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抽动秽语综合征和强迫症共病的转基因模型。

A transgenic model of comorbid Tourette's syndrome and obsessive-compulsive disorder circuitry.

作者信息

Nordstrom E J, Burton F H

机构信息

Department of Pharmacology, University of Minnesota, Minneapolis, MN 55455-0217, USA.

出版信息

Mol Psychiatry. 2002;7(6):617-25, 524. doi: 10.1038/sj.mp.4001144.

Abstract

The tic disorder Tourette's Syndrome (TS) and obsessive-compulsive disorder (OCD) are comorbid behavioral disorders, suggesting a shared but still unknown neuronal basis. To 'circuit-test' such behaviors, we previously engineered transgenic mice expressing a neuropotentiating protein (cholera toxin A1 subunit) within a cortical-limbic subset of dopamine D1-receptor expressing (D1+) neurons known to trigger glutamatergic excitation of orbitofrontal, sensorimotor, limbic and efferent striatal circuits thought to be hyperactive or affected in OCD and TS. These mice exhibited OCD-like behaviors including generalized behavioral perseveration and compulsion-like leaping and grooming-associated pulling and biting of skin and hair. We now report that these OCD-like mice, like humans, also exhibit comorbid TS-like behaviors, including juvenile-onset tics; increased tic number, complexity and flurries; increased tic severity in males; voluntary tic suppression; and tic responsiveness to a non-cataleptic TS+OCD drug therapy (clonidine, 0.01 mg kg(-1)). These data suggest that hormonal gender differences, apart from the influence of genetic or autoimmune etiologic factors, may be sufficient to aggravate tic severity in human TS males compared to TS females. These data also proffer a precise neuronal basis for TS+OCD, wherein tics and primary compulsions or obsessions are evoked by hyperactivity of various cortical-limbic projection neurons' glutamatergic output to efferent targets like the striatum. The 'Cortical-limbic Glutamatergic Neuron' (CGN) neuronal circuit model merges formerly opposed neurotransmitter models of TS and OCD, and is consistent with new clinical reports of increased cortical hyperactivity, striatal glutamate and striatal inhibitory D2 receptors, and reduced striatal responsiveness, in these disorders.

摘要

抽动障碍妥瑞氏综合征(TS)和强迫症(OCD)是共病行为障碍,提示存在共同但仍未知的神经基础。为了对这类行为进行“环路测试”,我们之前构建了转基因小鼠,这些小鼠在表达多巴胺D1受体(D1+)的神经元的皮质-边缘亚群中表达一种神经增强蛋白(霍乱毒素A1亚基),已知该亚群会触发眶额、感觉运动、边缘和传出纹状体环路的谷氨酸能兴奋,而这些环路在强迫症和妥瑞氏综合征中被认为是过度活跃或受影响的。这些小鼠表现出类似强迫症的行为,包括普遍的行为固执以及类似强迫行为的跳跃和与梳理相关的拉扯和咬皮肤及毛发。我们现在报告,这些类似强迫症的小鼠与人类一样,也表现出共病的类似妥瑞氏综合征的行为,包括青少年期起病的抽动;抽动次数、复杂性和发作频率增加;雄性抽动严重程度增加;自愿抑制抽动;以及抽动对一种非镇静性妥瑞氏综合征合并强迫症药物治疗(可乐定,0.01 mg kg(-1))的反应。这些数据表明,除了遗传或自身免疫病因因素的影响外,激素性别差异可能足以使人类妥瑞氏综合征男性的抽动严重程度比女性更严重。这些数据还为妥瑞氏综合征合并强迫症提供了精确的神经基础,其中抽动和原发性强迫行为或强迫观念是由各种皮质-边缘投射神经元向纹状体等传出靶点的谷氨酸能输出过度活跃所诱发的。“皮质-边缘谷氨酸能神经元”(CGN)神经环路模型融合了以前对立的妥瑞氏综合征和强迫症神经递质模型,并且与这些疾病中皮质过度活跃、纹状体谷氨酸和纹状体抑制性D2受体增加以及纹状体反应性降低的新临床报告一致。

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