PDF(Pubmed)
Abstract：
Microstructural alterations in white matter are evident in obsessive-compulsive disorder (OCD) both in adult and paediatric populations. Paediatric patients go through the process of maturation and thus may undergo different pathophysiology than adult OCD. Findings from studies in paediatric obsessive-compulsive disorder have been inconsistent, possibly due to their small sample size or heterogeneous populations. The aim of this review is to provide a comprehensive overview of white matter structures in paediatric obsessive-compulsive disorder and their correlation with clinical features. Based on PRISMA guidelines, we performed a systematic search on diffusion tensor imaging studies that reported fractional anisotropy, mean diffusivity, radial diffusivity, or axial diffusivity alterations between paediatric patients with obsessive-compulsive disorder and healthy controls using voxel-based analysis, or tract-based spatial statistics. We identified fifteen relevant studies. Most studies reported changes predominantly in the corpus callosum, cingulum, arcuate fasciculus, uncinate fasciculus, inferior longitudinal fasciculus, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, corticospinal tract, forceps minor and major, and the cerebellum in paediatric obsessive-compulsive disorder. These alterations included increased and decreased fractional anisotropy and radial diffusivity, and increased mean and axial diffusivity in different white matter tracts. These changes were associated with obsessive-compulsive disorder symptoms. Moreover, specific genetic polymorphisms were linked with cerebellar white matter changes in paediatric obsessive-compulsive disorder. White matter changes are widespread in paediatric OCD patients. These changes are often associated with symptoms however there are controversies in the direction of changes in some tracts.
摘要：
在成人和儿科人群中，强迫症（OCD）中白质的微结构改变都很明显。儿科患者经历成熟过程，因此可能经历与成人强迫症不同的病理生理学。儿科强迫症研究的结果不一致，可能是由于它们的样本量小或群体异质。这篇综述的目的是全面概述小儿强迫症的白质结构及其与临床特征的相关性。根据PRISMA指南，我们对报道分数各向异性的扩散张量成像研究进行了系统搜索，平均扩散系数,径向扩散系数,或使用基于体素的分析，强迫症的儿科患者和健康对照之间的轴向扩散改变，或基于道的空间统计。我们确定了15项相关研究。大多数研究报告的变化主要在call体，扣带,弓状束，钩肌束，下纵束，上纵束，下额枕骨束，皮质脊髓束，钳子未成年人和少校，以及小儿强迫症的小脑.这些改变包括增加和减少分数各向异性和径向扩散率，并增加了不同白质区域的平均和轴向扩散率。这些变化与强迫症症状有关。此外，特定的遗传多态性与小儿强迫症的小脑白质改变有关.白质变化在儿科强迫症患者中普遍存在。这些变化通常与症状有关，但是在某些领域的变化方向上存在争议。
