University Department of Adult Psychiatry, Guillaume Régnier Hospital, Rennes, France.
PLoS One. 2013;8(1):e53241. doi: 10.1371/journal.pone.0053241. Epub 2013 Jan 11.
Deep brain stimulation has shed new light on the central role of the prefrontal cortex (PFC) in obsessive compulsive disorder (OCD). We explored this structure from a functional perspective, synchronizing neuroimaging and cognitive measures.
This case-control cross-sectional study compared 15 OCD patients without comorbidities and not currently on serotonin reuptake inhibitors or cognitive behavioural therapy with 15 healthy controls (matched for age, sex and education level) on resting-state (18)FDG-PET scans and a neuropsychological battery assessing executive functions. We looked for correlations between metabolic modifications and impaired neuropsychological scores. Modifications in glucose metabolism were found in frontal regions (orbitofrontal cortex and dorsolateral cortices), the cingulate gyrus, insula and parietal gyrus. Neuropsychological differences between patients and controls, which were subtle, were correlated with the metabolism of the prefrontal, parietal, and temporal cortices.
As expected, we confirmed previous reports of a PFC dysfunction in OCD patients, and established a correlation with cognitive deficits. Other regions outside the prefrontal cortex, including the dorsoparietal cortex and the insula, also appeared to be implicated in the pathophysiology of OCD, providing fresh insights on the complexity of OCD syndromes.
深部脑刺激为强迫症（OCD）的前额叶皮层（PFC）的核心作用提供了新的认识。我们从功能的角度探讨了这一结构，将神经影像学和认知测量同步进行。
本病例对照横断面研究比较了 15 名无共病且未服用选择性 5-羟色胺再摄取抑制剂或认知行为疗法的强迫症患者与 15 名健康对照者（年龄、性别和教育程度匹配）的静息状态（18）FDG-PET 扫描和评估执行功能的神经心理学测试。我们寻找代谢改变与认知功能评分受损之间的相关性。在额叶区域（眶额皮层和背外侧皮质）、扣带回、岛叶和顶叶发现葡萄糖代谢改变。患者和对照组之间的神经心理学差异较小，但与前额叶、顶叶和颞叶皮质的代谢相关。
正如预期的那样，我们证实了 OCD 患者 PFC 功能障碍的先前报道，并确定了与认知缺陷的相关性。前额叶皮层以外的其他区域，包括背顶叶皮层和岛叶，似乎也与 OCD 的病理生理学有关，为 OCD 综合征的复杂性提供了新的见解。
