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抽动障碍与强迫症患者反应抑制的跨诊断比较。

Trans-diagnostic comparison of response inhibition in Tourette's disorder and obsessive-compulsive disorder.

机构信息

a Division of Social and Behavioural Science , Utrecht University , Utrecht , The Netherlands.

b Department of Anatomy and Neurosciences , VU University Medical Center (VUmc) , Amsterdam , The Netherlands.

出版信息

World J Biol Psychiatry. 2018 Oct;19(7):527-537. doi: 10.1080/15622975.2017.1347711. Epub 2017 Jul 25.

DOI:10.1080/15622975.2017.1347711
PMID:28741401
Abstract

OBJECTIVES

Impaired response inhibition is related to neurodevelopmental disorders, such as Tourette's disorder (TD) and obsessive-compulsive disorder (OCD). Unlike OCD, in which neural correlates of response inhibition have been extensively studied, TD literature is limited. By using a Stop-Signal task, we investigated the neural mechanisms underlying response inhibition deficits in TD compared to OCD and healthy controls (HCs).

METHODS

Twenty-three TD patients, 20 OCD patients and 22 HCs were scanned (3T MRI). Region-of-interest analyses were performed between TD, OCD and HCs.

RESULTS

Performance was similar across all subject groups. During inhibition TD compared with HCs showed higher right inferior parietal cortex (IPC) activation. During error processing TD compared with HCs showed hyperactivity in the left cerebellum, right mesencephalon, and right insula. Three-group comparison showed an effect of group for error-related activation in the supplementary motor area (SMA). Post-hoc analyses showed higher error-related SMA activity in TD compared with OCD and HCs. Error-related left cerebellar activity correlated positively with tic severity.

CONCLUSIONS

Hyperactivation of IPC during inhibition and a widespread hyperactivated network during error processing in TD suggest compensatory inhibition- and error-related circuit recruitment to boost task performance. The lack of overlap with activation pattern in OCD suggests such compensatory mechanism is TD-specific.

摘要

目的

反应抑制受损与神经发育障碍有关,如妥瑞氏症(TD)和强迫症(OCD)。与 OCD 不同,OCD 中反应抑制的神经相关性已得到广泛研究,而 TD 的文献有限。通过使用停止信号任务,我们研究了与 OCD 和健康对照组(HC)相比,TD 中反应抑制缺陷的神经机制。

方法

对 23 名 TD 患者、20 名 OCD 患者和 22 名 HCs 进行了扫描(3T MRI)。对 TD、OCD 和 HCs 之间进行了感兴趣区域分析。

结果

所有受试者组的表现相似。在抑制过程中,TD 患者与 HCs 相比,右侧下顶叶皮层(IPC)的激活度更高。在错误处理过程中,TD 患者与 HCs 相比,左小脑、中脑右侧和岛叶右侧的活动过度。三组比较显示,错误相关激活在辅助运动区(SMA)中存在组间效应。事后分析显示,TD 患者的 SMA 与错误相关的活动高于 OCD 和 HCs。错误相关的左小脑活动与抽动严重程度呈正相关。

结论

在抑制过程中 IPC 的过度激活和在错误处理过程中广泛的过度激活网络表明,为了提高任务表现,需要抑制和错误相关的电路补偿性招募。与 OCD 的激活模式没有重叠表明,这种补偿机制是 TD 特异性的。

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