强迫症共病抠皮障碍患者磁共振波谱分析

目的： 探讨强迫症共病抠皮障碍患者前扣带区神经生化代谢特征，为强迫性障碍的病理生理基础研究 提供参考。方法： 应用质子磁共振波谱技术(proton magnetic resonance spectroscopy，1H-MRS)对17 例强迫症不伴抠 皮障碍患者和13 例强迫症共病抠皮障碍患者的前扣带区进行检测，测定感兴趣区N-乙酰基天冬氨酸+N-乙酰基天冬 氨酰谷氨酸(total N-acetyl aspartyl，tNAA)、谷氨酸(glutamate，Glu)、谷氨酰氨(glutamine，Gln)、肌酸(creatine，Cr)、 肌醇(myo-inositol，mI)、胆碱化合物(choline-containing compounds，Cho)的代谢物浓度，对两组患者进行临床评估和 代谢物指标定量分析。结果： 强迫症共病抠皮障碍患者前扣带区Glu 浓度显著低于强迫症不伴抠皮障碍患者(P= 0.001)，其余代谢物浓度组间比较差异无统计学意义(P>0.05)。两组患者Glu 浓度与汉密尔顿焦虑量表(Hamilton Anxiety Rating Scale，HAMA)评分呈负相关(r=−0.55，P=0.002)。在强迫症合并抠皮障碍组中，女性患者Glu 浓度与 耶鲁-布朗强迫症状量表(Yale-Brown Obsessive Compulsive Scale，Y-BOCS)总分相关(r=0.69；P=0.041)，与其他临床 指标无明显相关(P>0.05)。结论： 前扣带区Glu 代谢改变参与了强迫症共病抠皮障碍的病理生理过程，为研究强迫症 和抠皮障碍的发病机制提供了一定证据支持。

Analysis of magnetic resonance spectroscopy in patients with obsessive-compulsive disorder comorbid skinpicking disorder

Objective: To investigate the neurobiochemical characteristics of the anterior cingulatecortex (ACC) in patients with obsessive-compulsive disorder (OCD) comorbid skinpicking disorder (SPD), and to provide reference for the pathophysiological basis for OCD. Methods: We examined the levels of glutamate and other neurochemicals in ACC of 30 adult OCD patients (13 with comorbid SPD, 17 without SPD), using proton magnetic resonance spectroscopy (1H-MRS) at 3T. The clinical evaluation and the quantitative analysis of metabolites were carried out in the two groups. Results: OCD patients with comorbid SPD showed significantly lower ACC glutamate than the patients without SPD (P=0.001). In all OCD patients, glutamate was negatively correlated with scores of Hamilton Anxiety Rating Scale (r=−0.55, P=0.002). Moreover, the ACC glutamate of female patients was correlated with the total score of Yale-Brown Obsessive Compulsive Scale (r=0.69, P=0.041) in the OCD with comorbid SPD patients. Conclusion: Alterations of the glutamate content in the ACC are involved in the pathophysiological process of OCD with comorbid SPD, which provides evidence for the study on the pathogenesis of OCD and SPD.