Brain structure and symptom dimension relationships in obsessive-compulsive disorder: A voxel-based morphometry study
Brain structure and symptom dimension relationships in obsessive-compulsive disorder: A voxel-based morphometry study
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DOI：
10.1016/j.jad.2007.12.223
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发表时间：
2008-07-01
影响因子：
6.6
通讯作者：
Phillips, Mary L.
中科院分区：
文献类型：
--
作者：
Gilbert, Andrew R.;Mataix-Cols, David;Phillips, Mary L.
背景：强迫症（OCD）是一种临床异质性疾病，其特征是症状维度暂时稳定。过去强迫症结构神经影像学研究中不一致的结果可能是由于这些特定症状维度以及其他社会人口统计学和临床变量对灰质（GM）体积的影响。方法：采用体素形态测量法（voxel-based morphometry， VBM）测量25例成人强迫症患者和20例成人健康对照者的脑GM体积，控制年龄和脑GM总体积。对GM差异区域与年龄、发病年龄、药物负荷、强迫症严重程度、抑郁严重程度和单独症状维度评分进行单因素和多因素回归分析。结果：与对照组相比，强迫症患者的皮质背区GM体积存在显著差异，包括双侧BA6、BA46、BA9和右侧BA8（对照组>患者）以及双侧中脑（对照组>患者）。逐步回归分析显示，总强迫症症状严重程度越高，双侧中脑皮质区GM体积越小，双侧中脑GM体积越大。年龄越大，右侧BA6、左侧BA9、左侧BA46的GM体积越小，右侧中脑GM体积越大。洗涤症状严重程度越大，右侧BA6区GM体积越小；囤积症状严重程度越大，左侧BA6区GM体积越小；局限性：样本相对较小，无法检验症状评分与GM体积之间的关系。多名患者正在服用药物并有合并症。结论：这些分析表明强迫症的背前额皮质和双侧中脑GM异常似乎主要是由强迫症症状严重程度的影响驱动的。关于GM体积和症状维度得分之间关系的结果需要在更大的样本中进行检查。(C) 2008 Elsevier B.V.版权所有
Background: Obsessive-compulsive disorder (OCD) is a clinically heterogenous disorder characterized by temporally stable symptom dimensions. Past inconsistent results from structural neuroimaging studies of OCD may have resulted from the effects of these specific symptom dimensions as well as other socio-demographic and clinical variables upon gray matter (GM) volume.Methods: GM volume was measured in 25 adult OCD patients and 20 adult healthy controls using voxel-based morphometry (VBM), controlling for age and total brain GM volume. Univariate and multivariate regression analyses were carried out between regions of GM difference and age, age of onset, medication load, OCD severity, depression severity, and separate symptom dimension scores.Results: Significant GM volumetric differences in OCD patients relative to controls were found in dorsal cortical regions, including bilateral BA6, BA46, BA9 and right BA8 (controls > patients), and bilateral midbrain (patients > controls). Stepwise regression analyses revealed highly significant relationships between greater total OCD symptom severity and smaller GM volumes in dorsal cortical regions and larger GM volumes in bilateral midbrain. Greater age was independently associated with smaller GM volumes in right BA6, left BA9, left BA46 and larger GM volumes in right midbrain. Greater washing symptom severity was independently associated with smaller GM volume in right BA6, while there was a trend association between greater hoarding symptom severity and lower GM volume in left BA6.Limitations: The sample was relatively small to examine the relationship between symptom scores and GM volumes. Multiple patients were taking medication and had comorbid disorders.Conclusions: These analyses suggest dorsal prefrontal cortical and bilateral midbrain GM abnormalities in OCD that appear to be primarily driven by the effects of total OCD symptom severity. The results regarding the relationship between GM volumes and symptom dimension scores require examination in larger samples. (C) 2008 Elsevier B.V. All rights reserved.