【摘要】 目的 探讨首发强迫症患者皮质-纹状体-丘脑-皮质(cortico-striatal-thalamic-co rtical,CSTC)环路中关键脑区的代谢异常。方法 利用氢质子磁共振波谱分析技术~1H-MRS检测20例首发强迫症患者和20例健康志愿者的前额叶、前扣带回、眶额叶、纹状体区及丘脑的多个代谢指标,包括N-乙酰天门冬氨酸(NAA)、胆碱复合物(Cho)、肌酸(Cr)及肌醇(MI),并计算NAA、Cho、MI与Cr的比值。结果 (1)与对照组相比,首发强迫症患者双侧纹状体区NAA/Cr值降低,P<0.05,而双侧丘脑、前扣带回、前额叶及双侧眶额叶NAA/Cr值较对照组升高,P<0.05。(2)首发强迫症患者双侧前额叶Cho/Cr值较对照组升高,P<0.01,双侧前扣带回、眶额叶、纹状体区及丘脑与对照组比较无显著变化,P>0.05。(3)首发强迫症患者双侧前扣带回MI/Cr低于对照组,P<0.05,而双侧前额叶、眶额叶、纹状体区、丘脑较对照组无显著变化,P>0.05。结论 CSTC环路与强迫症关系密切,其关键脑区的代谢异常可能构成强迫症的神经生物学基础。更多还原

【Abstract】 Objective To explore the abnormality of the brain ’ s metabolism about the cortico-striatal-thalamic-cortical cycle(CSTC) at first-episode obsessive-compulsive disorder.Methods Multiple metabolic indices including NAA,Cho,MI,Cr of the anterior cingutate,prefrontal lobe,orbital frontal lobe,corpus striatum and thalamus were detected by using ~1 H magnetic resonance spectroscopy in 20 patients with CSTC and 20 healthy volunteers.NAA/Cr,Cho/Cr and MI/Cr were also calculated.Results(1)The values of NAA/Cr in the bilateral corpus striatum of the obsessive-compulsive disorder group decreased(P<0.05),and the values of NAA/Cr in anterior cingutate,prefrontal lobe,orbital frontal lobe and thalamus of the obsessive-compulsive disorder group were higher as contrasted to control group(P<0.05).(2)The values of Cho/Cr in the bilateral anterior cingutate of the obsessivecompulsive disorder group were significantly higher(P<0.01),and the values of Cho/Cr in the bilateral corpus striatum,prefrontal lobe,orbital frontal lobe and thalamus of the obsessive-compulsive disorder group were no significantly different(P>0.05) as contrasted to control group.(3)The values of MI/Cr in the bilateral prefrontal lobe of the obsessive-compulsive disorder group decreased significantly(P<0.05),and the values of MI/Cr in the bilateral prefrontal corpus striatum,anterior cingutate,orbital frontal lobe and thalamus were no significantly different(P>0.05) as cntrasted to control group.Conclusion CSTC have a close relation with the first-episode obsessive-compulsive disorder,the abnormal metabolism in the key regions maybe constitute the nervous biochemical basis of first-episode obsessive-compulsive disorder.更多还原