To investigate the dynamic functional connectivity (dFC) of bilateral precuneus at resting-state in obsessive-compulsive disorder (OCD). Methods Fifty patients with OCD who matched the criteria of ICD-10 and 50 healthy controls (HCs) were examined by the resting-state functional magnetic resonance imaging scanning. Voxel-based whole-brain dFC method was used to analyze the dFC of bilateral precuneus at resting-state in OCD; Pearson correlation analyses was used to analyze the relationship between the abnormal dFC values and clinical symptoms in OCD; support vector machine analyses was used to explore whether abnormal dFC could be used to identify OCD. Results Compared with HCs, patients with OCD showed decreased dFC values between left precuneus and left medial prefrontal cortex (MPFC) (0.23±0.02 vs. 0.26±0.03, t=-6.23, P<0.05, GRF corrected), left cuneus (0.24±0.03 vs. 0.28±0.04, t=-5.30, P<0.05, GRF corrected), and left paracentral lobule (0.23±0.03 vs. 0.27±0.04, t=-5.36, P<0.05, GRF corrected); and decreased dFC values between right precuneus and left postcentral gyrus (0.23±0.04 vs. 0.27±0.04, t=-5.12, P<0.05, GRF corrected). The decreased dFC values between left precuneus and left MPFC was positively correlated with the total score of Yale-Brown obsessive compulsive scale (Y-BOCS)(r=0.289, P<0.05, uncorrected); the decreased dFC values between right precuneus and left posterior central gyrus was positively correlated with Y-BOCS total scores (r=0.292, P<0.05, uncorrected) and obsessive subscale scores (r=0.304, P<0.05, uncorrected). The area under the curve value of the decreased dFC values between right precuneus and left posterior central gyrus was 0.856; the Youden Index was 0.52; the sensitivity was 100%, and the specificity was 52%.

目的探讨强迫症患者在静息状态下双侧楔前叶动态功能连接(dynamic functional connectivity, dFC)的模式。方法对符合ICD-10诊断标准的50例强迫症患者(患者组)和50名健康对照者(对照组)进行全脑静息态功能磁共振成像(functional magnetic resonance imaging, fMRI)扫描。采用基于全脑体素的dFC分析强迫症患者静息状态下双侧楔前叶dFC模式;采用皮尔逊相关分析方法, 探讨强迫症患者异常dFC值与临床症状之间的关系;采用支持向量机分析方法, 探索异常的dFC值是否可以用于识别强迫症。结果与健康对照组比较, 患者组左侧楔前叶与左侧内侧前额叶皮质(0.23±0.02与0.26±0.03, t=-6.23, P<0.05, GRF校正)、左侧楔叶(0.24±0.03与0.28±0.04, t =-5.30, P<0.05, GRF校正)、左侧中央旁小叶(0.23±0.03与0.27±0.04, t =-5.36, P<0.05, GRF校正)dFC值降低, 右侧楔前叶与左侧中央后回(0.23±0.04与0.27±0.04, t =-5.12, P<0.05, GRF校正)dFC值降低;患者组降低的左侧楔前叶与左侧内侧前额叶皮质dFC值(r=0.289, P<0.05, 未校正)与Y-BOCS总分呈正相关, 降低的右侧楔前叶与左侧中央后回dFC值与Y-BOCS总分(r=0.292, P<0.05, 未校正)、强迫思维因子分(r=0.304, P<0.05, 未校正)呈正相关;降低的右侧楔前叶与左侧中央后回dFC值的受试者操作特征曲线的曲线下面积为0.856, 约登指数为0.52, 敏感度为100%, 特异度为52%。结论静息状态下, 强迫症患者双侧楔前叶dFC降低;降低的右侧楔前叶与左侧中央后回dFC值可能对于强迫症的识别有提示作用。

黑龙江省自然科学基金(LH2019H064)