Functional MRI study of brain activation alterations in patients with obsessive-compulsive disorder after symptom improvement
Functional MRI study of brain activation alterations in patients with obsessive-compulsive disorder after symptom improvement
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DOI：
10.1016/j.pscychresns.2007.11.001
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发表时间：
2008-08-30
影响因子：
2.3
通讯作者：
Kanba, Shigenobu
中科院分区：
文献类型：
--
作者：
Nabeyama, Maiko;Nakagawa, Akiko;Kanba, Shigenobu
额叶皮层下回路功能障碍是强迫症（OCD）病理生理学中最常见的发现，最近的神经心理学研究表明，强迫症中存在认知障碍。为了阐明强迫症的病理生理学而不受药物的干扰，我们研究了强迫症患者脑功能的改变以及仅因行为治疗而临床改善后的变化。研究对象为11名门诊强迫症患者和19名正常人。患者接受了12周的行为治疗。我们研究了患者和正常对照组在Stroop测试中的行为表现和功能磁共振成像结果的差异，以及患者治疗后的变化。与对照组相比，患者的前扣带回和小脑的激活较少。OC症状显著改善后，小脑和顶叶的激活增加，眶额皮质，额中回和颞叶区域在Stroop任务中的激活减少，任务本身的性能未得到证实。我们的研究结果表明，后脑区域的功能障碍，特别是小脑，参与了强迫症的发病机制，并正常化的功能可以发生与改善OC症状。(c)2007爱思唯尔爱尔兰有限公司保留所有权利。
Dysfunction of the frontal-subcortical circuits has been the most common finding in the pathophysiology of obsessive-compulsive disorder (OCD), and recent neuropsychological studies have shown cognitive impairments in OCD. To clarify the pathophysiology of OCD without the confounding effects of medication, we investigated the alterations of brain function in OCD patients and changes after clinical improvement due solely to behavior therapy. The participants were 11 outpatients with OCD and 19 normal controls. The patients received 12 weeks of behavior therapy. We investigated the differences in the behavioral performance and functional magnetic resonance imaging results during the Stroop test in the patients and normal controls, and their changes after treatment in the patients. The patients showed less activation in the anterior cingulate gyrus and cerebellum than control subjects. Following significant improvement in OC symptoms, the cerebellum and parietal lobe showed increased activation, and the orbitofrontal cortex, middle frontal gyrus, and temporal regions showed decreased activation during the Stroop task, and performance of the task itself unproved. Our findings Suggest that dysfunction of the posterior brain regions, especially the cerebellum, is involved in the pathogenesis of OCD, and that normalization in function can occur with improvement of OC symptoms. (c) 2007 Elsevier Ireland Ltd. All rights reserved.