摘要目的:探讨首发未用药儿童少年强迫症患者脑白质网络拓扑属性的特征。方法:本研究为病例对照研究。收集2018年7月至2023年10月在新乡医学院第二附属医院门诊或住院治疗的首发儿童少年强迫症患者（强迫症组）为研究对象。匹配性别、年龄和受教育程度相匹配的健康在校学生（对照组）做对照。采用确定性纤维追踪技术构建全脑白质结构网络，运用图论分析方法分析儿童少年强迫症患者全脑白质结构网络拓扑属性的特点，采用基于网络的统计方法检验全脑网络功能连接强度的组间差异。结果:最终纳入强迫症组31例，男22例，女9例，年龄（13.5±1.6）岁；对照组34名，男22名，女12名，年龄（12.7±1.4）岁。强迫症组的全局效率、局部效率（0.62±0.03、0.70±0.07）高于对照组（0.50±0.06、0.54±0.21）［均 P<0.01，错误发现率（FDR）校正］；而特征路径长度（1.77±0.08）小于对照组（2.10±0.23）（ P<0.01，FDR校正）；节点介数中心性比较结果显示，强迫症组左眶额回外侧区、右背侧无颗粒岛叶、左背侧颗粒岛叶、右侧颗粒岛叶、顶叶右中央后回主干区、左腹侧颗粒和颗粒状岛叶、左腹侧无颗粒岛叶、左侧颗粒岛叶、左背侧无颗粒岛叶节点连接增强［均 P<0.001，整体错误率（FWE）校正］；右侧丘脑节点连接减弱（ P<0.001，FWE校正）；强迫症患者存在以皮质下、视觉网络、默认网络中相关节点连接强度增强为特征的子网络（ P<0.05，置换检验5 000次）。 结论:儿童少年强迫症患者脑功能网络的拓扑属性存在异常；脑功能连接特征更不成熟。

abstractsObjective:To investigate the topological properties of the white matter network in the drug-naive first-episode children and adolescent with obsessive-compulsive disorder (OCD).Methods:This study was a case-control study. First-episode OCD childhren and adolescents(OCD group) who were treated in the outpatient or inpatient department of the Second Affiliated Hospital of Xinxiang Medical University from July 2018 to October 2023 were collected as the research subjects. Healthy controls (control group)matched by gender, age and education level were used as controls. Deterministic tractography technique was used to construct the whole brain white matter structural network, and graph theory analysis method was used to analyze the topological attributes of the whole brain white matter structure network in OCD children and adolescents. A network-based statistical method was used to examine the inter-group differences in the functional connectivity strength of the whole brain network.Results:Finally, 31 cases were included in the obsessive-compulsive disorder group, including 22 males and 9 females, with an age of (13.5±1.6) years; There were 34 cases in the control group, including 22 males and 12 females, with an age of (12.7±1.4) years. The global efficiency and local efficiency of the OCD group (0.62±0.03, 0.70±0.07) were significantly higher than those of the control group (0.50±0.06, 0.54±0.21) [both P<0.01, false discovery rate(FDR)correction]; while the characteristic path length (1.77±0.08) was significantly smaller than that of the control group (2.10±0.23) ( P<0.01, FDR correction).The centrality comparison of nodal betweenness centrality showed that in the OCD group, the connections were enhanced in the left lateral orbitofrontal gyrus, right dorsal agranular insula, left dorsal granular insula, right granular insula, right posterior central gyrus main area of parietal lobe, left ventral granular insula, granular insula, left ventral granulosa, left granular insula, and left dorsal agranular insula [all P<0.001, family wise error (FWE) correction], while the connection of right thalamic was weakened ( P<0.001, FWE correction), There were sub-networks characterized by significantly enhanced connection strength of relevant nodes in subcortical, visual network, and default mode network ( P<0.05, permutation test 5 000 times). Conclusions:The topological properties of the brain′s functional network in children and adolescents with OCD exhibit abnormalities, indicating an immature state of brain functional connectivity.