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中前额皮质和右侧上颞叶的异常自发性神经活动与强迫症患者快感缺失严重程度相关。

Abnormal spontaneous neural activity in the medial prefrontal cortex and right superior temporal gyrus correlates with anhedonia severity in obsessive-compulsive disorder.

机构信息

Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; School of Education, Hunan University of Humanities, Science and Technology, Loudi, Hunan 417000, China.

Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.

出版信息

J Affect Disord. 2019 Dec 1;259:47-55. doi: 10.1016/j.jad.2019.08.019. Epub 2019 Aug 13.

Abstract

BACKGROUD

Converging evidence indicated the presence of clinically significant anhedonia in patients with obsessive-compulsive disorder (OCD). Studying anhedonia and its neural correlates in OCD may be beneficial in understanding the pathophysiology and treatment of OCD. However, the neural mechanisms that underlie anhedonia in OCD still remain unclear. The present study was designed to bridge this research gap by using resting-state functional magnetic resonance imaging (fMRI).

METHODS

29 OCD patients with anhedonia (OCD-AH), 31 OCD patients with normal hedonia (OCD-NH), and 30 healthy controls (HC) received the fMRI scan. The low-frequency fluctuation (ALFF) approach was applied to compare spontaneous neural activity among the three groups. Relationships between the regional ALFFs and anhedonia levels were examined in OCD patients.

RESULT

OCD-AH and OCD-NH manifested overlapping but partially distinct brain alterations. Notably, compared to OCD-NH, the OCD-AH showed decreased ALFF in right superior temporal gyrus (STG) and increased ALFF in medial prefontal cortex (MPFC). Moreover, ALFF values in the right STG were negatively correlated with social anhedonia severity, and ALFFs in the MPFC were positively correlated with both physical and social anhedonia severity in patients with OCD.

LIMITATIONS

Relatively small sample size; ALFF could not provide more holistic information of brain network.

CONCLUSION

The present study revealed that abnormal spontaneous neural activity in MPFC is associated with both physical and social anhedonia, while altered intrinsic brain function in right STG is specifically associated with social anhedonia in OCD. These findings contribute to our understandings of the neurobiological mechanisms underlying anhedonia in OCD.

摘要

背景

越来越多的证据表明强迫症(OCD)患者存在临床显著的快感缺失。研究 OCD 中的快感缺失及其神经相关性可能有助于理解 OCD 的病理生理学和治疗方法。然而,OCD 中快感缺失的神经机制仍不清楚。本研究旨在通过静息态功能磁共振成像(fMRI)来弥补这一研究空白。

方法

29 名有快感缺失的强迫症患者(OCD-AH)、31 名有正常快感的强迫症患者(OCD-NH)和 30 名健康对照者(HC)接受了 fMRI 扫描。采用低频波动(ALFF)方法比较三组之间的自发性神经活动。在 OCD 患者中,检查了区域 ALFF 与快感缺失程度之间的关系。

结果

OCD-AH 和 OCD-NH 表现出重叠但部分不同的大脑改变。值得注意的是,与 OCD-NH 相比,OCD-AH 右侧颞上回(STG)的 ALFF 降低,内侧前额叶皮层(MPFC)的 ALFF 增加。此外,右侧 STG 的 ALFF 值与社交快感缺失的严重程度呈负相关,MPFC 的 ALFF 值与 OCD 患者的身体和社交快感缺失的严重程度呈正相关。

局限性

样本量相对较小;ALFF 不能提供大脑网络的更全面信息。

结论

本研究表明,MPFC 中异常的自发性神经活动与身体和社交快感缺失有关,而右侧 STG 中内在大脑功能的改变与 OCD 中的社交快感缺失特异性相关。这些发现有助于我们理解 OCD 中快感缺失的神经生物学机制。

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