Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using oxygen 15-labeled carbon dioxide and positron emission tomography.
Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using oxygen 15-labeled carbon dioxide and positron emission tomography.
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DOI：
10.1001/archpsyc.1994.03950010062008
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发表时间：
1994
影响因子：
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通讯作者：
S. Rauch;M. Jenike;N. Alpert;L. Baer;H. Breiter;C. Savage;A. Fischman
中科院分区：
文献类型：
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作者：
S. Rauch;M. Jenike;N. Alpert;L. Baer;H. Breiter;C. Savage;A. Fischman
背景本研究旨在确定强迫症（OCD）的介导神经解剖。方法使用短半衰期示踪剂氧15标记的二氧化碳，允许重复正电子发射断层扫描测定8例强迫症患者在静息和激发（症状）状态下的局部脑血流量。结果：与成对的无害刺激相比，单独定制的刺激成功地激发了强迫症症状，通过强迫症模拟量表的自我报告进行测量（P = .002）。综合减影图像显示，在强迫症症状状态下与静息状态相比，右侧尾状核（P <0.006）、左侧前扣带回皮质（P <0.045）和双侧眶额皮质（P <0.008）的相对局部脑血流量在统计学上显著增加;左侧丘脑的增加接近但未达到统计学显著性（P = 0.07）。结论：这些发现与以前的功能性神经影像学研究和当代强迫症神经回路模型的结果一致。这些数据进一步暗示眶额皮质、尾状核和前扣带皮质参与了强迫症的病理生理学和介导强迫症症状。
BACKGROUND The study was designed to determine the mediating neuroanatomy of obsessive-compulsive disorder (OCD). METHODS The short half-life tracer oxygen 15-labeled carbon dioxide was used to allow for repeated positron emission tomographic determinations of regional cerebral blood flow on each of eight patients with OCD during a resting and a provoked (symptomatic) state. RESULTS Individually tailored provocative stimuli were successful in provoking OCD symptoms, in comparison with paired innocuous stimuli, as measured by self-report on OCD analogue scales (P = .002). Omnibus subtraction images demonstrated a statistically significant increase in relative regional cerebral blood flow during the OCD symptomatic state vs the resting state in right caudate nucleus (P < .006), left anterior cingulate cortex (P < .045), and bilateral orbitofrontal cortex (P < .008); increases in the left thalamus approached but did not reach statistical significance (P = .07). CONCLUSIONS These findings are consistent with results of previous functional neuroimaging studies and contemporary neurocircuitry models of OCD. The data further implicate orbitofrontal cortex, caudate nucleus, and anterior cingulate cortex in the pathophysiology of OCD and in mediating OCD symptoms.