Sachse Elizabeth M, Widge Alik S
University of Minnesota, Department of Psychiatry, 2312 6 Street South, Floor 2, Suite F-275, Minneapolis+, MN 55454.
University of Minnesota, Department of Neuroscience, 6-145 Jackson Hall, 321 Church Street SE, Minneapolis, MN 55455.
Curr Opin Behav Sci. 2025 Apr;62. doi: 10.1016/j.cobeha.2025.101484. Epub 2025 Feb 6.
Cognitive flexibility, the capacity to adapt behaviors in response to changing environments, is impaired across mental illnesses, including depression, anxiety, addiction, and obsessive-compulsive disorder. Cortico-striatal-cortical circuits are integral to cognition and goal-directed behavior and disruptions in these circuits are linked to cognitive inflexibility in mental illnesses. We review evidence that neurostimulation of these circuits can improve cognitive flexibility and ameliorate symptoms, and that this may be a mechanism of action of current clinical therapies. Further, we discuss how animal models can offer insights into the mechanisms underlying cognitive flexibility and effects of neurostimulation. We review research from animal studies that may, if translated, yield better approaches to modulating flexibility. Future research should focus on refining definitions of cognitive flexibility, improving detection of impaired flexibility, and developing new methods for optimizing neurostimulation parameters. This could enhance neurostimulation therapies through more personalized treatments that leverage cognitive flexibility to improve patient outcomes.
认知灵活性是指根据不断变化的环境调整行为的能力，在包括抑郁症、焦虑症、成瘾和强迫症在内的各种精神疾病中都会受损。皮质-纹状体-皮质回路对于认知和目标导向行为至关重要，这些回路的破坏与精神疾病中的认知僵化有关。我们综述了证据，表明对这些回路进行神经刺激可以提高认知灵活性并改善症状，而且这可能是当前临床治疗的作用机制。此外，我们讨论了动物模型如何能够深入了解认知灵活性的潜在机制以及神经刺激的效果。我们综述了动物研究中的相关研究，如果能够转化应用，可能会产生更好的调节灵活性的方法。未来的研究应专注于完善认知灵活性的定义，改进对受损灵活性的检测，并开发优化神经刺激参数的新方法。这可以通过更个性化的治疗来增强神经刺激疗法，利用认知灵活性来改善患者的治疗效果。
