针刺足三里穴后续效应的脑功能成像研究

[目的]利用功能磁共振探讨针刺足三里穴的后续效应对脑部的影响.[方法]选择16名健康志愿者,分别在针刺足三里前及拔针后25 min对其进行磁共振功能扫描,应用局部一致性(regionall homogeneity,ReHi)方法处理fNRI数据.[结果]拔针后25 min时,右侧额中回、左侧额上回、右侧颞上回、后扣带回...     

针灸刺激对健康人及中风患者功能磁共振显像脑活动的影响

Objective

To investigate brain activity patterns during acupuncture in stroke patients, and to compare the result with normal subjects using functional magnetic resonance imaging (fMRI).

Methods

A total of 11 stroke patients with motor weakness and 10 healthy subjects were studied. fMRI was performed during acupuncture on the left side at points Quchi (LI11) and Zusanli (ST36). Data were analyzed using statistical parametric maps of brain activation induced by acupuncture stimulation.

Results

The results showed that stimulation of both LI11 and ST36 produced significantly different brain activation patterns between the two groups. The normal group showed a greater overall activation than the stroke group. In the normal group, parts of the frontal lobe, parietal lobe, sub-lobar, cerebellum and midbrain regions were activated by acupuncture at the left LI11. On the other hand, only the right side of the inferior parietal lobule region was activated in the stroke patients. When the left ST36 was stimulated in the normal group, both sides of the frontal lobe, parietal lobe, temporal lobe, and sub-lobar, and the left side of occipital lobe, and the right side of cerebellum and midbrain regions were activated. For the same stimulation in the stroke group, only both sides of the inferior parietal lobule and cerebellum regions were activated (P<0.05, cluster level). Deactivation pattern was not noted during any acupuncture stimulation in both groups.

Conclusion

Brain signal activations during the same acupuncture were different between the healthy and the stroke patients, and the effects showed a correlation of different acupuncture points.     

慢性腰痛(cLBP)针刺“同病异治”效应的脑网络影像学的客观评价

目的 本研究旨在诊断病(慢性腰痛)基础上进行中医辨证(肾虚和非肾虚慢性腰痛),并观察不同证型针刺治疗前后脑活动间的差异性,用以研究“同病异治”理论。方法 采用静息态功能性磁共振技术经不同针刺方案对由16例肾虚腰痛患者和16例非肾虚腰痛患者组成的32例慢性腰痛组进行治疗,对25例年龄和性别匹配的健康对照组进行扫描,并用局部一致性(regional homogeneity,ReHo)分析法对健康对照组和慢性腰痛组(包括肾虚和非肾虚)分别进行分析,采用视觉模拟评分表评估患者临床症状。结果 相对健康对照组,慢性腰痛患者ReHo值增加的区域主要在于双侧颞下回、左侧颞上回、左顶上叶等;ReHo值下降的区域主要在双侧中央后回、双侧额上回、右侧辅助运动区等。相比非肾虚腰痛组,肾虚腰痛组患者ReHo值增加的区域主要位于左侧颞上回、右侧颞下回、右侧颞中回、右侧楔叶、右侧顶上回等,无ReHo值显著下降的脑区。经过分型治疗后,非肾虚腰痛组和肾虚腰痛组的脑ReHo图均与健康对照组相接近,3组间差异无统计学意义。结论 不同的中医证型慢性腰痛会引起脑区不同的活动变化,脑网络能够反映“同病异证”之间的差异。不同取穴方案均能改善疼痛症状,且改善程度间无明显差异。     

基于fMRI的合谷穴功能特异性研究

目的：研究合谷穴功能的特异性为临床应用提供依据。方法：将健康志愿受试者扫描序列分为对照序列和针刺序列。对照序列采用合谷穴与非经穴贴皮电刺激,针刺序列采用针刺合谷穴与非经穴贴皮形成电刺激。针刺受试者左合谷穴或右合谷穴,通过Bold-fMRI观察针刺合谷穴在大脑皮层的激活区域。采集fMRI大脑扫描数据进行分析得出脑功能图像。结果：针刺左侧合谷可激活右侧额内侧回、右侧颞上回、右侧颞中回、右侧岛叶、左侧尾状核,双侧额下回;针刺右侧合谷可激活：左侧额内侧回、左侧颞中回、左侧额下回、右侧辅助运动区。结论：针刺合谷穴可激活大脑皮层语言运用中枢、面部反应区、听觉皮区,与合谷穴功能基本吻合。     

Effects of three needling manipulations of the right-side Zusanli (ST 36) on brain using functional magnetic resonance imaging

Objective

To investigate the effects on the brain using three needling manipulations (twirling, lifting-thrusting, and twirling plus lifting-thrusting) when the right-side Zusanli (ST 36) acupoint was stimulated with needles.

食蟹猴左足三里穴针刺fMRI研究

目的 对食蟹猴进行左侧足三里穴针刺的fMRI研究,探讨左侧足三里穴针刺所引起的脑功能活动.方法 食蟹猴6只,采用3.0T MR扫描仪,动物麻醉后进行左侧足三里穴磁共振功能成像扫描.针刺fMRI采用"静息-刺激-静息"设计模式.fMRI-BOLD扫描16层,128 phase.采用SPM2软件处理fMRI实验数据,采用t检验来分析特定任务刺激下脑激活的状态.结果 针刺左侧足三里穴可以观察到左侧中央前回、右侧中央后回、双侧岛叶、楔前叶、右侧颞叶激活;额叶、顶叶、枕叶、扣带回有负激活点.结论 可以在临床使用的MRI设备上对非人灵长类动物进行脑fMRI的研究.针刺食蟹猴左侧足三里穴,fMRI可以显示不同脑组织区域的正激活和负激活.针刺的作用机理可能与中央前回、岛叶及颞上回有较密切关系.针刺足三里穴引起的负激活定位性较差,扣带回的负激活在针刺机理及针灸止痛中可能有重要作用.     

首发与复发抑郁症患者静息态下脑局部一致性差异的功能磁共振成像研究

目的 探讨静息态下重性抑郁症首发与复发患者的脑功能特点及其差异.方法 首发与复发抑郁患者各14例及15例健康者参加磁共振扫描.结果 较健康组,首发抑郁组右额下回、左颞上回、左颞中回、左颞下回、左前扣带回腹侧、右后扣带回、左海马、左海马旁回、左尾状核、左豆状核及左屏状核局部一致性(ReHo值)减低,而右梭状回ReHo值增高;复发抑郁组双侧额上回、双侧额中回、左额下回、左颢上回、左颞中回、左颢下回、双侧后扣带回、左海马及左海马旁回ReHo值减低,而左缘上回ReHo值增高.复发较首发抑郁组左颞中回、左颞下回及右眶额皮质ReHo值增高,而右额中回、右楔前叶、右后扣带回及右海马旁回ReHo值减低.结论 首发与复发抑郁患者脑功能均存在异常,两者的异常有共同点,也有各自特征,且首发与复发患者脑功能存在明显差异.     

静息态功能磁共振评估2型糖尿病周围神经病变患者的脑功能

目的采用静息态功能磁共振成像（rs-fMRI）技术,观察2型糖尿病周围神经病变（DPN）患者局部脑区神经元活动的局部 一致性（ReHo）与糖尿病无神经病变患者的差异,分析脑功能活动改变与DPN的关系。方法纳入36例DPN患者,分为痛性糖 尿病神经病变组（Painful DPN组）20 例,非痛性糖尿病神经病变组（Painless DPN组）16 例,对照组为16 例糖尿病无神经病变 （Non-DPN组）患者。对所有受试者进行一般临床指标检查、认知与情绪量表评估及脑部rs-fMRI扫描。应用数据处理软件对 扫描图像进行分析,计算各组ReHo并进行组间比较。结果三组间比较,年龄、性别、受教育年限、糖尿病病程、蒙特利尔认知评 估无显著统计学差异（P>0.05）。与Non-DPN组相比,Painful DPN组及Painless DPN组焦虑及抑郁自评量表、睡眠自评量表评 分均显著升高（P<0.05）。与Non-DPN组相比,Painful DPN组左侧颞下回、右侧中央后回ReHo升高,后扣带回、右侧顶下回、左 侧顶上回ReHo降低（P<0.05）。与Non-DPN组相比,Painless DPN组左侧颞下回、右侧颞中回、右侧额上回ReHo升高,左侧丘 脑ReHo降低（P<0.05）。Painful DPN组与Painless DPN组间ReHo无显著统计学差异（P>0.05）。结论DPN患者存在多个脑区 及默认网络区域神经元活动的局部一致性改变,左侧颞下回可能是其功能代偿脑区。Painful DPN患者的疼痛症状可能与右侧 中央后回神经元活动异常相关。     

Study on the Regulatory Effect of Electro-acupuncture on Hegu Point （LI4） in Cerebral Response with Functional Magnetic Resonance Imaging

Objective To study, through blood oxygen level dependent functional magnetic resonance imaging (BOLD fMRI), the cerebral activated areas evoked by electro-acupuncturing (EA) the right Hegu point (LI4) or non-acupoint points on the face, and through comparing their similarities and differences, to speculate on the specific cerebral areas activated by stimulating LI4, for exploring the mechanism of its effect in potential clinical application. Methods EA was applied at volunteers’ right LI4 (of 9 subjects in the LI4 group) and facial non-acupoint points (of 5 subjects in the control group), and whole brain 3-dimensional T1 anatomical imaging of high resolution 1 × 1 × 1 mm³ used was performed with clustered stimulatory mode adopted by BOLD fMRI. Pretreatment and statistical t-test were conducted on the data by SPM2 software, then the statistical parameters were superimposed to the 3-dimensional anatomical imaging. Results Data from 3 testees of the 9 subjects in the LI4 group were given up eventually because they were unfit to the demand due to different causes such as movement of patients’ location or machinery factors. Statistical analysis showed that signal activation or deactivation was found in multiple cerebral areas in 6 subjects of LI4 group and 5 subjects of the control group (P<0.01). In the LI4 group, the areas which showed signal activation were: midline nuclear group of thalamus, left supra marginal gyrus, left supra temporal gyrus, right precuneous lobe, bilateral temporal pole, left precentral gyrus and left cerebellum; those which showed signal deactivation were: bilateral hippocampus, parahippocampal gyrus, amygdala body area, rostral side/audal side of cingulate gyrus, prefrontal lobe and occipital lobe as well as left infratemporal gyrus. In the control group, areas which showed signal activation were: bilateral frontal lobe, postcentral gyrus, Reil’s island lobe, primary somato-sensory cortex, cingulate gyrus, superior temporal gyrus, occipital cuneiform gyrus and/or precuneus gyrus and right brainstem; and the area that showed deactivation was left median frontal lobe. Conclusion The effects of EA LI4 in regulating cerebral activities could be displayed and recorded through BOLD fMRI, the distribution of signally deactivated area evoked by EA LI4 was similar to the known distribution of anatomical orientation of pain in brain, and closely related to the anatomic structure of limbic system, which areas are possibly the acupuncture analgesic effect’s cerebral regulating area. Furthermore, activated portion of left central anterior gyrus, which represent the movement of oral facial muscles, and the activated portion of cerebellum are possibly related with the effect of using EA LI4 in treating facial palsy and facial muscle spasm. As for the mechanism of signal deactivation of cerebral activities exhibited in the present study that is unable to be elucidated, it awaits for further research. Supported by the National Natural Science Foundation (No. 90209031)     

基于皮质分析睡眠剥夺后针刺神门穴对大脑局部一致性的影响

目的 基于皮质分析方法探究针刺神门穴对24 h睡眠剥夺(sleep deprivation, SD)后大脑神经活动局部一致性(regional homogeneity, ReHo)的影响。方法 对30名健康受试者进行24 h SD,随后进行针刺双侧神门穴,应用3.0T 磁共振分别在24 h SD前后以及针刺神门穴后进行静息态功能磁共振成像扫描。基于皮质分析方法采用DPABISurf软件计算每个被试24 h SD前后和针刺后脑区的ReHo值。结果 与SD前相比,24 h SD后左侧第二视皮质、左侧中央前回和左侧颞横回等脑区的ReHo值显著增高;双侧后扣带回、双侧角回和双侧背外侧前额叶等脑区的ReHo值显著降低。与SD后相比,针刺神门穴后仅引起了左侧大脑半球多个脑区ReHo值的异常改变,包括后扣带回、背外侧前额叶和角回ReHo值显著降低,而颞中回ReHo值显著增高。而与SD前相比,针刺后各个脑区的ReHo值无显著性改变。结论 针刺神门穴改善SD后脑功能损害的中枢效应机制可能是通过调节相应脑区的神经活动,从而降低个体觉醒、改善情绪和认知功能。     

基于局部一致性的重度抑郁症患者脑静息态功能磁共振成像研究

目的 采用脑静息态功能磁共振成像(rs-fMRI)局部一致性(ReHo)方法探讨重度抑郁症(MDD)患者脑区自发性活动特征,评价其与抑郁严重程度的相关性.方法 对24例MDD患者和26例相匹配的康对照组(HC)进行rs-fMRI扫描,分析两组ReHo值,将差异显著的脑区内平均ReHo值与HAMD-17评分进行相关性分析.结果 MDD患者较HC组左侧直回、左侧海马、右侧楔前叶、右侧顶上回、左侧顶下缘角回、右侧楔叶ReHo值显著升高;右背外侧前额叶、右侧后扣带回、左侧枕下回、双侧颞下回、右侧颞上回ReHo值降低(P<0.05,Alphasim矫正).Pearson相关分析显示两组差异脑区左侧海马ReHo值与HAMD-17评分呈正相关(r=0.593,P=0.002),右侧后扣带回ReHo值与HAMD-17评分呈负相关(r=-0.431,P=0.035).结论 MDD患者静息态下脑功能损害主要集中于边缘系统及默认网络等多个脑区,且左侧海马与右侧后扣带回局部脑区自发活动的时间同步性与抑郁严重程度存在相关性.ReHo分析可作为抑郁症严重程度评价的潜在生物学标记.     

青年重性抑郁症患者弥散张量和静息 状态下的功能磁共振成像

目的：利用弥散张量成像（diffusion tensor imaging, DTI）和静息状态下功能磁共振成像（functional magnetic resonance imaging, fMRI) 技术,探讨抑郁症可能的病因和发病机制。方法：对16例青年重性抑郁症患者（抑郁症组）和16例性别年龄及受教育程度匹配的自愿者（对照组）进行DTI和静息状态fMRI研究,采用基于体素法（voxel-based method, VBA）分析全脑的分数各向异性 (fractional anisotropy, FA),局部一致性（regional homogeneity, ReHo）法处理fMRI数据,并进行两组比较。结果：抑郁症患者双侧额中回、双侧中央前回、左颞上回、右颞中回、左梭状回、右枕颞外侧回、左角回、左岛叶、左小脑后叶的FA值较对照组低（P＜0.01）。抑郁症患者双侧额上回、双侧额中回、双侧额叶内侧回、双侧中央旁小叶、双侧中央后回、右顶下小叶、右楔状叶、左枕中回、左语言中枢、左颞上回、右颞中回、右扣带回及右壳核ReHo值较对照组明显降低（P＜0.01）。结论：青年重性抑郁症患者存在广泛的脑白质微观结构损害和脑功能异常,多个脑区及它们之间的结构和功能连接失常可能是抑郁症发病的重要因素之一。     

针灸治疗中风偏瘫的疗效观察

目的观察针灸治疗中风偏瘫促进神经功能恢复的疗效。方法将82例偏瘫患者随机分成针灸组41例、康复组41例。针灸组采用针灸治疗,取穴：百会、四神聪、臂臑、曲池、手三里、外关、合谷、梁丘、阴陵泉、阳陵泉、足三里、丘墟、太冲等;康复组采用理疗、肢体功能训练等其他康复治疗。5周后观察比较两组治疗前后神经功能缺损的减少程度。结果两组患者治疗后,针灸组与康复组治疗总有效率分别为：90.4%、83.3%;显著有效率分别为：33.3%、23.8%,两组比较差异有统计学意义（P〈0.05）,针灸组的疗效明显高于康复组。结论针灸疗法治疗,可促进中风偏瘫患者神经功能恢复,减少致残率,疗效较显著,且不良反应小,值得临床推广。     

基于fMRI的近似熵和ReHo在肠易激综合征检测中的敏感性和有效性比较

目的比较基于功能磁共振成像（fMRI）数据的熵分析方法和热门的局部一致性（ReHo）方法在检测肠易激综合征患者脑 活动状态的有效性和敏感性。方法本研究基于54例肠易激综合征（IBS）患者与54例健康被试的静息态fMRI数据,计算所有 被试体素水平上的近似熵（ApEn）。然后采用双样本t检验进行特征筛选,并用支持向量机方法对两组被试进行分类判别,得到 不同特征数目下的分类性能,并将该结果与ReHo获得的特征分类性能进行对比。结果IBS 患者与健康对照组ReHo在左 侧三角部额下回、右侧顶下缘角回、左侧颞下回、左侧颞中回、左侧舌回、双侧枕中回和双侧枕上回区域差异具有统计学意义 （P<0.05）,ApEn在双侧中央后回、右侧中央前回、右侧颞下回、双侧颞中回和左侧枕上回区域差异存在统计学意义（P<0.05）。 而且,无论特征数目如何变化,以ApEn为特征的识别效果均优于以ReHo为特征的识别效果。以ApEn为特征得到的分类正确 率、特异性和敏感性可高达93.5%、90.7%与96.2%,而以ReHo为特征得到的分类正确率、特异性和敏感性则高达86.1%、85.1% 与87.0%。结论与ReHo方法相比,基于fMRI的熵分析方法在IBS的识别和诊断中具有更高的敏感性和有效性。     

Increased regional homogeneity in internet addiction disorder: a resting state functional magnetic resonance imaging study

Background Internet addition disorder （lAD） is currently becoming a serious mental health problem among Chinese adolescents. The pathogenesis of lAD, however, remains unclear. The purpose of this study applied regional homogeneity （ReHo） method to analyze encephalic functional characteristic of lAD college students under resting state. Methods Functional magnetic resonanc image （fMRI） was performed in 19 lAD college students and 19 controls under resting state. ReHo method was used to analyze the differences between the average ReHo in two groups. Results The following increased ReHo brain regions were found in lAD group compared with control group： cerebellum, brainstem, right cingulate gyrus, bilateral parahippocampus, right frontal lobe （rectal gyrus, inferior frontal gyrus and middle frontal gyrus）, left superior frontal gyrus, left precuneus, right postcentral gyrus, right middle occipital gyrus, right inferior temporal gyrus, left superior temporal gyrus and middle temporal gyrus. The decreased ReHo brain regions were not found in the lAD group compared with the control group. Conclusions There are abnormalities in regional homogeneity in lAD college students compared with the controls and enhancement of synchronization in most encephalic regions can be found. The results reflect the functional change of brain in lAD college students. The connections between the enhancement of synchronization among cerebellum, brainstem, limbic lobe, frontal lobe and apical lobe may be relative to reward pathways.     

温和灸功能性消化不良患者足三里的中枢即刻响应特征

目的:探讨温和灸功能性消化不良(Functional Dyspepsia,FD)患者足三里的即刻脑功能响应特征。方法:选取符合纳入与排除标准的FD患者38例,分定位相、结构相、艾灸前静息态(6 min)、艾灸足三里任务态(3 min)与艾灸后静息态(10 min)五个步骤进行BOLD-f MRI扫描,对采集数据运用DPARSF软件分析,足三里穴均取左侧,温和灸持续3 min。结果:与艾灸前相比,艾灸足三里时FD患者的左壳核、右额中回、右中央前回、左颞中回和左小脑等脑区磁共振数据降低;与艾灸后静息相比,艾灸足三里时FD患者的左枕叶中部,小脑,右枕叶中部等脑区磁共振数据降低;与艾灸后静息相比,艾灸前静息FD患者的左海马、右小脑脚等脑区磁共振数据降低。结论:温和灸FD患者足三里穴的中枢即刻响应特征可能为通过协调左小脑、左颞极、左颞中回脑区活动降低内脏敏感性,调节前额叶、中央前皮质、颞中回、颞上回、海马等脑区活动来抑制内脏感受传导,提高疼痛、饱胀等感觉的阈值。     

胃俞募配穴针刺对功能性消化不良患者静息态脑功能局部一致性和胃电图的影响

目的 观察胃俞募配穴与非经非穴针刺对功能性消化不良(FD)患者静息态脑功能局部一致性(ReHo)和胃电图(EGG)的影响,探讨胃俞募配穴针刺调节FD患者胃运动效应的中枢作用机制。方法 将37例FD患者随机分为配穴组（19例）和非穴组（18例）,分别予以双侧胃俞+中脘、同节段非经非穴针刺治疗,同时选取19名健康人作为对照组。治疗前后分别对2组患者进行静息态脑功能磁共振成像( rs-fMRI)扫描和EGG检测,观察2组患者针刺治疗前后各脑区ReHo及EGG变化情况,并对差异脑区ReHo变化与胃运动变化进行相关性分析。结果 治疗后,①配穴组EGG振幅、频次均增高（P＜0.05~0.01）。非穴组EGG振幅增高（P＜0.01）,频次较治疗前未见明显差异（P>0.05）。②与对照组相比,FD患者小脑、额叶、扣带回、脑岛、颞叶等脑区内不同区域ReHo值异常。配穴组针刺后FD患者梭状回、后扣带回等脑区ReHo值增高（P＜0.05）,海马、额中回等脑区ReHo值降低（P＜0.05）。非穴组针刺后FD患者小脑、额上回、额中回、楔前叶、角回等脑区ReHo值发生变化。③相关性分析可见:配穴组颞上回、颞极颞中回、后扣带回、额中回、海马与EGG变化相关。非穴组各差异脑区ReHo值变化与EGG变化无显著相关。结论 胃俞募配穴针刺可引起FD患者多个脑区ReHo值变化且其对胃运动调节效应优于非穴,海马、后扣带回等脑区可能参与了针刺对胃运动的调节。胃俞募配穴针刺可能通过对边缘系统、胃肠感觉矩阵相关脑区的良性调控而发挥对FD患者胃运动功能的调节作用。      

“扶正补土”针刺法联合康复训练治疗中风后偏瘫患者的效果

目的:观察“扶正补土”针刺法联合康复训练治疗中风后偏瘫患者的效果。方法:选取73例中风后偏瘫患者为研究对象,依据随机数字表法分为对照组36例和观察组37例。对照组采用康复训练治疗,观察组在对照组基础上联合“扶正补土”针刺法治疗,比较两组治疗前后肢体运动功能[四肢简化评分量表(Fugl-Meyer)]评分、平衡能力[Berg平衡量表(BBS)]评分和临床疗效。结果:治疗后,观察组Fugl-Meyer上、下肢评分均高于对照组,差异有统计学意义(P<0.05);观察组BBS评分高于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为94.59%(35/37),高于对照组的75.00%(27/36),差异有统计学意义(P<0.05)。结论:“扶正补土”针刺法联合康复训练治疗中风后偏瘫患者可提高肢体运动功能评分、平衡能力评分和治疗总有效率,其效果优于单纯康复训练治疗。     

Effect of acupuncture plus conventional treatment on brain activity in ischemic stroke patients: a regional homogeneity analysis

Objective

To determine differences in cerebral activity evoked by acupuncture and conventional stroke treatment, and identify the treatment targets.

强迫性障碍患者的脑功能活动特点及丘脑与全脑功能连接分析

目的 比较静息状态下强迫性障碍患者脑功能活动与健康对照的差异,并分析患者双侧丘脑与全脑功能连接模式的特点。 方法 按照ICD-10中强迫性障碍的诊断标准,选取26例强迫性障碍患者(OCD组)和性别、年龄、受教育程度相匹配的25例健康志愿者(HC组),分别进行Y-BOCS、HAMA、HAMD量表测验和大脑功能磁共振扫描。在全脑体素水平上进行ReHo分析,筛选出2组间ReHo值有差异的脑区,分别以左右两侧丘脑作为种子点进行全脑功能连接分析。 结果 将统计阈值设置为P<0.005,激活体素>1 512 mm3,Alphasim校正(P<0.005),结果显示OCD组与HC组ReHo值有差异的脑区:左侧丘脑、右侧丘脑、右侧中央旁小叶、右侧中央后回、左侧角回。将左侧丘脑作为种子点的脑功能连接分析,OCD组较HC组功能连接减弱的脑区:双侧丘脑、左侧额中回、右侧海马、右侧尾状核;OCD组较HC组功能连接增强的脑区:双侧中央前回、左侧顶叶、双侧颞叶、双侧中央后回、双侧距状回、双侧舌回、双侧楔前叶、双侧楔叶、双侧小脑、右侧梭状回、双侧中央旁小叶。将右侧丘脑作为种子点的脑功能连接分析,OCD组较HC组功能连接减弱的脑区:左侧额中回、右侧额上回、双侧丘脑、双侧前扣带回、双侧中扣带回、右侧缘回;OCD组较HC组功能连接增强的脑区:双侧颞叶、双侧枕叶、双侧小脑、双侧楔叶、左侧梭状回、双侧舌回、双侧距状回。 结论 强迫性障碍患者多个脑区功能活动异常,边缘CSTC环路功能连接减弱,丘脑与大脑中后部出现代偿性功能连接增强。