| BackgroundObsessive–compulsive disorder(OCD)is a neuropsychiatric disorder characterized by obsessions and/or compulsions.Clinical characteristics were onset in young,high prevalence,recurrent attacks and chronic course.In general,earning,living and working which was seriously affected in patients with obsessive-compulsive disorder.Both domestic and foreign literatures reported that there were cognitive impairment in patients with obsessive-compulsive disorder,and the impairment of cognitive function was closely related to the clinical manifestation,prognosis and recovery of social function.Despite the high morbidity associated with OCD,the pathophysiology of the disorder remains unclear.The study found that the pathological mechanism of OCD may be related to abnormal brain function.The cognitive dysfunction is related to the change of brain structure and function.There are few reports on the brain function and the relationship between the brain function and cognitive function of childhood and adolescence OCD,so we carried out a research into this subject.Objectives1.To investigate the characteristics of cognitive function in childhood and adolescence-first-onset Obsessive-compulsive disorder.2.To analyze the resting state of brain function characteristic in childhood and adolescence-first-onset Obsessive-compulsive disorder.3.To explore the relationship between the cognitive function and resting state brain function in childhood and adolescence-first-onset Obsessive-compulsive disorder.Methods1.24 cases of DSM-?and 33 age/gender/education years matched healthy controls were enrolled in this study.2.The cognitive function was estimated with Trail Making Test,STROOP test,Hopkins Verbal Learning Test-Revised(HVLT-R),Brief Visuospatial Memory Test-revised(BVMT-R),Symbol Coding,Digital Span test,Verbal Fluency Test(VF)and Maze Test in all study controls.3.All the subjects were using functional magnetic resonance imaging(f MRI)3.0 system to check the whole brain resting state f MRI.DPARSF software was used to analyze the imaging date of preprocessing.All study controls were studied using Resting-State f MRI Data Analysis Toolkit(REST)software to obtain the areas of the brain where the ALFF changes were statistically significant.4.The ALFF of the blood oxygenation level dependent resting-state functional Magnetic Resonance Imaging(BOLD-f MRI)signal for each participant was calculated.Groups of ALFF values were correlated with their cognitive function scores to find the areas of the brain where are positively correlated with cognitive function scores.5.Selecting the areas of the brain where the ALFF values are correlated with cognitive function scores as seeds point,to find the areas of the whole brain where has statistically significant connection with seed point.Results1.The comparison of cognitive function in case group and the healthy control groupCompared with the controls,the patients showed significant differences in Symbol Coding(45.24±10.32/56.85±9.57,t=3.96),BVMT-R(21.94±6.99/30.58±2.76,t=4.90),Digital Span test(64.06±20.00/78.03±18.08,t=2.50).Compared to the control group,the differences were statistically significant(P<0.05).2.Analysis of low frequency amplitude results between case group and control groupCompared to the controls,Childhood and adolescence-first-onset Obsessive-compulsive disorder showed significantly decreased ALFF in the left and right lentiform nucleus,left putamen while in the area of left and right temporal lobe,left and right cerebellum posterior lobe,left middle temporal were increased(P<0.05,corrected by Alphasim).3.The correlation analyses between the value of ALFF and cognitive function in the first-onset children and adolescents with OCD and healthy controls(1)The correlation between the cognitive function and the value of ALFF in our study group.Pearson correlation analysis showed that Trail Making Test scores were positively correlated with the value of ALFF in the right temporal lobe(r=0.67);color scores were positively correlated with the value of ALFF in the right middle temporal(r=0.53);color scores were negatively correlated with the value of ALFF in the right temporal lobe(r=-0.54);the test of multiple correlation coefficient were statistically significant(P<0.05).(2)The correlation between the cognitive function and the value of ALFF in the healthy controls.Pearson correlation analysis showed that BVMT-R scores and digit span scores were positively correlated with the value of ALFF in the left temporal lobe(r=0.47,0.41);digit span scores were negatively correlated with the value of ALFF in the right temporal lobe(r=-0.49);color scores were negatively correlated with the value of ALFF in the left temporal lobe(r=-0.35);word scores and color-word scores were negatively correlated with the value of ALFF in the right middle temporal(r=-0.39,-0.36);the test of multiple correlation coefficient were statistically significant(P<0.05).4.Comparison of functional connectivity between the study group and control groupSelecting the brain areas where correlated with cognitive function as seeds point to analysis the resting state dysfunctional connection of the whole brain regions.When the right temporal lobe was used as seed,compared to healthy controls,reduced connection were observed in the Left insula,right superior temporal gyrus,left frontal lobe and Left parietal lobe;When the right middle temporal gyrus was used as seed,compared to healthy controls,reduced connection were observed in the right superior temporal gyrus,left postcentral gyrus,right parietal lobe,left frontal lobe and left inferior parietal lobule;When the left temporal lobe was used as seed,compared to healthy controls,reduced connection were observed in the left fusiform gyrus,left frontal lobe,right temporal lobe,right posterior central gyrus and left parietal lobe.the differences were statistically significant(p< 0.05,corrected by FDR).Conclusions1.There were cognitive impairment in the attention,memory and processing rate in the childhood and adolescence-first-onset Obsessive-compulsive disorder 2.There have some abnormal spontaneous neural activity of the brain regions in the childhood and adolescence-first-onset Obsessive-compulsive disorder.These abnormalities may be the neural development mechanism for Obsessive-compulsive disorder.3.The ALFF values of some brain regions in the temporal lobe were related to their cognitive function in the first-onset childhood and adolescence Obsessive-compulsive disorder,suggesting that cognitive dysfunction may be related to the local spontaneous neural activity in the temporal lobe.4.Functional connectivity abnormalities of the temporal lobe and multiple brain regions in the resting state of children and adolescents with obsessive compulsive disorder... |
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