首诊强迫症患者的工作记忆及氢质子磁共振波谱成像研究
发布时间：2018-08-27 12:18
【摘要】：目的:通过氢质子磁共振波谱成像技术(1H Magnetic Resonance Spectroscopy,1H-MRS)结合工作记忆的心理认知功能测试,对首诊强迫症(Obsessive-Compulsive Disorder,OCD)患者进行研究,以期发现首诊强迫症患者的脑生化代谢及工作记忆特征,为强迫症的记忆病理机制研究及早期干预治疗提供依据。方法:采用与工作记忆相关的数字广度、2-back、视觉空间位置记忆测试、Stroop色-词关联测试四项神经心理测验分别评估63例首诊强迫症患者与58名正常对照的工作记忆容量、语言工作记忆、视觉空间工作记忆以及中央执行系统的抑制功能。运用1H-MRS技术对其中的30例强迫症患者及30名正常对照的额叶、基底节豆状核两大区域N-乙酰天门冬氨酸(N-Acetylasparte,NAA)、胆碱复合物(Choline Compounds,Cho)、肌酸(Creatine,Cr)水平进行测量,比较两组被试在脑生化代谢功能上存在的差异。同时对首诊强迫症患者的工作记忆损害程度与脑代谢水平进行相关分析,考察工作记忆与额叶、基底节两大区域脑生化代谢物含量之间的关系。结果:(1)患者组数字广度顺背、倒背、总分均较正常对照组差;患者组2-back任务、视觉空间位置记忆测试得分低于正常对照组,且视觉空间位置记忆测试用时多于正常对照组;患者组Stroop色-词测试中读字色(Stroop-CW)完成时间长于正常对照组;两组被试在2-back和Stroop-C测试的完成时上未见统计学差异。(2)患者组左侧额叶的NAA/Cr值显著低于正常对照组;两组被试在右侧额叶NAA/Cr值、双侧额叶Cho/Cr值、双侧豆状核NAA/Cr值及双侧豆状核Cho/Cr值上均未见明显差异。(3)患者组2-back反应时与左侧额叶的NAA/Cr值呈显著负相关;数字广度倒背、总分与受教育年限呈正相关;Stroop-C反应时与受教育年限呈显著负相关,与病程呈正相关;Stroop-CW反应时也与受教育年限呈负相关。患者组右侧豆状核NAA/Cr值与Y-BOCS总分呈正相关;其他MRS结果与各临床症状特征变量之间则无明显的相关性。结论:(1)首诊强迫症患者存在工作记忆损害,且涉及语音环、视觉空间模板和中央执行系统等多个子系统功能受损。(2)首诊强迫症患者左侧额叶的神经元活性显著降低,且患者语言工作记忆能力受损或与前额叶神经元功能异常密切相关。(3)首诊强迫症患者受教育程度越低,可能记忆及注意能力越差,抑制功能受损也越严重;病情严重程度则可能与右侧豆状核的神经元功能异常有关。
[Abstract]:Objective: to study the mental cognitive function of first diagnosed obsessive-compulsive disorder (Obsessive-Compulsive Disorder,OCD) by using 1H Magnetic Resonance Spectroscopy,1H-MRS and working memory test, in order to find out the characteristics of brain biochemical metabolism and working memory in patients with first diagnosed obsessive-compulsive disorder (OCD). To provide evidence for the study of memory pathological mechanism and early intervention treatment of obsessive-compulsive disorder (OCD). Methods: the working memory capacity of 63 patients with first diagnosis obsessive-compulsive disorder (OCD) and 58 normal controls were evaluated by four neuropsychological tests, including the number span 2-backand the Stroop color-word association test of visual spatial location memory. Working memory of language, working memory of visual space and inhibition function of central executive system. The levels of N-Acetylasparte NAA (N-Acetylasparte NAA), choline complex (Choline Compounds,Cho) and creatine (Creatine,Cr) in frontal lobe of 30 patients with obsessive-compulsive disorder and 30 normal controls were measured by 1H-MRS technique. To compare the difference of brain biochemical metabolic function between the two groups. At the same time, the relationship between the degree of working memory impairment and the level of brain metabolism was analyzed, and the relationship between working memory and the contents of biochemical metabolites in frontal lobe and basal ganglia was investigated. Results: (1) the scores of digit span, backward back and total score in the patients group were lower than those in the normal control group, the scores of 2-back task and visual spatial memory test in the patient group were lower than those in the normal control group, and the scores of the visual spatial position memory test were higher than that of the normal control group. The completion time of Stroop-CW in the Stroop color-word test was longer than that in the normal control group, and there was no statistical difference between the two groups when the 2-back and Stroop-C tests were completed. (2) the NAA/Cr value of the left frontal lobe in the patient group was significantly lower than that in the normal control group. There was no significant difference in NAA/Cr value of right frontal lobe, Cho/Cr value of bilateral frontal lobe, NAA/Cr value of bilateral lentiform nucleus and Cho/Cr value of bilateral lenticular nucleus between the two groups. (3) there was a significant negative correlation between 2-back reaction time and NAA/Cr value in left frontal lobe in the patient group. The total score was positively correlated with the number of years of education and the Stroop-C reaction time was negatively correlated with the years of education, and was negatively correlated with the duration of disease and the duration of education during Stroop-CW reaction. There was a positive correlation between the NAA/Cr value of the right lenticular nucleus and the total score of Y-BOCS in the patients group, but there was no significant correlation between the other MRS results and the characteristic variables of clinical symptoms. Conclusion: (1) working memory is impaired in patients with first visit obsessive-compulsive disorder, and the function of several subsystems, such as phonetic ring, visual space template and central executive system, is impaired. (2) the activity of neurons in the left frontal lobe of patients with first diagnosis obsessive-compulsive disorder is significantly decreased. And the language working memory ability is impaired or closely related to the prefrontal neuron function. (3) the lower the education level of the first diagnosis obsessive compulsive disorder, the worse the memory and attention ability may be, the more serious the inhibition function is; The severity of the disease may be associated with abnormal neuronal function in the right lenticular nucleus.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.7;B842.3
[Abstract]:Objective: to study the mental cognitive function of first diagnosed obsessive-compulsive disorder (Obsessive-Compulsive Disorder,OCD) by using 1H Magnetic Resonance Spectroscopy,1H-MRS and working memory test, in order to find out the characteristics of brain biochemical metabolism and working memory in patients with first diagnosed obsessive-compulsive disorder (OCD). To provide evidence for the study of memory pathological mechanism and early intervention treatment of obsessive-compulsive disorder (OCD). Methods: the working memory capacity of 63 patients with first diagnosis obsessive-compulsive disorder (OCD) and 58 normal controls were evaluated by four neuropsychological tests, including the number span 2-backand the Stroop color-word association test of visual spatial location memory. Working memory of language, working memory of visual space and inhibition function of central executive system. The levels of N-Acetylasparte NAA (N-Acetylasparte NAA), choline complex (Choline Compounds,Cho) and creatine (Creatine,Cr) in frontal lobe of 30 patients with obsessive-compulsive disorder and 30 normal controls were measured by 1H-MRS technique. To compare the difference of brain biochemical metabolic function between the two groups. At the same time, the relationship between the degree of working memory impairment and the level of brain metabolism was analyzed, and the relationship between working memory and the contents of biochemical metabolites in frontal lobe and basal ganglia was investigated. Results: (1) the scores of digit span, backward back and total score in the patients group were lower than those in the normal control group, the scores of 2-back task and visual spatial memory test in the patient group were lower than those in the normal control group, and the scores of the visual spatial position memory test were higher than that of the normal control group. The completion time of Stroop-CW in the Stroop color-word test was longer than that in the normal control group, and there was no statistical difference between the two groups when the 2-back and Stroop-C tests were completed. (2) the NAA/Cr value of the left frontal lobe in the patient group was significantly lower than that in the normal control group. There was no significant difference in NAA/Cr value of right frontal lobe, Cho/Cr value of bilateral frontal lobe, NAA/Cr value of bilateral lentiform nucleus and Cho/Cr value of bilateral lenticular nucleus between the two groups. (3) there was a significant negative correlation between 2-back reaction time and NAA/Cr value in left frontal lobe in the patient group. The total score was positively correlated with the number of years of education and the Stroop-C reaction time was negatively correlated with the years of education, and was negatively correlated with the duration of disease and the duration of education during Stroop-CW reaction. There was a positive correlation between the NAA/Cr value of the right lenticular nucleus and the total score of Y-BOCS in the patients group, but there was no significant correlation between the other MRS results and the characteristic variables of clinical symptoms. Conclusion: (1) working memory is impaired in patients with first visit obsessive-compulsive disorder, and the function of several subsystems, such as phonetic ring, visual space template and central executive system, is impaired. (2) the activity of neurons in the left frontal lobe of patients with first diagnosis obsessive-compulsive disorder is significantly decreased. And the language working memory ability is impaired or closely related to the prefrontal neuron function. (3) the lower the education level of the first diagnosis obsessive compulsive disorder, the worse the memory and attention ability may be, the more serious the inhibition function is; The severity of the disease may be associated with abnormal neuronal function in the right lenticular nucleus.
【学位授予单位】：暨南大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.7;B842.3
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