REGIONAL CEREBRAL BLOOD-FLOW IN OBSESSIVE-COMPULSIVE DISORDERED PATIENTS AT REST - DIFFERENTIAL CORRELATES WITH OBSESSIVE-COMPULSIVE AND ANXIOUS-AVOIDANT DIMENSIONS
REGIONAL CEREBRAL BLOOD-FLOW IN OBSESSIVE-COMPULSIVE DISORDERED PATIENTS AT REST - DIFFERENTIAL CORRELATES WITH OBSESSIVE-COMPULSIVE AND ANXIOUS-AVOIDANT DIMENSIONS
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DOI：
10.1192/bjp.167.5.629
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发表时间：
1995-11-01
影响因子：
10.5
通讯作者：
KERWIN, RW
中科院分区：
文献类型：
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作者：
LUCEY, JV;COSTA, DC;KERWIN, RW
背景。我们测试了强迫症（OCD）患者和健康对照者的皮质和皮质下局部脑血流量（rCBF）是否存在差异。然后我们探讨了rCBF与OCD精神状态的关系。方法。使用脑部专用、高分辨率、单光子发射断层扫描技术对莫兹利医院 (Maudsley Hospital) 的 30 名患有 DSM-III-R 中定义的强迫症的门诊患者进行静息扫描。 RCBF 测量为 15 个感兴趣区域中 99mTc-HMPAO 的摄取量，并与 30 名年龄、性别和惯用手习惯相匹配的健康人的 rCBF 数据进行比较。症状评级是在扫描当天使用标准措施获得的。主成分因子分析确定了两个不同的临床维度：强迫症（OC）和焦虑回避症（AA）。使用 Spearman 等级相关系数和计算的多元回归系数将这些结果与患者的 rCBF 测量结果相关。我们发现强迫症患者的 rCBF 测量值与静息的健康对照组相比显着降低（F=7.92，P=0.04），七个大脑区域：左右额上皮层、右额下皮层、左颞叶皮层、左顶叶皮层、右尾状核和右丘脑。区域差异并不是患者脑灌注普遍减少的继发因素。右下额皮质血流量减少与疾病严重程度显着相关（r=0.37，P=0.02）。与年龄、发病年龄、性别、惯用手、抑郁或药物状况无关。 OC 临床维度，涉及强迫观念、强迫行为和情绪低落，与左下额叶、内侧额叶和右顶叶 rCBF 显着负相关。 AA维度涉及焦虑和回避，与左右额上叶、右额下叶、内侧额叶皮质、左右尾状核和丘脑rCBF显着正相关。结论。静息状态的强迫症患者和健康对照之间的 rCBF 存在显着差异，并且不同的临床维度与功能上不同的 rCBF 模式相关。
Background. We tested whether cortical and subcortical regional cerebral blood flow (rCBF) differs between patients with obsessive-compulsive disorder (OCD) and healthy controls. We then explored the relationship between rCBF and OCD mental state.Method. Thirty out-patients from the Maudsley Hospital with OCD as defined in DSM-III-R were scanned at rest using brain-dedicated, high-resolution, single photon emission tomography. RCBF was measured as uptake of 99mTc-HMPAO in 15 regions of interest and compared with rCBF data in 30 healthy people matched for age, sex and handedness. Symptom ratings were obtained using standard measures on the scanning day. Principal components factor analysis identified two distinct clinical dimensions: obsessive-compulsive (OC) and anxious-avoidant (AA). These were correlated with patients' rCBF measurements, using Spearman's rank correlation coefficient, and multiple regression coefficients calculated.Results. We found significant reductions in rCBF measurements of OCD patients compared with resting, healthy controls (F=7.92, P=0.04) in seven brain regions: the right and left superior frontal cortex, right inferior frontal cortex, left temporal cortex, left parietal cortex, right caudate nucleus and right thalamus. Regional differences were not secondary to generalised reduction in patients' brain perfusion. Reduced blood flow to the right inferior frontal cortex correlated significantly with illness severity (r=0.37, P=0.02). There was no relationship with age, age-of-onset, sex, handedness, depression or medication status. OC clinical dimension, concerning obsessions, compulsions and low mood, was significantly negatively correlated with left inferior frontal, medial frontal and right parietal rCBF. AA dimension, concerning anxiety and avoidance, was significantly positively associated with left and right superior frontal, right inferior frontal, medial frontal cortical, and right and left caudate and thalamic rCBF.Conclusions. rCBF differs significantly between resting OCD patients and healthy controls, and separate clinical dimensions are associated with functionally distinct rCBF patterns.