Recently, the academic journal Biological Psychiatry published a research paper online, pointing out that functional magnetic resonance imaging was used to analyze preoperative and postoperative functional connectivity changes in the frontal and striatum related circuits. The dorsal frontal lobe-striatum functional pathway corresponds to the mechanism of action and predictive factors of surgical treatment, and provides an important basis for the use of functional imaging biomarkers to guide clinical treatment decisions.
The research was completed by Sun Boyong, a functional neurosurgery team of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and the brain imaging platform of the National Key Laboratory of Neuroscience, Institute of Neuroscience, Chinese Academy of Sciences.
Obsessive-compulsive disorder is a chronic mental illness that can easily occur in adolescence. The prevalence rate is 1%. Among them, patients with severe obsessive compulsive disorder are unlikely to respond positively to common treatments such as drugs and cognitive behaviors, and it is difficult to maintain daily life and work. In the middle of the 20th century, mental surgery was used as the ultimate salvage therapy to treat a variety of severe and intractable mental diseases such as severe anorexia and obsessive compulsive disorder, but the effect of surgery and the effect of individual treatment on the neural circuit mechanism Not very clear.
To address these issues, the researchers analyzed preoperative and postoperative imagery of resting state brain function in 36 patients with severe obsessive-compulsive neurosurgery at Ruijin Hospital since 2013, using presumptively driven methods to study the frontal lobe — Striatum-related neural circuit functional connectivity patterns. The study found that 56% of these patients were effective for treatment and found that the abnormally increased functional connectivity between the ventral striatum and the dorsal anterior cingulate gyrus significantly decreased after surgery, and the reduced strength of functional connectivity and clinical symptoms improved. The degree of significant correlation.
To further explore whether it is possible to use preoperative functional magnetic resonance to predict the patient's surgical outcome in advance, the researchers first determined which functional connections in the preoperative frontal-striatal loop could distinguish between effective and ineffective patients, and clinical symptoms. The evaluation established a linear regression model. Finally, this model was applied to a group of independent surgical patients. It was found that the functional connection between the preoperative dorsal caudate nucleus and the dorsal anterior cingulate gyrus can predict the clinical effect. This work not only reveals that psychosocial surgery for severe obsessive compulsive disorder is achieved by restoring abnormally enhanced ventral frontal-striatal functional connectivity, but also establishes a computational model for preoperative prediction of patient surgical outcomes and a deep understanding of stereo How Directional Surgery Regulates Brain Function Networks (Specialist reporter Zhu Fan)
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