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目的:应用基于体素的节点中心度(degree centrality,DC)方法探讨强迫障碍患者静息态下脑功能网络连接属性的改变。方法:纳入符合美国精神障碍诊断与统计手册第4版修订版(DSM-IVTR)强迫障碍诊断标准的30例门诊和住院患者,以及30名性别、年龄和受教育程度相匹配的健康对照。采用耶鲁-布郎强迫量表、汉密顿抑郁量表、汉密顿焦虑量表评估强迫障碍患者强迫思维和强迫行为以及抑郁焦虑症状。所有被试进行全脑静息态功能磁共振成像扫描,采用DPARSFA分析软件计算被试的DC值。结果:与正常对照相比,强迫障碍患者右侧眶额回[(-0.22±0.45)vs.(-0.57±0.22)]和左侧前扣带回[(0.14±0.48)vs.(-0.21±0.33)]的DC值升高(P<0.001);右侧岛叶的DC值降低[(-0.12±0.37)vs.(0.35±0.54)](P<0.001);右侧眶额回的DC值与耶鲁-布郎强迫量表总分正相关(r=0.68,P<0.05)。结论:静息状态下,大脑执行控制网络和突显网络重要节点/脑区连接属性的异常可能与强迫障碍的病理生理机制有关。
OBJECTIVE: To explore the changes of brain functional network connectivity under resting state in patients with obsessive-compulsive disorder using a voxel-based central centrality (DC) method. METHODS: Thirty outpatients and inpatients who met diagnostic criteria for obsessive-compulsive disorder (DSM-IVTR) version 4 of the Diagnostic and Statistical Manual of Mental Disorders, and 30 healthy controls matched for gender, age and education were included. The Yale-Brown’s Obesity Scale, the Hamilton Depression Scale, and the Hamilton Anxiety Scale were used to assess obsessive-compulsive and compulsive behaviors and symptoms of depression and anxiety in obsessive-compulsive disorder patients. All subjects underwent whole-brain resting state functional magnetic resonance imaging scanning, and DPARSFA analysis software was used to calculate the DC value of the subjects. RESULTS: Compared with the control group, the orbital frontal gyrus of patients with obsessive-compulsive disorder (-0.22 ± 0.45 vs. -0.57 ± 0.22) and left anterior cingulate gyrus (0.14 ± 0.48) vs (-0.21 ± 0.33)] (P <0.001). The DC value in the right insula was decreased [(-0.12 ± 0.37) vs. (0.35 ± 0.54)] (P <0.001) DC value was positively correlated with Yale-Brown’s forced score scale (r = 0.68, P <0.05). CONCLUSIONS: At rest, abnormalities in the executive control network of the brain and in highlighting the important node / brain connectivity properties of the network may be related to the pathophysiologic mechanisms of obsessive-compulsive disorder.