强迫症：病因、神经病理学和认知功能障碍。
Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction.
机构信息
Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Behavioural and Clinical Neuroscience Institute, Department of Psychology, University of Cambridge, Cambridge, UK.
出版信息
Brain Behav. 2023 Jun;13(6):e3000. doi: 10.1002/brb3.3000. Epub 2023 May 3.
BACKGROUND
This review provides an overview of obsessive-compulsive disorder (OCD) symptoms, including the four partially distinct subtypes of the disorder, current diagnostic criteria, and common comorbidities. Critically, it focuses on the etiology of OCD, including its underlying neuropathology, and examines cognitive dysfunction in OCD.
METHODS
This review study was conducted by library method.
RESULTS
We show how dysfunction in cortico-striato-thalamo-cortical (CSTC) circuits may underpin symptoms; and shed light on the putative neurochemistry within these loops such as the role of serotonin, dopamine, and glutamate systems. We also show how OCD is characterized by cognitive dysfunction including problems in cognitive flexibility, visuospatial memory, response inhibition, and goal-directed behavior, linked to aberrant activity within CSTC circuits.
CONCLUSIONS
In brief, research questions we shed light on include (1) what are the symptoms in OCD; (2) what is the etiology of the disorder and do existing models explain OCD; and (3) what are key cognitive deficits in OCD and do these improve with treatment?
背景
本综述概述了强迫症（OCD）的症状，包括该疾病的四个部分不同的亚型、当前的诊断标准和常见的合并症。重要的是，它重点关注强迫症的病因，包括其潜在的神经病理学，并研究了强迫症中的认知功能障碍。
方法
本综述研究通过文献法进行。
结果
我们展示了皮质纹状体丘脑皮质（CSTC）回路的功能障碍如何可能是症状的基础；并阐明了这些回路中的假定神经化学物质，例如 5-羟色胺、多巴胺和谷氨酸系统的作用。我们还展示了强迫症的特征是认知功能障碍，包括认知灵活性、视空间记忆、反应抑制和目标导向行为方面的问题，这些问题与 CSTC 回路中的异常活动有关。
结论
简而言之，我们阐明的研究问题包括：（1）强迫症的症状有哪些；（2）该疾病的病因是什么，现有的模型是否能解释强迫症；以及（3）强迫症的关键认知缺陷是什么，这些缺陷是否会随着治疗而改善？
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