Rauch S L, Jenike M A, Alpert N M, Baer L, Breiter H C, Savage C R, Fischman A J
Department of Psychiatry, Massachusetts General Hospital, Boston.
Arch Gen Psychiatry. 1994 Jan;51(1):62-70. doi: 10.1001/archpsyc.1994.03950010062008.
The study was designed to determine the mediating neuroanatomy of obsessive-compulsive disorder (OCD).
The short half-life tracer oxygen 15-labeled carbon dioxide was used to allow for repeated positron emission tomographic determinations of regional cerebral blood flow on each of eight patients with OCD during a resting and a provoked (symptomatic) state.
Individually tailored provocative stimuli were successful in provoking OCD symptoms, in comparison with paired innocuous stimuli, as measured by self-report on OCD analogue scales (P = .002). Omnibus subtraction images demonstrated a statistically significant increase in relative regional cerebral blood flow during the OCD symptomatic state vs the resting state in right caudate nucleus (P < .006), left anterior cingulate cortex (P < .045), and bilateral orbitofrontal cortex (P < .008); increases in the left thalamus approached but did not reach statistical significance (P = .07).
These findings are consistent with results of previous functional neuroimaging studies and contemporary neurocircuitry models of OCD. The data further implicate orbitofrontal cortex, caudate nucleus, and anterior cingulate cortex in the pathophysiology of OCD and in mediating OCD symptoms.
本研究旨在确定强迫症（OCD）的中介神经解剖结构。
使用半衰期短的示踪剂氧15标记二氧化碳，以便在静息状态和激发（有症状）状态下，对8例强迫症患者分别进行多次正电子发射断层扫描以测定局部脑血流量。
与配对的无害刺激相比，通过强迫症类似量表的自我报告测量，个体化定制的激发性刺激成功诱发了强迫症症状（P = 0.002）。总体减法图像显示，在强迫症有症状状态与静息状态相比，右侧尾状核（P < 0.006）、左侧前扣带回皮质（P < 0.045）和双侧眶额皮质（P < 0.008）的相对局部脑血流量有统计学显著增加；左侧丘脑的增加接近但未达到统计学显著性（P = 0.07）。
这些发现与先前功能性神经影像学研究结果及当代强迫症神经回路模型一致。数据进一步表明眶额皮质、尾状核和前扣带回皮质在强迫症的病理生理学及介导强迫症症状中起作用。
Zotero 插件