Haber Suzanne N, Brucker Justin L
Department of Pharmacology and Physiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, New York 14642, USA.
Front Biosci (Landmark Ed). 2009 Jan 1;14(5):1823-34. doi: 10.2741/3344.
Several lines of evidence indicate that the neural network that underlies the pathophysiology of obsessive-compulsive disorder and depression centers on the prefronto-basal ganglia system. Particularly involved are anterior cingulate cortex, the orbital prefrontal cortex, the ventral striatum, and parts of the thalamus. Additional integral parts of the network include, the amygdala, the midbrain dopamine cells and the serotonergic neurons. Collectively, these brain regions are involved in various aspects of reward-based learning and good decision-making skills. They are also associated with sadness and depression, pathological risk-taking, addictive behaviors, and obsessive-compulsive disorder. Two of the most successful deep brain stimulation targets for obsessive-compulsive disorder and depression are centered in white matter tracts. These targets were chosen for their central location and ability to capture specific ascending and descending connections, with a particular focus on fibers connecting the subgenual anterior cingulate and orbital cortex with the basal ganglia, thalamus, and amygdala. As more knowledge is obtained concerning the details of these connections, more precise targets may be possible.
多条证据表明，构成强迫症和抑郁症病理生理学基础的神经网络以额叶前部-基底神经节系统为中心。特别涉及的是前扣带回皮质、眶额前皮质、腹侧纹状体和丘脑的部分区域。该网络的其他组成部分包括杏仁核、中脑多巴胺细胞和血清素能神经元。总体而言，这些脑区参与基于奖励的学习和良好决策技能的各个方面。它们还与悲伤和抑郁、病理性冒险行为、成瘾行为以及强迫症有关。强迫症和抑郁症最成功的两个深部脑刺激靶点集中在白质束。选择这些靶点是因其位于中心位置且能够捕捉特定的上行和下行连接，特别关注连接膝下前扣带回和眶皮质与基底神经节、丘脑和杏仁核的纤维。随着关于这些连接细节的更多知识被获取，可能会有更精确的靶点。
