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前额叶皮质谷氨酸在强迫症与注意力缺陷多动障碍对立现象学中的作用

On the role of prefrontal cortex glutamate for the antithetical phenomenology of obsessive compulsive disorder and attention deficit hyperactivity disorder.

作者信息

Carlsson M L

机构信息

Carlsson Research, Göteborg, Sweden.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2001 Jan;25(1):5-26. doi: 10.1016/s0278-5846(00)00146-9.

DOI:10.1016/s0278-5846(00)00146-9
PMID:11263758
Abstract
  1. The objective of the present study was to compare the phenomenology and pathophysiology of obsessive compulsive disorder (OCD) and attention deficit hyperactivity disorder/deficits in attention, motor control and perception (ADHD/DAMP). 2. Through detailed studies of the literature on OCD and ADHD/DAMP, the phenomenology of these two conditions is compared, and possible underlying pathophysiological mechanisms involving interactions between glutamate, dopamine, serotonin and acetylcholine are discussed, with emphasis on OCD. The present paper also discusses possible mechanisms of action for current pharmacological treatments of OCD and ADHD, as well as possible future treatment strategies for these disorders. 3. OCD and ADHD/DAMP are common neuropsychiatric conditions which in many regards appear to be each other's antipodes with respect to clinical manifestations, associated personality traits and brain biochemistry, notably prefrontal cortical glutamate activity. Future pharmacological treatments of these disorders may involve manipulations with glutamate, dopamine D , serotonin 2A and nicotine receptors. 4. It appears that OCD is a hyperglutamatergic and ADHD a hypoglutamatergic condition, with prefrontal brain regions being especially affected.
摘要
  1. 本研究的目的是比较强迫症(OCD)与注意力缺陷多动障碍/注意力、运动控制和感知缺陷(ADHD/DAMP)的现象学和病理生理学。2. 通过对有关OCD和ADHD/DAMP的文献进行详细研究,比较了这两种病症的现象学,并讨论了涉及谷氨酸、多巴胺、血清素和乙酰胆碱相互作用的潜在病理生理机制,重点是OCD。本文还讨论了当前OCD和ADHD药物治疗的可能作用机制,以及这些病症未来可能的治疗策略。3. OCD和ADHD/DAMP是常见的神经精神病症,在临床表现、相关人格特质和脑生物化学方面,尤其是前额叶皮质谷氨酸活性方面,在许多方面似乎是彼此的对立面。这些病症未来的药物治疗可能涉及对谷氨酸、多巴胺D、血清素2A和尼古丁受体的调控。4. 似乎OCD是一种高谷氨酸能病症,而ADHD是一种低谷氨酸能病症,前额叶脑区尤其受到影响。

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