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强迫症相关功能失调信念的神经相关物。

Neural correlates of obsessive-compulsive related dysfunctional beliefs.

机构信息

OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Spain; CRC-Hospital del Mar, Barcelona, Spain.

出版信息

Prog Neuropsychopharmacol Biol Psychiatry. 2013 Dec 2;47:25-32. doi: 10.1016/j.pnpbp.2013.07.016. Epub 2013 Aug 2.

Abstract

There have been few attempts to integrate neurobiological and cognitive models of obsessive-compulsive disorder (OCD), although this might constitute a key approach to clarify the complex etiology of the disorder. Our study aimed to explore the neural correlates underlying dysfunctional beliefs hypothesized by cognitive models to be involved in the development and maintenance of OCD. We obtained a high-resolution magnetic resonance image from fifty OCD patients and 30 healthy controls, and correlated them, voxel-wise, with the severity of OC-related dysfunctional beliefs assessed by the Obsessive Beliefs Questionnaire-44. In healthy controls, significant negative correlations were observed between anterior temporal lobe (ATL) volume and scores on perfectionism/intolerance of uncertainty and overimportance/need to control thoughts. No significant correlations between OBQ-44 domains and regional gray matter volumes were observed in OCD patients. A post-hoc region-of-interest analysis detected that the ATLs was bilaterally smaller in OCD patients. On splitting subjects into high- and low-belief subgroups, we observed that such brain structural differences between OCD patients and healthy controls were explained by significantly larger ATL volumes among healthy subjects from the low-belief subgroup. Our results suggest a significant correlation between OC-related dysfunctional beliefs and morphometric variability in the anterior temporal lobe, a brain structure related to socio-emotional processing. Future studies should address the interaction of these correlations with environmental factors to fully characterize the bases of OC-related dysfunctional beliefs and to advance in the integration of biological and cognitive models of OCD.

摘要

尽管将神经生物学和强迫症 (OCD) 的认知模型整合起来可能是阐明该疾病复杂病因的关键方法,但目前很少有人尝试这样做。我们的研究旨在探索认知模型假设的与 OCD 的发展和维持有关的功能失调信念的神经相关性。我们从 50 名 OCD 患者和 30 名健康对照者中获得了高分辨率磁共振图像,并与通过 44 项强迫观念问卷评估的 OC 相关功能失调信念的严重程度进行了体素相关分析。在健康对照组中,前颞叶 (ATL) 体积与完美主义/不确定性容忍度和过度重要性/控制思想的必要性评分呈显著负相关。在 OCD 患者中,OBQ-44 各领域与局部灰质体积之间未观察到显著相关性。事后的感兴趣区域分析检测到 OCD 患者双侧 ATL 较小。通过将受试者分为高信念和低信念亚组,我们观察到 OCD 患者和健康对照组之间的这种大脑结构差异是由低信念亚组中健康受试者的 ATL 体积明显较大所解释的。我们的研究结果表明,OC 相关功能失调信念与前颞叶形态变异之间存在显著相关性,而前颞叶是与社会情感处理相关的脑结构。未来的研究应该探讨这些相关性与环境因素的相互作用,以充分描述 OC 相关功能失调信念的基础,并推进 OCD 的生物学和认知模型的整合。

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