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A ~1H Magnetic Resonance Spectroscopy Imaging Study and a Cognitive Function Research of Obsessive-compulsive Disorder

Author: ZhaoXiuZhi
Tutor: YangZhiYin;SuZhongHua
School: Shandong University
Course: Internal Medicine
Keywords: Obsessive-compulsive disorder Proton magnetic resonance spectroscopy Cognitive function
CLC: R749.7
Type: Master's thesis
Year: 2011
Downloads: 45
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Abstract


Background: obsessive-compulsive disorder (Obsessive-compulsive disorder) in obsessions, forced impulse or compulsive behavior and other symptoms mainly a neurological disorder, the patient is well aware of these compulsive symptoms unreasonable, unnecessary, but can not control and get rid of , thus anxiety and pain, and most studies found that patients with varying degrees and types of cognitive impairment, however, the mechanism is not clear. Some scholars believe that the cortex - basal ganglia - thalamus - cortical loop exception doctrine played an important role in neuropathological mechanisms. Newly developed non-invasive proton magnetic resonance spectroscopy (1H magnetic resonance spectroscopy, 1H-MRS), through the monitoring of gray matter in the brain neurons metabolite levels of reactive functional status of the gray matter. Has been widely applied to psychiatric disorders such as schizophrenia, depression, epilepsy, but little research on obsessive-compulsive disorder, therefore, this paper using 1H-MRS scans of OCD patients with multiple brain regions, and then explore the obsessive-compulsive disorder biochemical metabolic characteristics of brain function in patients with abnormal neural provide an objective basis for obsessive-compulsive disorder loop anomaly doctrine, and further clarify these metabolic changes and changes in cognitive function in patients with obsessive-compulsive disorder, the relationship between the severity of the disease and its course of the disease. Objective: application of 1H-MRS detection of gray matter in the brain of patients with OCD function abnormalities, and to explore the relationship between cognitive function, disease severity, duration. Methods: 19 cases of patients with obsessive-compulsive disorder, and 19 cases of healthy control group in age, gender, education level, handedness, and familiar with the extent of the case group match on the computer 1H-MRS scans, were measured bilateral anterior frontal lobe, parietal lobe , temporal lobe, occipital lobe, anterior cingulate, parahippocampal gyrus, corpus callosum, and knee, bilateral head of caudate nucleus, thalamus area of ??interest in multiple brain N-acetyl aspartic acid (NAA), acetylcholine ( Cho), and creatine (Cr) content; the computer edition neuropsychological cognitive assessment tool test subjects (including cognitive function without making 24 1H-MRS). And to explore the relationship between the measured values ??and cognitive function, severity of illness, duration. Results: the left parahippocampal gyrus NAA / Cr ratio is higher than the normal control group (P lt; 0.05), and the corpus callosum NAA / Cr ratio is lower than the normal control group (P lt; 0.01); right caudate nucleus head higher than the normal control group (P lt; 0.05); Cho / Cr and NAA / Cr was negatively correlated (P lt; 0.05); Yale - Brown Obsessive Compulsive Symptom Scale total score and the corpus callosum NAA / Cr course and right prefrontal as well as the left temporal lobe CHO / Cr was negatively correlated (P lt; 0.01). Attention to the results of network tests part in the assessment of cognitive function: vigilance network efficiency OCD group was significantly lower than the control (P lt; 0.01), the directional network efficiency and execution efficiency of control network was no significant difference between the two groups; vigilance network efficiency and right side hippocampus beside the back of NAA / Cr, Cho / Cr is related (P lt; 0.05); execution control network efficiency and the left temporal leaf and corpus callosum body pressure the Ministry of NAA / of Cr ratio was negatively correlated (P lt; 0.05); directional network efficiency was negatively correlated with the left temporal lobe Cho / Cr (P lt; 0.05). Wisconsin Card Sorting Test results show: response number, the number of errors, the number of non-persistent error was significantly higher than the control group (P lt; 0.01), and complete classification number was significantly lower than the control group (P lt; 0.01); acknowledge the number of left anterior cingulate gyrus and bilateral occipital Cho / Cr values ??were positively correlated (P lt; 0.01); classification number and the left temporal lobe and occipital lobe Cho / Cr values ??negatively correlated (P lt; 0.05); number of correct left thalamus NAA / Cr, Cho / Cr values ??positively correlated (P lt; 0.05); number of errors, the number of non-persistent error bilateral occipital Cho / Cr values ??positively correlated (P lt; 0.01). Iowa game quiz results: the control group in tests carried out to the third stage, the of advantageous selection with adverse selection difference was significantly higher than the OCD group (P lt; 0.05); difference between the first stage and the left temporal lobe NAA / Cr values ??positively correlated (P lt; 0.05), the second phase of the difference between the right thalamus and the left caudate nucleus head Cho / Cr values ??as well as the right anterior cingulate gyrus of NAA / Cr was significantly related (P lt; 0.05) the third stage, the difference between the right frontal lobe NAA / Cr values ??related to the left parahippocampal gyrus Cho / Cr (P lt; 0.05), the difference between the left side of the fourth stage of parahippocampal gyrus NAA / Cr, and left side of the parahippocampal gyrus, bilateral occipital lobe Cho / Cr values ??negatively correlated (P lt; 0.05), advantageous selection in the fifth stage of the difference between the adverse selection with the left frontal lobe, the left parahippocampal gyrus of NAA / Cr and right thalamus, left parahippocampal gyrus, bilateral occipital lobe Cho / Cr negative correlation (P lt; 0.05). Mental rotation results: OCD group average reaction time (MRT), mirroring MRT, 0 ° MRT, 60 ° MRT the 180 ° MRT, 240 ° MRT was significantly higher than the control group (P lt; 0.05), no significant difference in accuracy rate. ; reaction time average of the left temporal lobe, the left parahippocampal gyrus NAA / Cr values, and the left parahippocampal gyrus Cho / Cr values ??positively correlated (P lt; 0.05); Just as average response time, 240 ° MRT and the left parahippocampal gyrus Cho / Cr values ??positively correlated (P lt; 0.01); mirror the average response time and the left temporal lobe, the left parahippocampal back of NAA / Cr, and the left parahippocampal back, left anterior cingulate gyrus Cho / Cr value Related (P lt; 0.05); 0. MRT and the left temporal lobe, the left parahippocampal gyrus NAA / Cr values, and the left thalamus, left parahippocampal gyrus, left anterior cingulate gyrus Cho / Cr values ??positively correlated (P lt; 0.05); 60 ° MRT the left parahippocampal gyrus, left anterior cingulate, corpus callosum Cho / Cr values ??related (P lt; 0.05); 120 ° MRT bilateral parahippocampal gyrus and the left cingulate gyrus Cho / Cr values ??related (P lt ; 0.01); 180 ° MRT and the left parietal lobe, left temporal lobe, the left parahippocampal gyrus of NAA / Cr, and the left parahippocampal back Cho / Cr values ??related (P lt; 0.05). Conclusion: the right side of the head of caudate nucleus of patients with obsessive-compulsive disorder and left parahippocampal back neuronal function enhancements, reduce the corpus callosum activity and significantly associated with the duration and severity of the disease. At the same time, the study also found that the frontal lobe, parietal lobe, temporal lobe, anterior cingulate gyrus, and occipital lobe, the left parahippocampal gyrus, left caudate nucleus head, corpus callosum, abnormal function of the hypothalamus may pay attention, memory, and perform played an important role in the function of cognitive impairment, for the cortex - basal ganglia - thalamus - cortical loop anomaly doctrine provides a theoretical basis.

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