强迫症患者大脑形态学特征研究进展

摘要/Abstract

摘要：

强迫症（obsessive-compulsive disorder，OCD）是一种致残率高的常见精神障碍，以反复出现的闯入性想法或重复行为为主要临床特征，其病因与发病机制目前仍未被完全阐明。探索OCD患者大脑形态学特征对于了解OCD的病理机制具有重要的作用。作为一种潜在的生物标志物，大脑形态学特征在辅助临床诊断与治疗上具有良好的应用前景。近年来，重复经颅磁刺激（repetitive transcranial magnetic stimulation，rTMS）和深部脑刺激（deep brain stimulation，DBS）等神经调控技术在治疗OCD中得到了广泛的应用，探索OCD患者大脑形态学特征的异常可为神经调控靶点的选择提供依据。目前关于OCD患者大脑形态学特征的研究主要关注皮质—纹状体—丘脑—皮质（cortico-striato-thalamo-cortical，CSTC）环路，该环路的异常与OCD的病理机制存在密切的关系。受限于不同研究之间入排标准、用药情况和数据分析方法的差异，目前的研究存在很多不一致的结果，如何推进临床上的应用还需要进一步的探索。该文梳理了OCD患者大脑形态学特征的相关研究成果，并讨论了临床上的应用前景，指出了未来的发展方向，以期推动OCD病因学和临床治疗的进展。

关键词: 强迫症, 大脑形态学特征, 结构性磁共振成像, 弥散张量成像

Abstract:

Obsessive-compulsive disorder (OCD) is a high disabling psychiatric disease with the clinical symptoms of recurrent intrusive thoughts or repetitive behaviors. The etiology and pathogenesis of OCD have not been fully elucidated. Exploring the brain morphological characteristics of OCD is important for understanding the pathological mechanism of OCD. Besides, as potential biomarkers, brain morphological characteristics have a good application prospect in assisting clinical diagnosis and treatment. In recent years, neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation (DBS) have been widely used in the treatment of OCD. Exploring the abnormal brain morphological characteristics of OCD may provide a basis for the selection of neuromodulation targets. Current studies on the brain morphological characteristics of OCD mainly focus on the cortico-striato-thalamo-cortical (CSTC) circuit, which is closely related to the pathological mechanism of OCD. Limited by the differences in inclusion and exclusion criteria, medication and data analysis methods among these studies, there are many inconsistent results on the brain morphological characteristics of OCD, and how to promote the clinical application needs further exploration. This article reviews the research results of brain morphological characteristics of OCD, discusses the clinical application prospect, and points out the future development direction, in order to promote the progress of etiology and clinical treatment of OCD.

Key words: obsessive-compulsive disorder (OCD), brain morphological characteristic, structural magnetic resonance imaging (sMRI), diffusion tensor imaging (DTI)

中图分类号:

R749.7

张晨, 郭其辉, 范青. 强迫症患者大脑形态学特征研究进展[J]. 上海交通大学学报（医学版）.

ZHANG Chen, GUO Qihui, FAN Qing. Research progress in brain morphological characteristics of obsessive-compulsive disorder[J]. Journal of Shanghai Jiao Tong University (Medical Science).

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