Hôpital La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
Hôpital La Pitié Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
Encephale. 2020 Oct;46(5):399-403. doi: 10.1016/j.encep.2019.11.003. Epub 2020 Jan 31.
The use of invasive and non-invasive brain stimulation and neuromodulation technologies combined with neuroimaging approaches can help refine with causal evidence our physiopathological understanding of the Obsessive-Compulsive Disorder (OCD). Two key structures, the Orbitofrontal Cortex (OFC) and the Anterior Cingulate Cortex (ACC) have been found dysfunctional in OCD compared to healthy volunteers and on such basis have been tested as therapeutic targets for invasive and non-invasive neuromodulation therapy. Hereinafter, evidence addressing the cognitive processes subtended by to those two brain regions and their role in wider associated cortico-subcortical networks is reviewed. Very specifically, their relevance for OCD clinical features is discussed in extenso and its modulation with invasive and non-invasive focal brain stimulation such as deep brain stimulation (DBS) or transcranial magnetic Stimulation (TMS). Most importantly, this article brings new insights bridging causal evidence on the structural and functional neuroanatomy subtending OCD and novel therapeutic perspectives based on focal brain stimulation.
使用侵入性和非侵入性脑刺激和神经调节技术结合神经影像学方法，可以帮助我们用因果证据来完善对强迫症（OCD）的生理病理学理解。与健康志愿者相比，眶额皮层（OFC）和前扣带皮层（ACC）这两个关键结构在 OCD 中被发现功能失调，并且已经作为侵入性和非侵入性神经调节治疗的治疗靶点进行了测试。下文综述了涉及这两个脑区的认知过程及其在更广泛的相关皮质下网络中的作用的证据。特别是，详细讨论了它们与 OCD 临床特征的相关性，并对其进行了调制，包括深部脑刺激（DBS）或经颅磁刺激（TMS）等侵入性和非侵入性的局部脑刺激。最重要的是，本文通过因果证据将 OCD 的结构和功能神经解剖学联系起来，并基于局部脑刺激提出了新的治疗观点，为 OCD 带来了新的见解。
