Yamamuro Kazuhiko, Okada Koji, Kishimoto Naoko, Ota Toyosaku, Iida Junzo, Kishimoto Toshifumi
Department of Psychiatry, Nara Medical University School of Medicine.
Department of Psychiatry, Jingumaecocorono-Clinic.
Neuropsychiatr Dis Treat. 2016 Sep 26;12:2463-2471. doi: 10.2147/NDT.S117100. eCollection 2016.
Earlier brain imaging research studies have suggested that brain abnormalities in obsessive-compulsive disorder (OCD) normalize as clinical symptoms improve. However, although many studies have investigated event-related potentials (ERPs) in patients with OCD compared with healthy control subjects, it is currently unknown whether ERP changes reflect pharmacological and psychotherapeutic effects. As such, the current study examined the neurocognitive components of OCD to elucidate the pathophysiological abnormalities involved in the disorder, including the frontal-subcortical circuits.
The Yale-Brown Obsessive-Compulsive Scale was used to evaluate 14 adult patients with OCD. The present study also included ten age-, sex-, and IQ-matched controls. The P300 and mismatch negativity (MMN) components during an auditory oddball task at baseline for both groups and after 1 year of treatment for patients with OCD were measured.
Compared with controls, P300 amplitude was attenuated in the OCD group at Cz and C4 at baseline. Pharmacotherapy and psychotherapy treatment for 1 year reduced OCD symptomology. P300 amplitude after 1 year of treatment was significantly increased, indicating normalization compared with baseline at Fz, Cz, C3, and C4. We found no differences in P300 latency, MMN amplitude, or MMN latency between baseline and after one year of treatment.
ERPs may be a useful tool for evaluating pharmacological and cognitive behavioral therapy in adult patients with OCD.
早期的脑成像研究表明，强迫症（OCD）患者的脑异常会随着临床症状的改善而恢复正常。然而，尽管许多研究已将强迫症患者与健康对照者的事件相关电位（ERP）进行了对比，但目前尚不清楚ERP变化是否反映了药物治疗和心理治疗的效果。因此，本研究对强迫症的神经认知成分进行了检测，以阐明该疾病所涉及的病理生理异常，包括额叶-皮质下环路。
采用耶鲁-布朗强迫症量表对14名成年强迫症患者进行评估。本研究还纳入了10名年龄、性别和智商相匹配的对照者。测量了两组在基线时以及强迫症患者治疗1年后进行听觉oddball任务期间的P300和失配负波（MMN）成分。
与对照组相比，强迫症组在基线时Cz和C4处的P300波幅减弱。药物治疗和心理治疗1年可减轻强迫症症状。治疗1年后，Fz、Cz、C3和C4处的P300波幅显著增加，表明与基线相比已恢复正常。我们发现，基线与治疗1年后之间，P300潜伏期、MMN波幅或MMN潜伏期并无差异。
ERP可能是评估成年强迫症患者药物治疗和认知行为疗法的有用工具。
