J Cerebr Blood F Met：PET研究显示部分脑区代谢改变与强迫症症状改善相关

　　侧前囊切开术治疗难治性强迫症的治疗获益可能是通过破坏皮质-纹状体-下丘脑-皮质通路。我国上海复旦大学附属华山医院的管一晖教授等人进行的一项研究，使用PET成像评估了残存脑的代谢情况与强迫症患者的治疗效果。结果表明患者的临床改善与双侧背侧扣带前回和中央枕回右侧的代谢改变相关。对那些进行神经外科治疗的强迫症患者，研究强调了内囊对调节腹侧前额部与背侧扣带回前神经元活性的重要性。

　　研究者对8位强迫症患者在前囊切开术前后进行18-氟脱氧葡萄糖PET检查。研究人员对患者的术前影像中的代谢情况与8位年龄匹配的健康对照志愿者的情况进行对比，也比较了术后改变与患者临床的相关性。

　　研究结果显示，强迫症患者在双侧视前区皮质、额下回、扣带前回与双侧桥脑/小脑出现了广泛的代谢增加，双侧中央前回和舌回的代谢减少。双侧前囊切开引起双侧前额皮质区（特别是在背侧扣带前皮质、背侧丘脑内侧及尾状核）代谢显著减少。相反，在双侧中央前回及舌回出现代谢增加。患者的临床改善与双侧背侧扣带前回和中央枕回右侧的代谢改变相关。

与代谢相关的拓展阅读： 

• JAMA:脂质代谢基因或与非裔美国人阿尔茨海默病相关
• Neurology：特发性正常颅压性脑积水脑室旁代谢降低并轴索变性
• Diabetes Care：T1DM患者维生素D代谢受损与动脉粥样硬化没有相关性
• 【会议预告】2013中国医师协会内分泌代谢科医师分会年会通知
• Medscape：胃束带手术可长期缓解代谢综合征 更多信息请点击：有关代谢更多资讯

Metabolic imaging of bilateral anterior capsulotomy in refractory obsessive compulsive disorder: an FDG PET study.
Abstract
The therapeutic benefits of bilateral capsulotomy for the treatment of refractory obsessive compulsive disorder (OCD) are probably attributed to interruption of the cortico-striato-thalamo-cortical circuitry. We evaluated resting brain metabolism and treatment response in OCD patients using positron emission tomography (PET) imaging. [(18)F]-fluoro-deoxy-glucose PET was performed in eight OCD patients precapsulotomy and postcapsulotomy. We determined metabolic differences between preoperative images in patients and those in eight age-matched healthy volunteers, and postoperative changes and clinical correlations in the patients. The OCD patients showed widespread metabolic increases in normalized glucose metabolism in the bilateral orbitofrontal cortex and inferior frontal gyrus, cingulate gyrus, and bilateral pons/cerebellum, and metabolic decreases bilaterally in the precentral and lingual gyri. Bilateral capsulotomy resulted in significant metabolic decreases bilaterally in the prefrontal cortical regions, especially in the dorsal anterior cingulate cortex (ACC) and in the medial dorsal thalamus and caudate nucleus. In contrast, metabolism increased bilaterally in the precentral and lingual gyri. Clinical improvement in patients correlated with metabolic changes in the bilateral dorsal ACC and in the right middle occipital gyrus after capsulotomy. This study underscores the importance of the internal capsule in modulating ventral prefrontal and dorsal anterior cingulate neuronal activity in the neurosurgical management of OCD patients.Journal of Cerebral Blood Flow & Metabolism advance online publication, 27 February 2013; doi:10.1038/jcbfm.2013.23.