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广泛性焦虑障碍和强迫障碍的基于体素的大脑灰质体积研究
  • 摘要

    目的:应用磁共振成像(MRI)技术探讨广泛性焦虑障碍(GAD)和强迫障碍(OCD)患者大脑灰质体积的特征性表现。方法:选取符合精神障碍诊断与统计手册第四修订版(DSM-IV-TR)或疾病和有关健康问题的国际统计分类第十次修订本(ICD-10)诊断标准的28例 GAD、25例 OCD 及39例健康对照。全部研究对象完成高分辨率结构磁共振成像扫描,使用汉密顿焦虑量表(HAMA)和耶鲁布朗强迫量表(Y-BOCS)评估患者的焦虑或强迫症状严重程度。在全脑范围内采用基于体素的形态学分析方法,分别比较各组研究对象之间灰质体积的差异,并探讨 GAD 和 OCD 患者全脑灰质体积与 HAMA 和 Y-BOCS总分的相关性。结果:与健康对照相比,GAD 左侧前扣带回脑区灰质体积增加(P =0.016,小体积校正),OCD 患者双侧眶额皮层等脑区灰质体积下降(P <0.001,未校正);GAD 患者较 OCD 患者在双侧眶额皮层等多个脑区灰质体积增加(P <0.001,未校正)。GAD 患者的 HAMA 总分与右侧颞叶的灰质体积增加相关,而 OCD 患者的 HAMA 总分则与眶额皮层等脑区的灰质体积变化相关(P <0.001,未校正)。讨论:GAD 和 OCD 患者并未共享相同的灰质体积异常脑区,两种疾病可能具有完全不同的大脑结构特征,并且其焦虑症状具有不同的神经机制。

  • 作者

    阎浩  黄悦勤  刘肇瑞  韩鸿宾  张岱  YAN Hao  HUANG Yue-Qin  LIU Zhao-Rui  HAN Hong-Bin  ZHANG Dai 

  • 作者单位

    北京大学第六医院,北京大学精神卫生研究所,卫生部精神卫生学重点实验室 北京大学,北京 100191/北京大学第三医院放射科,北京,100191

  • 刊期

    2015年3期 ISTIC PKU CSSCI

  • 关键词

    广泛性焦虑障碍  强迫障碍  基于体素的形态学分析  灰质体积  general anxiety disorder  obsessive compulsive disorder  voxel-based morphometry  gray matter volume 

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