认知行为治疗对强迫症患者特定神经环路调节作用机制

Obsessive-Compulsive Disorder (OCD) is a serious mental disorder that significantly affect public health. In this research, a randomized controlled trail investigating different mechanisms of cognitive therapy (CT), behavior therapy (BT), and cognitive behavior therapy (CBT) in adolescents with OCD will be conducted. Behavior and magnetic resonance imaging data will be collected before, during and after therapy. Data of baseline will be used to find structural and functional predictors of treatment outcome; date during treatment will used to find early functional change following psychological treatment in predicting outcome; and data after all treatment will be used to find the target area of CBT. The aim of this study is to reveal different mechanism of CT and BT, meanwhile identify regional indicators and neural markers predicting outcome of therapy. We anticipate that these data may enable more targeted treatment delivery by identifying those patients who may be optimal candidates for therapeutic response.

强迫症是一种严重损害患者社会功能的精神疾病，给患者带来极大的精神痛苦，给社会带来巨大的公共医疗负担。本研究采用认知治疗、行为治疗、认知行为治疗对未服药强迫症患者进行随机对照临床干预，并在治疗前、治疗中、治疗后获取患者眶额叶-纹状体环路及其他相关脑区动态改变数据，以期探讨认知及行为治疗对患者神经环路的不同调节作用，以及二者的叠加效应。通过获得基线期及治疗中患者相关的脑区功能变化结合患者的疗效差异，以期获得治疗结果的预测因子，并为进一步发展更有针对性的治疗策略奠定基础。

强迫症是一种严重损害患者社会功能的精神疾病，给患者带来极大的精神痛苦。本研究通过对强迫症患者进行量表评估及磁共振扫描，分析与强迫症相关的额叶-纹状体环路及其他相关脑区数据，以期探索强迫症患者与正常对照相比显著不同的脑生物学标记。研究纳入强迫症患者43名，纳入正常对照27名。数据在进一步整理分析中，初步的纤维弥散张量分析显示强迫症患者与正常对照相比，小世界属性中的Cp和Gam显著高于正常对照，p值分别为0.033(-2.213)和0.044（t=-2.065). 同时研究发现，强迫症患者Hierarchy_b与患者的耶鲁布朗强迫症量表的强迫症状评分相关(r=-0.400，P=0.043)，可提示症状的严重程度。因此，本研究揭示了一部分与强迫症相关的脑影像标记。