Steinman Shari A, Ahmari Susanne E, Choo Tse, Kimeldorf Marcia B, Feit Rachel, Loh Sarah, Risbrough Victoria, Geyer Mark A, Steinglass Joanna E, Wall Melanie, Schneier Franklin R, Fyer Abby J, Simpson H Blair
Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York.
Department of Psychiatry, Columbia University Medical Center, New York, New York.
Depress Anxiety. 2016 Mar;33(3):238-46. doi: 10.1002/da.22474. Epub 2016 Feb 15.
Deficits in sensorimotor gating have been hypothesized to underlie the inability to inhibit repetitive thoughts and behaviors. To test this hypothesis, this study assessed prepulse inhibition (PPI), a measure of sensorimotor gating, across three psychiatric disorders (obsessive-compulsive disorder [OCD], social anxiety disorder [SAD], and anorexia nervosa [AN]) whose clinical presentations include repetitive thoughts and behaviors
We tested acoustic PPI in unmedicated individuals with OCD (n = 45), SAD (n = 37), and AN (n = 26), and compared their results to matched healthy volunteers (n = 62). All participants completed a structured clinical interview and a clinical assessment of psychiatric symptom severity.
Percent PPI was significantly diminished in females with OCD compared to healthy female volunteers (P = .039). No other differences between healthy volunteers and participants with disorders (male or female) were observed. Percent PPI was not correlated with severity of obsessions and compulsions, as measured by the Yale-Brown Obsessive Compulsive Scale.
This is the first study to assess PPI in participants with SAD or AN, and the largest study to assess PPI in participants with OCD. We found PPI deficits only in females with OCD, which suggests that the cortico-striato-pallido-thalamic and pontine circuitry (believed to underlie PPI) differs between males and females with OCD. Given that PPI deficits were only present in females with OCD and not related to repetitive thoughts and behaviors, our results do not support the hypothesis that sensorimotor gating deficits, as measured by PPI, underlie the inability to inhibit repetitive thoughts and behaviors in individuals with OCD, SAD, and AN.
感觉运动门控缺陷被认为是无法抑制重复性思维和行为的潜在原因。为了验证这一假设，本研究评估了前脉冲抑制（PPI），这是一种感觉运动门控的测量方法，涉及三种精神疾病（强迫症[OCD]、社交焦虑症[SAD]和神经性厌食症[AN]），其临床表现包括重复性思维和行为。
我们对未服药的强迫症患者（n = 45）、社交焦虑症患者（n = 37）和神经性厌食症患者（n = 26）进行了听觉PPI测试，并将他们的结果与匹配的健康志愿者（n = 62）进行比较。所有参与者都完成了结构化临床访谈和精神症状严重程度的临床评估。
与健康女性志愿者相比，患有强迫症的女性的PPI百分比显著降低（P = 0.039）。在健康志愿者和患有疾病的参与者（男性或女性）之间未观察到其他差异。PPI百分比与耶鲁-布朗强迫症量表测量的强迫观念和强迫行为的严重程度无关。
这是第一项评估社交焦虑症或神经性厌食症患者PPI的研究，也是评估强迫症患者PPI的最大规模研究。我们仅在患有强迫症的女性中发现了PPI缺陷，这表明强迫症男性和女性之间，被认为是PPI基础的皮质-纹状体-苍白球-丘脑和脑桥回路存在差异。鉴于PPI缺陷仅存在于患有强迫症的女性中，且与重复性思维和行为无关，我们的结果不支持以下假设：即通过PPI测量的感觉运动门控缺陷是导致强迫症、社交焦虑症和神经性厌食症患者无法抑制重复性思维和行为的潜在原因。
