Local cerebral glucose metabolic rates in obsessive-compulsive disorder. A comparison with rates in unipolar depression and in normal controls.
Local cerebral glucose metabolic rates in obsessive-compulsive disorder. A comparison with rates in unipolar depression and in normal controls.
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DOI：
10.1001/archpsyc.1987.01800150017003
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发表时间：
1987-03
影响因子：
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通讯作者：
L. Baxter;M. Phelps;J. Mazziotta;B. Guze;Jeffrey M. Schwartz;C. Selin
中科院分区：
文献类型：
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作者：
L. Baxter;M. Phelps;J. Mazziotta;B. Guze;Jeffrey M. Schwartz;C. Selin
我们研究了14例强迫症（OCD）患者的正电子发射断层扫描和氟脱氧葡萄糖的方法，寻找异常的局部脑葡萄糖代谢率的大脑结构，已被假设为功能异常的强迫症。并与14例正常对照组和14例单相抑郁症患者进行比较。单相抑郁症和强迫症患者在焦虑、紧张或抑郁水平上没有差异。在强迫症，代谢率显着增加，在左眶回和双侧尾状核。这在与对照组和单相抑郁症的所有统计学比较中是明显的。在所有比较中，右眶回至少显示出代谢率增加的趋势。与对照组和单相抑郁症受试者相比，左眶回的代谢率相对于同侧半球（眶回/半球比）显著升高，即使成功的药物治疗也保持较高水平。虽然在病态状态下处于正常范围，但随着药物治疗后强迫症症状的改善，尾状核/半球代谢比率均匀且显著地双侧增加。在对治疗无反应的患者中，这一比例没有增加。因此，强迫症表现出大脑葡萄糖代谢模式，从症状和恢复状态的控制不同。
We studied 14 patients with obsessive-compulsive disorder (OCD) by positron emission tomography and the fluorodeoxyglucose method, looking for abnormalities in local cerebral metabolic rates for glucose in brain structures that have been hypothesized to function abnormally in OCD. These patients were compared with 14 normal controls and 14 patients with unipolar depression. The patients with unipolar depression and OCD did not differ in levels of anxiety, tension, or depression. In OCD, metabolic rates were significantly increased in the left orbital gyrus and bilaterally in the caudate nuclei. This was apparent on all statistical comparisons with both controls and unipolar depression. The right orbital gyrus showed at least a trend to an increased metabolic rate in all comparisons. The metabolic rate in the left orbital gyrus, relative to that in the ipsilateral hemisphere (orbital gyrus/hemisphere ratio), was significantly elevated compared to controls and subjects with unipolar depression, and stayed high even with successful drug treatment. Though it was in the normal range in the morbid state, with improvement in OCD symptoms after drug treatment, the caudate/hemisphere metabolic ratio increased uniformly and significantly bilaterally. This ratio did not increase in patients who did not respond to treatment. Thus, OCD showed cerebral glucose metabolic patterns that differed from controls in both the symptomatic and recovered states.