Woolley James, Heyman Isobel, Brammer Mick, Frampton Ian, McGuire Philip K, Rubia Katya
Child and Adolescent Psychiatry (PO 46), Institute of Psychiatry, Denmark Hill, London SE5 8AF, UK.
Br J Psychiatry. 2008 Jan;192(1):25-31. doi: 10.1192/bjp.bp.107.036558.
Obsessive-compulsive disorder (OCD) may be related to a dysfunction in frontostriatal pathways mediating inhibitory control. However, no functional magnetic resonance imaging (fMRI) study has tested this in children.
To test whether adolescents with OCD in partial remission would show abnormal frontostriatal brain activation during tasks of inhibition.
Event-related fMRI was used to compare brain activation in 10 adolescent boys with OCD with that of 9 matched controls during three different tasks of inhibitory control.
During a 'stop' task, participants with OCD showed reduced activation in right orbitofrontal cortex, thalamus and basal ganglia; inhibition failure elicited mesial frontal underactivation. Task switching and interference inhibition were associated with attenuated activation in frontal, temporoparietal and cerebellar regions.
These preliminary findings support the hypothesis that paediatric OCD is characterised by a dysregulation of frontostriatothalamic brain regions necessary for motor inhibition, and also demonstrate dysfunction of temporoparietal and frontocerebellar attention networks during more cognitive forms of inhibition.
强迫症（OCD）可能与介导抑制控制的额纹状体通路功能障碍有关。然而，尚无功能磁共振成像（fMRI）研究在儿童中对此进行测试。
测试部分缓解期的强迫症青少年在抑制任务期间是否会出现额纹状体脑区激活异常。
采用事件相关功能磁共振成像，在三种不同的抑制控制任务中，比较10名患有强迫症的青少年男孩与9名匹配对照的脑激活情况。
在“停止”任务期间，患有强迫症的参与者在右侧眶额皮质、丘脑和基底神经节的激活减少；抑制失败引发内侧额叶激活不足。任务转换和干扰抑制与额叶、颞顶叶和小脑区域的激活减弱有关。
这些初步发现支持以下假设，即小儿强迫症的特征是运动抑制所需的额纹状体丘脑脑区调节异常，并且还证明在更多认知形式的抑制过程中，颞顶叶和额小脑注意网络存在功能障碍。
