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强迫障碍的抑制缺陷有多具特异性?与惊恐障碍的神经生理学比较。

How specific are inhibitory deficits to obsessive-compulsive disorder? A neurophysiological comparison with panic disorder.

作者信息

Thomas Susan J, Gonsalvez Craig J, Johnstone Stuart J

机构信息

Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, NSW, Australia; Graduate School of Medicine, University of Wollongong, NSW, Australia.

Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, NSW, Australia; Centre for Psychophysics, Psychophysiology & Psychopharmacology, University of Wollongong, NSW, Australia.

出版信息

Clin Neurophysiol. 2014 Mar;125(3):463-75. doi: 10.1016/j.clinph.2013.08.018. Epub 2013 Sep 27.

Abstract

OBJECTIVE

Impaired inhibition may perpetuate repetitive symptoms in obsessive-compulsive disorder (OCD), however OCD-specific deficits have yet to be established. We investigated neural correlates of inhibition in OCD vs. healthy and anxious controls.

METHODS

ERPs and reaction times (RTs) were compared between participants with OCD (n=20), panic disorder (PD; n=20) and healthy controls (HCs; n=20) during an adapted Go/NoGo task, which manipulated inhibitory difficulty.

RESULTS

A classic P3 NoGo anteriorisation effect occurred across groups. Both clinical groups showed RT impairment, and similar topographical anomalies of several (P2, N2 and P3) ERP components. Notably, both clinical groups lacked the strong frontally maximal N2 component topography seen in the HCs, across stimuli. Additionally, with increasing inhibitory difficulty, N2 latency increased in HCs but not in the clinical groups.

CONCLUSIONS

Unexpectedly, ERP and behavioural anomalies during inhibition in OCD were not qualitatively different to those in PD, but were generally more severe. Common general and inhibitory deficits may underlie intrusive mental phenomena in both conditions.

SIGNIFICANCE

This first ERP response inhibition study in OCD to include anxious controls disconfirmed hypotheses regarding OCD-specific inhibitory deficits, indicating the importance of comparing OCD to other conditions, to evaluate neurobiological models.

摘要

目的

抑制功能受损可能使强迫症(OCD)的重复症状持续存在,然而,OCD特有的缺陷尚未得到证实。我们研究了OCD患者与健康对照者及焦虑对照者在抑制方面的神经相关性。

方法

在一项经过调整的Go/NoGo任务中,比较了强迫症患者(n = 20)、惊恐障碍患者(PD;n = 20)和健康对照者(HCs;n = 20)的事件相关电位(ERPs)和反应时间(RTs),该任务操纵了抑制难度。

结果

各组均出现了经典的P3 NoGo前部化效应。两个临床组均表现出反应时间受损,以及几个(P2、N2和P3)ERP成分类似的地形异常。值得注意的是,在所有刺激条件下,两个临床组均缺乏健康对照者中所见的强大的额叶最大N2成分地形。此外,随着抑制难度的增加,健康对照者的N2潜伏期增加,而临床组则没有。

结论

出乎意料的是,OCD患者在抑制过程中的ERP和行为异常与惊恐障碍患者并无质的差异,但通常更为严重。两种情况下,常见的一般缺陷和抑制缺陷可能是侵入性心理现象的基础。

意义

这项首次在OCD患者中纳入焦虑对照者的ERP反应抑制研究,否定了关于OCD特异性抑制缺陷的假设,表明将OCD与其他疾病进行比较以评估神经生物学模型的重要性。

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