早年创伤对强迫症患者神经环路影响的纵向磁共振研究

Early life trauma can disturb brain development and is a risk factor of many mental disorders. Our previous research shows early life trauma is very common in obsessive-compulsive disorder (OCD) patients, and often lead to early onset and more severe symptoms. The most recent research found that early life trauma was associated with gray matter volume alteration of orbitofrontal and prefrontal gyrus, and cause structural and functional impairment of limbic system (include hippocampus and amygdala). In this proposed project, we aim to investigate the effect of early life trauma on the cortical-striatal-thalamic-cortical circuit and frontal limbic cortical, and it’s role in the development of OCD. In this proposed longitudinal study, the resting-state and task-related fMRI, as well as diffusion tensor imaging (DTI) will be used to examine the structure and function of circuits of untreated OCD patients and health controls. Meanwhile, the early life trauma of all the participants will be multidimensional assessed. We will evaluate the impact of early life trauma on OCD treatment response and its relationship with neural circuitry abnormality after 12 weeks standardized pharmacotherapy. These works would provide new insights of the role of the abnormal circuits as well as the communication between circuits in the development of obsessive-compulsive disorder, and get some new clue for seeking neuroimaging predictor of efficacy.

早年创伤影响大脑发育，是众多精神疾病的风险因素，本项目组既往研究显示强迫症患者早年创伤多见，且导致疾病早发和更严重的症状。最近的研究发现早年创伤与成人眶额叶、前额叶灰质体积异常有关，并造成边缘系统（海马和杏仁核等）结构和功能显著损害。本课题拟以这些新发现为基础，深入探寻早年创伤对“皮质-纹状体-丘脑-皮质”环路和“额叶-边缘环路”的影响及其在强迫发病中作用。课题将采用纵向研究设计，运用静息态与任务态fMRI及扩散张量成像技术（DTI）对未治疗的强迫症患者及健康对照的神经环路功能与结构进行检测，并对被试的早年创伤进行多维评估；同时，在12周规范化药物治疗后评估早年创伤对强迫症药物疗效的影响及其与神经环路异常的关系。这些研究工作将进一步揭示神经环路异常及环路交互作用在强迫症发病中的作用，并为寻找强迫症疗效预测的神经影像学指标提供线索。

强迫症（OCD）是一种难治性疾病，其患者早年创伤多见，导致强迫症早发和更严重的症状。近年来神经影像学研究发现早年创伤与OCD患者的大脑结构和功能损害相关，但由于缺乏前瞻性，无法明确早年创伤对强迫症神经环路的影响及其与临床干预疗效的关系。本研究采用纵向研究设计，入组强迫症患者90例，在12周规范化药物治疗后评估早年创伤对强迫症药物疗效的影响及其与神经环路异常的关系。结果显示：.1.早年创伤通过人格特质的中介影响强迫症状的严重度；.2.不同程度的童年创伤对强迫症患者皮质-丘脑环路的影响存在差异；.3.默认-中央网络、边缘-亚皮质网络的模块间连接可预测药物治疗后强迫症状的改善情况。