Section of Psychiatry, Laboratory of Translational and Molecular Psychiatry and Unit of Treatment-Resistant Psychosis, Department of Neuroscience, Reproductive Sciences and Dentistry University Medical School of Naples "Federico II", Via Pansini 5, 80131 Naples, Italy.
Biomolecules. 2023 Aug 5;13(8):1220. doi: 10.3390/biom13081220.
Almost 25% of schizophrenia patients suffer from obsessive-compulsive symptoms (OCS) considered a transdiagnostic clinical continuum. The presence of symptoms pertaining to both schizophrenia and obsessive-compulsive disorder (OCD) may complicate pharmacological treatment and could contribute to lack or poor response to the therapy. Despite the clinical relevance, no reviews have been recently published on the possible neurobiological underpinnings of this comorbidity, which is still unclear. An integrative view exploring this topic should take into account the following aspects: (i) the implication for glutamate, dopamine, and serotonin neurotransmission as demonstrated by genetic findings; (ii) the growing neuroimaging evidence of the common brain regions and dysfunctional circuits involved in both diseases; (iii) the pharmacological modulation of dopaminergic, serotoninergic, and glutamatergic systems as current therapeutic strategies in schizophrenia OCS; (iv) the recent discovery of midbrain dopamine neurons and dopamine D1- and D2-like receptors as orchestrating hubs in repetitive and psychotic behaviors; (v) the contribution of N-methyl-D-aspartate receptor subunits to both psychosis and OCD neurobiology. Finally, we discuss the potential role of the postsynaptic density as a structural and functional hub for multiple molecular signaling both in schizophrenia and OCD pathophysiology.
近 25%的精神分裂症患者患有强迫症症状（OCS），被认为是一种跨诊断的临床连续体。既有精神分裂症又有强迫症（OCD）症状的存在可能会使药物治疗复杂化，并导致对治疗缺乏或反应不佳。尽管具有临床相关性，但最近没有关于这种共病的可能神经生物学基础的综述发表，这仍然不清楚。一个综合的观点来探索这个话题应该考虑以下几个方面：（i）遗传发现表明谷氨酸、多巴胺和血清素神经递质的影响；（ii）越来越多的神经影像学证据表明这两种疾病涉及共同的大脑区域和功能障碍的回路；（iii）多巴胺能、血清素能和谷氨酸能系统的药理学调节作为精神分裂症 OCS 的当前治疗策略；（iv）中脑多巴胺神经元和多巴胺 D1 和 D2 样受体作为重复和精神病行为的协调中枢的最新发现；（v）N-甲基-D-天冬氨酸受体亚基对精神分裂症和强迫症神经生物学的贡献。最后，我们讨论了突触后密度作为精神分裂症和强迫症病理生理学中多种分子信号的结构和功能枢纽的潜在作用。
