PDF(Pubmed)
Abstract：
Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive, compulsive behaviors, with childhood trauma recognized as a contributing factor to its pathophysiology. This study aimed to delineate brain functional aberrations in OCD patients and explore the association between these abnormalities and childhood trauma, to gain insights into the neural underpinnings of OCD. Forty-eight drug-naive OCD patients and forty-two healthy controls (HC) underwent resting-state functional magnetic resonance imaging and clinical assessments, including the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Childhood Trauma Questionnaire-Short Form (CTQ-SF). Compared to HCs, OCD patients exhibited significantly decreased amplitude of low-frequency fluctuations (ALFF) in the right cerebellum, decreased regional homogeneity (ReHo) in the right cerebellum and right superior occipital lobes (FWE-corrected p < 0.05), which negatively correlated with Y-BOCS scores (p < 0.05). Furthermore, cerebellar ALFF negatively correlated with the CTQ emotional abuse subscale (r = - 0.514, p < 0.01). Mediation analysis revealed that cerebellar ALFF mediated the relationship between CTQ-emotional abuse and Y-BOCS (good model fit: R2 = 0.231, MSE = 14.311, F = 5.721, p < 0.01; direct effect, c\' = 0.153, indirect effect, a*b = 0.191). Findings indicated abnormal spontaneous and regional cerebellar activity in OCD, suggesting childhood trauma impacts OCD symptoms through cerebellar neural remodeling, highlighting its importance for clinical treatment selection.
摘要：
强迫症（OCD）的特征是侵入性思想和重复性，强迫行为,儿童创伤被认为是其病理生理学的一个促成因素。这项研究旨在描述强迫症患者的脑功能异常，并探讨这些异常与儿童创伤之间的关系。深入了解强迫症的神经基础。48名未经药物治疗的强迫症患者和42名健康对照（HC）接受了静息状态功能磁共振成像和临床评估，包括耶鲁-布朗强迫症量表（Y-BOCS）和儿童创伤问卷简表（CTQ-SF）。与HC相比，强迫症患者表现出右小脑低频波动(ALFF)振幅显著降低,右侧小脑和右侧上枕叶的区域同质性（ReHo）降低（FWE校正p<0.05），与Y-BOCS评分呈负相关(p<0.05)。此外，小脑ALFF与CTQ情绪虐待分量表呈负相关(r=-0.514,p<0.01)。中介分析表明，小脑ALFF介导了CTQ情绪虐待与Y-BOCS之间的关系（良好的模型拟合：R2=0.231，MSE=14.311，F=5.721，p<0.01；直接效应，c\'=0.153，间接效应，a*b=0.191)。研究结果表明，强迫症患者的自发性和区域性小脑活动异常，提示儿童创伤通过小脑神经重塑影响强迫症症状，突出了其对临床治疗选择的重要性。
