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儿童强迫症治疗前后与错误相关的大脑活动增加。

Increased error-related brain activity in pediatric obsessive-compulsive disorder before and after treatment.

作者信息

Hajcak Greg, Franklin Martin E, Foa Edna B, Simons Robert F

机构信息

Department of Psychology, Stony Brook University, Stony Brook, NY 11794-2500, USA.

出版信息

Am J Psychiatry. 2008 Jan;165(1):116-23. doi: 10.1176/appi.ajp.2007.07010143. Epub 2007 Nov 6.

Abstract

OBJECTIVE

The error-related negativity is a negative deflection in the event-related potential maximal approximately 50 msec after the commission of errors. The error-related negativity is generated in the anterior cingulate cortex, and both anterior cingulate cortex hyperactivity and increased error-related brain activity have been reported in adults with obsessive-compulsive disorder (OCD). However, no study to date, to the authors' knowledge, has examined error-related brain activity in pediatric patients with OCD, and no study has examined error-related brain activity in OCD both before and after treatment.

METHOD

The error-related negativity was measured in 18 treatment-seeking pediatric patients with OCD and 18 age-matched comparison subjects. Of these patients, 10 returned for a second testing session after cognitive behavior therapy; 13 comparison children participated a second time after a comparable interval.

RESULTS

In the pretreatment group, the error-related negativity was reliably larger in pediatric patients with OCD in relation to comparison subjects. This difference was also evident after treatment. There was no relationship between error-related negativity and symptom severity or changes in symptom severity.

CONCLUSIONS

Consistent with studies in adult patients, increased error-related brain activity is evident in pediatric patients with OCD. Furthermore, increased error-related brain activity does not appear to change as a function of symptom reduction after therapy. These results suggest that an increased error-related negativity may be a trait-like marker for psychopathology and might be a useful endophenotype.

摘要

目的

错误相关负波是在犯错后约50毫秒达到最大值的事件相关电位中的负向偏转。错误相关负波在前扣带回皮层产生,据报道,强迫症(OCD)成年患者存在前扣带回皮层活动亢进以及与错误相关的大脑活动增加的情况。然而,据作者所知,迄今为止尚无研究对患有强迫症的儿科患者的错误相关大脑活动进行过检查,也没有研究在治疗前后对强迫症患者的错误相关大脑活动进行过检查。

方法

对18名寻求治疗的患有强迫症的儿科患者和18名年龄匹配的对照受试者测量错误相关负波。在这些患者中,10名在接受认知行为治疗后返回进行第二次测试;13名对照儿童在相当的间隔后再次参与测试。

结果

在预处理组中,与对照受试者相比,患有强迫症的儿科患者的错误相关负波确实更大。治疗后这种差异也很明显。错误相关负波与症状严重程度或症状严重程度的变化之间没有关系。

结论

与成年患者的研究一致,患有强迫症的儿科患者中与错误相关的大脑活动增加是明显的。此外,与错误相关的大脑活动增加似乎不会随着治疗后症状的减轻而改变。这些结果表明,错误相关负波增加可能是精神病理学的一种特质样标志物,并且可能是一种有用的内表型。

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