Cingulate and thalamic metabolites in obsessive-compulsive disorder.

Cingulate and thalamic metabolites in obsessive-compulsive disorder.
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强迫症中的扣带和丘脑代谢物。

DOI:
10.1016/j.pscychresns.2016.05.005
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发表时间:
2016-08-30
期刊:
Psychiatry research. Neuroimaging
影响因子:
--
通讯作者:
Feusner JD
Feusner JD
中科院分区:
其他
文献类型:
--
作者:
O'Neill J;Lai TM;Sheen C;Salgari GC;Ly R;Armstrong C;Chang S;Levitt JG;Salamon N;Alger JR;Feusner JD

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质子磁共振波谱(MRS)检测强迫症(OCD)的局灶性脑代谢效应是临床状态的前瞻性指标,对治疗设计具有指导意义。在40名成年患者和16名健康对照者的双侧生殖前扣带皮层(pACC)、前中扣带皮层(aMCC)和丘脑中取样,研究了神经代谢物谷氨酸+谷氨酰胺(Glx)、肌酸+磷酸肌酸(Cr)和胆碱化合物(Cho)与强迫症诊断和多种症状类型的关系。后者包括强迫症核心症状(耶鲁-布朗强迫症量表——YBOCS)、抑郁症状(Montgomery-Åsberg抑郁评定量表——MADRS)和一般功能(全球评估量表——GAS)。患者的pACC Glx比对照组高9.7%。在患者体内,Cr和Cho与YBOCS和MADRS呈负相关,而Cr与GAS呈正相关。在aMCC中,Cr和Cho与MADRS呈负相关,而在丘脑中,Cr与GAS呈正相关。这些发现为谷氨酸能和神经中心的强迫症观点提供了适度的支持。基于我们之前的强迫症代谢模型,我们提供了一种可能的解释,这些群体和相关效应是皮质丘脑状态下谷氨酸受体活性升高和谷氨酸转运蛋白活性低于正常水平的结果。
Focal brain metabolic effects detected by proton magnetic resonance spectroscopy (MRS) in obsessive-compulsive disorder (OCD) represent prospective indices of clinical status and guides to treatment design. Sampling bilateral pregenual anterior cingulate cortex (pACC), anterior middle cingulate cortex (aMCC), and thalamus in 40 adult patients and 16 healthy controls, we examined relationships of the neurometabolites glutamate+glutamine (Glx), creatine+phosphocreatine (Cr), and choline-compounds (Cho) with OCD diagnosis and multiple symptom types. The latter included OC core symptoms (Yale-Brown Obsessive-Compulsive Scale--YBOCS), depressive symptoms (Montgomery-Åsberg Depression Rating Scale--MADRS), and general functioning (Global Assessment Scale--GAS). pACC Glx was 9.7% higher in patients than controls. Within patients, Cr and Cho correlated negatively with YBOCS and MADRS, while Cr correlated positively with the GAS. In aMCC, Cr and Cho correlated negatively with MADRS, while Cr in thalamus correlated positively with GAS. These findings present moderate support for glutamatergic and cingulocentric perspectives on OCD. Based on our prior metabolic model of OCD, we offer one possible interpretation of these group and correlational effects as consequences of a corticothalamic state of elevated glutamatergic receptor activity alongside below-normal glutamatergic transporter activity.
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