Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany; Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.
Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China.
Neurosci Biobehav Rev. 2022 Jun;137:104677. doi: 10.1016/j.neubiorev.2022.104677. Epub 2022 Apr 22.
Obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) are multi-faceted neuropsychiatric conditions that in many aspects appear to be each other's antipodes. We suggest a dimensional approach, according to which these partially opposing disorders fall onto a continuum that reflects variability regarding alterations of cortico-striato-thalamo-cortical (CSTC) circuits and of the processing of neural noise during cognition. By using theoretical accounts of human cognitive metacontrol, we develop a framework according to which OCD can be characterized by a chronic bias towards exaggerated cognitive persistence, equivalent to a high signal-to-noise ratio (SNR)-which facilitates perseverative behaviour but impairs mental flexibility. In contrast, ADHD is characterized by a chronic bias towards inflated cognitive flexibility, equivalent to a low SNR-which increases behavioural variability but impairs the focusing on one goal and on relevant information. We argue that, when pharmacology is not feasible, novel treatments of these disorders may involve methods to manipulate the signal-to-noise ratio via non-invasive brain stimulation techniques, in order to normalize the situational imbalance between cognitive persistence and cognitive flexibility.
强迫症（OCD）和注意缺陷多动障碍（ADHD）是多方面的神经精神疾病，在许多方面似乎是彼此的对立面。我们建议采用一种维度方法，根据这种方法，这些部分对立的疾病落在反映皮质纹状体丘脑皮质（CSTC）回路改变和认知过程中神经噪声处理变异性的连续体上。通过使用人类认知元控制的理论解释，我们根据 OCD 可以通过对夸大的认知持久性的慢性偏见来进行特征描述，相当于高信噪比（SNR）-这有利于坚持行为，但损害了心理灵活性。相比之下，ADHD 的特征是对过度认知灵活性的慢性偏见，相当于低 SNR-这增加了行为变异性，但损害了对一个目标和相关信息的关注。我们认为，当药理学不可行时，这些疾病的新治疗方法可能涉及通过非侵入性脑刺激技术来操纵信噪比的方法，以在认知持久性和认知灵活性之间的情境失衡中恢复正常。
