Spessot Alexandra L, Plessen Kerstin J, Peterson Bradley S
Columbia College of Physicians & Surgeons and New York State Psychiatric Institute, Unit 74, 1051 Riverside Drive, New York, NY 10032, USA.
Ann N Y Acad Sci. 2004 Jun;1021:86-104. doi: 10.1196/annals.1308.010.
Normal brain maturational and developmental processes, together with plastic reorganization of the brain in response to experiential demands, contribute to the acquisition of improved capacities for self-regulation and impulse control during adolescence. The frontal lobe is a main focus for these developmental and plastic processes during the transition from adolescence into adulthood. Tourette syndrome (TS), defined as the chronic presence of motor and vocal tics, has been increasingly conceptualized as a disorder of impaired self-regulatory control. This disordered control is thought to give rise to semicompulsory urges to perform the movements that constitute simple tics, complex tics, or compulsions. Neuroimaging studies suggest that the expression of the genetic diathesis to TS is influenced by genetic and nongenetic factors affecting activity-dependent reorganization of neuroregulatory systems, thereby influencing the phenotype, illness severity, and adult outcome of tic disorders. Similar developmental processes during adolescence likely determine the phenotype and natural history of a broad range of other complex neuropsychiatric disorders of childhood onset, and they likely contribute to the acquisition of improved self-regulatory capacities that characterize normal adolescent development.
正常的大脑成熟和发育过程,以及大脑为响应经验需求而进行的可塑性重组,有助于在青春期获得更强的自我调节和冲动控制能力。从青春期到成年期的过渡过程中,额叶是这些发育和可塑性过程的主要关注点。抽动秽语综合征(TS)被定义为慢性运动性和发声性抽动,越来越被认为是一种自我调节控制受损的疾病。这种紊乱的控制被认为会产生半强迫性冲动,去做出构成简单抽动、复杂抽动或强迫行为的动作。神经影像学研究表明,抽动秽语综合征遗传易感性的表达受影响神经调节系统活动依赖性重组的遗传和非遗传因素影响,从而影响抽动障碍的表型、疾病严重程度和成人预后。青春期类似的发育过程可能决定了一系列其他儿童期起病的复杂神经精神障碍的表型和自然病程,并且它们可能有助于获得正常青少年发育所特有的更强的自我调节能力。