Molano-Eslava Juan Carlos, Iragorri-Cucalón Angela, Ucrós-Rodríguez Gonzalo, Bonilla-Jácome Carolina, Tovar-Perdomo Santiago, Herin David V, Orozco-Cabal Luis
Médico psiquiatra. Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia. Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia.
Rev Colomb Psiquiatr. 2008 Oct 1;37(4):644-654. doi: 10.1901/jaba.2008.37-644.
Few cases of obsessive-compulsive disorder (OCD) symptoms preceding the clinical onset of Huntington Disease (HD) or during later stages of the disease have been reported in the literature, but the nature of this association and its neurobiological mechanisms have not been well-investigated. OBJECTIVES: To review the scientific literature regarding OCD symptoms in patients with HD and describe a case study from our clinic. METHODS: Extensive literature searches were performed to identify reports of patients with concurrent HD and OCD symptoms. RESULTS: Recent studies and the current case report suggest that OCD symptoms may predate or coincide with motor, affective or behavioral symptoms in patients with HD. The development of OCD and HD symptoms may involve structural and functional changes affecting the orbital and medial prefrontal cortex, ventromedial caudate nucleus, and pallidal sites. CONCLUSIONS: Some patients with HD develop symptoms associated with OCD. Progressive and differential neuropathological changes in the ventromedial caudate nucleus and related neural circuits may underlie this association. No specific treatment strategy has been developed to treat these patients; however some medications attenuate associated symptoms. Further testing is needed to determine the neurobiological mechanisms of these disorders.
文献中报道过少数在亨廷顿病（HD）临床发病前或疾病后期出现强迫症（OCD）症状的病例，但这种关联的性质及其神经生物学机制尚未得到充分研究。目的：回顾关于HD患者OCD症状的科学文献，并描述我们诊所的一个病例研究。方法：进行广泛的文献检索，以确定同时患有HD和OCD症状患者的报告。结果：近期研究和当前病例报告表明，OCD症状可能先于或与HD患者的运动、情感或行为症状同时出现。OCD和HD症状的发展可能涉及影响眶额和内侧前额叶皮质、腹内侧尾状核和苍白球部位的结构和功能变化。结论：一些HD患者会出现与OCD相关的症状。腹内侧尾状核和相关神经回路中进行性和差异性的神经病理变化可能是这种关联的基础。尚未制定出针对这些患者的具体治疗策略；然而，一些药物可减轻相关症状。需要进一步测试以确定这些疾病的神经生物学机制。
