Schiepek Günter, Tominschek Igor, Karch Susanne, Mulert Christoph, Pogarell Oliver
Forschungseinrichtung für Dynamische Systeme, Institut für Psychologie, Alpen-Adria-Universität Klagenfurt.
Psychother Psychosom Med Psychol. 2007 Sep-Oct;57(9-10):379-94. doi: 10.1055/s-2006-952021.
The following review is focusing on results of functional neuroimaging. After some introductory remarks on the phenomenology, epidemiology, and psychotherapy approaches of obsessive-compulsive disorders (OCD) the most important OCD-related brain regions are presented. Obviously, not only the prominent cortico-striato-thalamo-cortical feedback loops are involved, as functional brain imaging studies tell us, but also other regions as the inferior parietal lobe, the anterior and posterior cingulate gyrus, insula, amygdala, cerebellum, and others. Subclassifications using factor-analysis methods support the hypothesis, that most important subtypes ("washing/contamination fear", "obsessions/checking", "symmetry/ordering", "hoarding") involve different, but partially overlapping brain areas. Stimulation paradigms in fMRI-research are commonly based on symptom provocation by visual or tactile stimuli, or on action-monitoring and error-monitoring tasks. Deficits in action-monitoring and planning are discussed to be one of the basic dysfunctions of OCD. Finally, results of psychotherapeutic induced variations of brain activations in OCD are presented.
以下综述聚焦于功能性神经影像学的研究结果。在对强迫症(OCD)的现象学、流行病学及心理治疗方法进行一些介绍性阐述之后,将呈现与OCD相关的最重要的脑区。显然,正如功能性脑成像研究所示,不仅突出的皮质-纹状体-丘脑-皮质反馈回路会涉及其中,其他区域如下顶叶、前扣带回和后扣带回、脑岛、杏仁核、小脑等也会涉及。使用因子分析方法的亚分类支持了这样一种假设,即最重要的亚型(“洗涤/污染恐惧”、“强迫观念/检查”、“对称/排序”、“囤积”)涉及不同但部分重叠的脑区。功能磁共振成像(fMRI)研究中的刺激范式通常基于视觉或触觉刺激引发症状,或基于动作监测和错误监测任务。动作监测和计划方面的缺陷被认为是OCD的基本功能障碍之一。最后,将呈现心理治疗引起的OCD患者脑激活变化的结果。