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[强迫症不同症状维度的神经影像学研究]

[Neuroimaging the various symptom dimensions of obsessive-compulsive disorder].

作者信息

Dold Markus, Aigner Martin

机构信息

Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien.

出版信息

Neuropsychiatr. 2009;23(4):193-205.

Abstract

INTRODUCTION

Following consensus on fronto-striato-thalamo-frontal dysfunction as the neuronal basis of obsessive-compulsive disorder, and increasing sub-classification of this clinical picture, neurobiological differentiation of the various obsessive symptoms is also attracting interest in neuroimaging research.

METHOD

Original papers studying the neurobiological correlates of the various dimensions of obsessive-compulsive disorder were listed by a systematic literature search.

RESULTS

The "washing" factor seems to involve particular brain structures dealing with emotional control (mainly the orbito-frontal cortex (OFC), anterior cingulate cortex (ACC), amygdala and insula), but the predominant areas in the "forbidden thoughts" factor are cognitive control brain regions (mainly basal ganglia and ACC), and in hoarding obsessions and compulsions they are decision-making areas (mainly ventro-medial parts of the OFC and dorso-lateral prefrontal cortex (DLPFC)).

DISCUSSION

The results underline the neurobiological heterogeneity of the obsessive-compulsive disorder clinical picture, pointing the way for future research approaches.

摘要

引言

在额叶 - 纹状体 - 丘脑 - 额叶功能障碍作为强迫症的神经基础达成共识之后,以及对这种临床症状的进一步细分,各种强迫症状的神经生物学差异也引起了神经影像学研究的关注。

方法

通过系统的文献检索列出研究强迫症各个维度神经生物学相关性的原始论文。

结果

“洗涤”因素似乎涉及处理情绪控制的特定脑结构(主要是眶额皮质(OFC)、前扣带回皮质(ACC)、杏仁核和脑岛),但“禁忌思想”因素中的主要区域是认知控制脑区(主要是基底神经节和ACC),而在囤积强迫观念和强迫行为中,它们是决策区域(主要是OFC的腹内侧部分和背外侧前额叶皮质(DLPFC))。

讨论

结果强调了强迫症临床症状的神经生物学异质性,为未来的研究方法指明了方向。

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