Fremont Rachel, Dworkin Jordan, Manoochehri Masood, Krueger Frank, Huey Edward, Grafman Jordan
Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.
Department of Psychiatry, New York State Psychiatric Institute, New York, New York, USA.
BMJ Neurol Open. 2022 Apr 18;4(1):e000229. doi: 10.1136/bmjno-2021-000229. eCollection 2022.
Damage to cortico-striato-thalamo-cortical (CSTC) circuits is associated with the development of repetitive behaviours in animals and humans. However, the types of repetitive behaviours that are developed after injury to these structures are poorly defined. This study examines the effect of damage to separate elements of CSTC circuits sustained by veterans of the Vietnam War on obsessions, compulsions, and tics.
We performed partial correlations (correcting for cognition, age, education, and global brain damage) between volume loss from traumatic brain injury in specific elements of CSTC circuits (lateral and medial orbitofrontal and dorsolateral prefrontal cortices, anterior cingulate cortex, thalamus, and basal ganglia) and scores on a modified version of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist and the Yale Global Tic Severity Scale in 83 Vietnam war veterans with penetrating brain injuries at different sites throughout the brain.
We found that volume loss in the left dorsolateral prefrontal cortex was associated with the development of compulsive behaviours (r=0.32, padj<0.05) whereas volume loss in the basal ganglia was associated with the development of tics (r=0.33, padj<0.05).
Our findings indicate that damage to specific CSTC elements can be associated with the development of compulsive behaviours and tics that are not necessarily accompanied by obsessions.
皮质-纹状体-丘脑-皮质（CSTC）回路损伤与动物和人类重复行为的发展有关。然而，这些结构损伤后所产生的重复行为类型定义尚不明确。本研究考察了越战退伍军人CSTC回路各独立组成部分损伤对强迫观念、强迫行为和抽动的影响。
我们在83名脑部不同部位有穿透性脑损伤的越战退伍军人中，对CSTC回路特定组成部分（外侧和内侧眶额皮质、背外侧前额叶皮质、前扣带回皮质、丘脑和基底神经节）因创伤性脑损伤导致的体积损失与经修订的耶鲁-布朗强迫量表症状清单得分以及耶鲁全球抽动严重程度量表得分之间进行了偏相关分析（校正认知、年龄、教育程度和全脑损伤情况）。
我们发现，左侧背外侧前额叶皮质的体积损失与强迫行为的发展有关（r = 0.32，校正后P值<0.05），而基底神经节的体积损失与抽动的发展有关（r = 0.33，校正后P值<0.05）。
我们的研究结果表明，特定CSTC组成部分的损伤可能与强迫行为和抽动的发展有关，而这些行为不一定伴有强迫观念。
