Serra F P, Palma V, Nolfe G, Buscaino G A
Clinica Neurologica Università Federico II-Napoli, 1st. Cibernetica Del Cnr, ARCO Felice, Napoli.
Acta Neurol (Napoli). 1994 Dec;16(5-6):240-8.
Recent anatomoclinical and neuroimaging studies have suggested a possible relation between obsessional compulsive disorders (OCD) and some brain damage, such as frontolenticular lesions, basal ganglia cavitations and local glucose metabolism impairment. A poor frontocaudal regulation of the left hemisphere and an autonomic nervous system dysfunction in OCD patients have been supposed. To absess these morphofunctional abnormalities, an electrophysiological approach has been performed in 100 consecutive neurotic patients, screened with various neuropsychological tests and divided in two groups, 50 with OCD and 50 with anxious neurosis (ANX). Patients were submitted to EEG spectral analysis and BAEP studies and comparated with 25 age-matched normal controls. The mean alpha power in occipital regions was significantly higher in OCD patients and reduced in ANX patients. A significant reduction of the beta activity was recorded in frontal regions in both patient groups as compared to controls. A slight (p < 0.11) increase in I-V interpeak latency (IPL) vs. control group was observed in BAEP from left ear. A significant increase of the same IPL in OCD vs. controls (p < 0.025) was observed in BAEP from right ear. A slight n.s. reduction in III wave amplitude in OCD patients was observed in BAEP from left ear, whereas a highly significant reduction in the same wave amplitude from BAEP from right ear was observed in OCD patients. The above findings cold be account for both a frontotemporal and brainstem dysfunction with a probable involvement of serotoninergic central pathways, with a significant impairment of pontine segment in ANX patients and of mesencephalic region in OCD patients.
最近的解剖临床和神经影像学研究表明,强迫症(OCD)与一些脑损伤之间可能存在关联,如额豆状核病变、基底节空洞形成和局部葡萄糖代谢受损。据推测,强迫症患者存在左半球额尾调节不良和自主神经系统功能障碍。为了研究这些形态功能异常,对100例连续的神经症患者进行了电生理检查,这些患者经过各种神经心理学测试筛选,并分为两组,50例患有强迫症,50例患有焦虑神经症(ANX)。患者接受了脑电图频谱分析和脑干听觉诱发电位(BAEP)研究,并与25名年龄匹配的正常对照进行比较。强迫症患者枕区的平均α波功率显著高于正常对照,而焦虑神经症患者的则降低。与对照组相比,两组患者额叶区域的β活动均显著降低。左耳BAEP中I-V峰间潜伏期(IPL)与对照组相比略有增加(p<0.11)。右耳BAEP中,强迫症患者的同一IPL与对照组相比显著增加(p<0.025)。左耳BAEP中观察到强迫症患者III波振幅略有非显著性降低,而右耳BAEP中观察到强迫症患者同一波振幅显著降低。上述发现可能解释了额颞叶和脑干功能障碍,可能涉及5-羟色胺能中枢通路,焦虑神经症患者脑桥段有显著损伤,强迫症患者中脑区域有显著损伤。