背景:这项研究的目的是调查睡眠质量差(PSQ定义为匹兹堡睡眠质量指数>5且睡眠效率≤85%)的强迫症(OCD)患者与睡眠质量好(GSQ)和健康对照(HCs)的强迫症患者的静息和活跃丘脑神经代谢水平和抑制功能之间的差异,以及这些指标与强迫症状的关系。
方法:使用功能磁共振波谱(fMRS)测量72名受试者(研究分析中包括20名HCs和38名OCD患者)的静息和活跃丘脑神经代谢物水平。在MRS记录之前和期间通过Go-Nogo任务测量反应抑制功能。使用匹兹堡睡眠质量指数(PSQI)评估主观睡眠质量。强迫症的症状,使用相关临床量表评估焦虑和抑郁情绪。
结果:OCD患者静息丘脑中Glx/Cr水平显着降低。静息丘脑Glu/Cr和Glx/Cr在伴PSQ的OCD患者中的程度显著最低。强迫症患者在围棋任务上的正确率明显较低,Nogo任务的错误率更高,对Nogo任务的错误平均响应时间(EART)更长。具有PSQ的OCD患者表现出最高的Nogo任务差错率和最长的EART至Nogo任务。此外,PSQI评分与静息丘脑中的Glu/Cr和Glx/Cr呈负相关。
结论:患有PSQ的强迫症患者表现出丘脑静息Glx水平降低和更明显的反应抑制功能损害。关键大脑区域的神经代谢物水平异常,再加上增强的反应抑制功能缺陷,可能是OCD患者通常表现出的PSQ的神经生物学基础。
BACKGROUND: The aim of this study was to investigate the differences between resting and active thalamic neurometabolite levels and inhibitory function in obsessive compulsive disorder (OCD) patients with poor sleep quality (PSQ was defined as Pittsburgh Sleep Quality Index >5 and sleep efficiency ≤85%) compared to OCD patients with good sleep quality (GSQ) and healthy controls (HCs), as well as the relationship of these indices to obsessive compulsive symptoms.
METHODS: Functional magnetic resonance spectroscopy (fMRS) was used to measure resting and active thalamic neurometabolite levels in 72 subjects (20 HCs and 38 OCD patients included in study analysis). Response inhibition function was measured by the Go-Nogo task before and during MRS recording. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The symptoms of OCD, anxiety and depression were evaluated using relevant clinical scales.
RESULTS: OCD patients exhibited significantly reduced Glx/Cr levels in the resting thalamus. The levels of resting thalamic Glu/Cr and Glx/Cr in OCD patients with PSQ were significantly lowest. OCD patients had significantly lower correct rates on Go tasks, higher error rates on Nogo tasks, and longer error average response times (EART) to the Nogo task. OCD patients with PSQ demonstrated the highest Nogo task error rate and the longest EART to Nogo task. Furthermore, PSQI scores exhibited negative correlations with Glu/Cr and Glx/Cr in the resting thalamus.
CONCLUSIONS: OCD patients with PSQ demonstrated reduced levels of thalamic resting Glx and more pronounced response inhibitory function impairment. Aberrant neurometabolite levels in critical brain regions, coupled with heightened response inhibition function deficits, may be a neurobiological basis for the PSQ that OCD patients generally exhibit.