, anterior cingutate, orbital frontal
lobe, caudate nucleus and thalamus with three-dimension 1H-proton magnetic resonance spectroscopy (3D 1H-MRS).
Results The values of Cho/Cr ratios in thalamus were significant higher in the study group than the control group
(P<0.01), and the values of NAA/Cr in caudate nucleus, thalamus were significantly lower in the study group (P<
0.01), but the values of NAA/Cr in anterior cingutate, orbital frontal lobe were higher (P<0.01). Conclusion There
are some special neurochemical and histological structure changes (cortico-striatal-thalamic-cortical cycle) in first-epi-
sode obsessive-compulsive disorder. 1H-MRS can find these changes through assessing the metabolic abnormalities.

      【Key words】 Obsessive-compulsive disorder; Brain; Magnetic resonance spectroscopy (MRS)
基金项目：国家自然科学基金(编号：81260209)；海南省重点科技项目（编号：zdxm20100043、Zdxm20130073)；海南省自然科学基金项
目(编号：30853)；海南省卫生厅科技项目(编号：琼卫2009-7、琼卫2009-11和琼卫2010-重点-38)。