Baumgarten H G, Grozdanovic Z
Institute of Anatomy, University Clinic Benjamin Franklin, Free University of Berlin, Germany.
Br J Psychiatry Suppl. 1998(35):13-20.
Serotonin may play a role in the pathophysiology of obsessive-compulsive disorder (OCD) because of the anti-obsessional effect of selective serotonin reuptake inhibitors (SSRIs).
The literature is reviewed on knowledge of the role of serotonergic neurons in brain function, studies on monoamine metabolites in cerebrospinal fluid (CSF), various stress neuropeptides, neuroendocrine and behavioural challenge after administration of direct and indirect serotomimetic compounds, and neuroanatomical data on brain circuits organising behaviour.
In most of the OCD cases analysed, CSF 5-hydroxyindoleacetic acid and homovanillic acid concentrations do not significantly differ from age-corrected controls. However, a relationship appears to exist between pre-treatment levels of these metabolites and clinical response to drugs acting on the serotonin transporter. Abnormalities in CSF arginine vasopressin, corticotropin-releasing hormone, oxytocin and somatostatin levels have been reported in OCD. Long-term treatment with high-doses of clomipramine, fluvoxamine, and fluoxetine tend to correct these neuropeptide abnormalities.
We hypothesise that continuous treatment with SSRIs alters serotonin turnover and neuropeptide expression patterns in OCD-entertaining functional forebrain/midbrain circuits.
由于选择性5-羟色胺再摄取抑制剂（SSRI）具有抗强迫作用，5-羟色胺可能在强迫症（OCD）的病理生理过程中发挥作用。
综述了关于5-羟色胺能神经元在脑功能中的作用、脑脊液（CSF）中单胺代谢产物的研究、各种应激神经肽、给予直接和间接5-羟色胺模拟化合物后的神经内分泌和行为激发试验，以及关于组织行为的脑回路的神经解剖学数据等方面的知识。
在分析的大多数强迫症病例中，脑脊液中5-羟吲哚乙酸和高香草酸的浓度与经年龄校正的对照组相比无显著差异。然而，这些代谢产物的治疗前水平与作用于5-羟色胺转运体的药物的临床反应之间似乎存在关联。据报道，强迫症患者脑脊液中精氨酸加压素、促肾上腺皮质激素释放激素、催产素和生长抑素水平存在异常。高剂量氯米帕明、氟伏沙明和氟西汀的长期治疗倾向于纠正这些神经肽异常。
我们推测，SSRI的持续治疗会改变强迫症相关的功能性前脑/中脑回路中的5-羟色胺周转率和神经肽表达模式。
