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强迫症的转化研究方法:从动物模型到临床治疗。

Translational approaches to obsessive-compulsive disorder: from animal models to clinical treatment.

机构信息

National OCDs Treatment Service, Hertfordshire Partnership NHS Foundation Trust, Welwyn Garden City, UK.

出版信息

Br J Pharmacol. 2011 Oct;164(4):1044-61. doi: 10.1111/j.1476-5381.2011.01422.x.

Abstract

Obsessive-compulsive disorder (OCD) is characterized by obsessions (intrusive thoughts) and compulsions (repetitive ritualistic behaviours) leading to functional impairment. Accumulating evidence links these conditions with underlying dysregulation of fronto-striatal circuitry and monoamine systems. These abnormalities represent key targets for existing and novel treatment interventions. However, the brain bases of these conditions and treatment mechanisms are still not fully elucidated. Animal models simulating the behavioural and clinical manifestations of the disorder show great potential for augmenting our understanding of the pathophysiology and treatment of OCD. This paper provides an overview of what is known about OCD from several perspectives. We begin by describing the clinical features of OCD and the criteria used to assess the validity of animal models of symptomatology; namely, face validity (phenomenological similarity between inducing conditions and specific symptoms of the human phenomenon), predictive validity (similarity in response to treatment) and construct validity (similarity in underlying physiological or psychological mechanisms). We then survey animal models of OC spectrum conditions within this framework, focusing on (i) ethological models; (ii) genetic and pharmacological models; and (iii) neurobehavioural models. We also discuss their advantages and shortcomings in relation to their capacity to identify potentially efficacious new compounds. It is of interest that there has been rather little evidence of 'false alarms' for therapeutic drug effects in OCD models which actually fail in the clinic. While it is more difficult to model obsessive cognition than compulsive behaviour in experimental animals, it is feasible to infer cognitive inflexibility in certain animal paradigms. Finally, key future neurobiological and treatment research areas are highlighted.

摘要

强迫症(OCD)的特征是存在强迫观念(侵入性思维)和强迫行为(重复的仪式性行为),导致功能受损。越来越多的证据表明,这些情况与额纹状体回路和单胺系统的潜在失调有关。这些异常是现有和新型治疗干预的关键靶点。然而,这些疾病的大脑基础和治疗机制仍未完全阐明。模拟该障碍行为和临床症状的动物模型为增强我们对强迫症病理生理学和治疗的理解显示出巨大的潜力。本文从几个角度概述了强迫症的已知情况。我们首先描述了强迫症的临床特征以及评估症状动物模型有效性的标准;即,表面效度(诱发条件与人类现象的特定症状之间的现象相似性)、预测效度(对治疗的相似反应)和结构效度(潜在生理或心理机制的相似性)。然后,我们在这个框架内调查了 OC 谱条件的动物模型,重点关注(i)行为模型;(ii)遗传和药理学模型;和(iii)神经行为模型。我们还讨论了它们在识别潜在有效新型化合物方面的优缺点。有趣的是,在实际上在临床上失败的 OCD 模型中,几乎没有证据表明治疗药物效应存在“误报”。虽然在实验动物中模拟强迫认知比强迫行为更困难,但在某些动物范式中推断认知灵活性是可行的。最后,突出了关键的未来神经生物学和治疗研究领域。

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