Assessing neurocognitive function in psychiatric disorders: a roadmap for enhancing consensus.
Assessing neurocognitive function in psychiatric disorders: a roadmap for enhancing consensus.
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DOI：
10.1016/j.nlm.2014.06.011
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发表时间：
2014-11
影响因子：
2.7
通讯作者：
Simpson, H. Blair
中科院分区：
文献类型：
--
作者：
Ahmari, Susanne E.;Eich, Teal;Cebenoyan, Deniz;Smith, Edward E.;Simpson, H. Blair
关键词：
在强迫症（OCD）患者的多项研究中，确定一致的核心神经认知缺陷一直具有挑战性。反过来，这导致难以将人类研究的结果转化为动物模型来剖析病理生理学。在这篇文章中，我们使用的工作记忆任务的强迫症患者的主要数据来说明这个问题。工作记忆缺陷已被提出作为一个解释模型的演变检查强迫症患者的一个子集。然而，由于任务设计、空间与文字工作记忆检查的差异以及患者人群的异质性，研究结果喜忧参半。因此，两个主要的问题仍然存在：第一，强迫症患者是否有工作记忆障碍？第二，如果强迫症患者存在工作记忆缺陷，它们会导致检查强迫症吗？为了研究这些问题，我们测试了19名未服药的强迫症患者和23名匹配的健康对照者，使用的是一项与经典数字跨度任务相比难度/任务负荷增加的言语工作记忆任务。与健康对照组相比，强迫症患者在这项任务上的表现没有显着差异，无论使用的结果测量（即反应时间或准确性）。探索性分析表明，尽管在具有最高工作记忆负荷的试验中表现正常，但具有主要怀疑/检查症状的患者子集可能具有降低的记忆信心。这些结果表明，检查强迫症的其他病因因素应予以考虑。此外，他们作为讨论的试金石，因此帮助我们产生一个路线图，以增加在精神疾病的神经认知功能评估的共识。
It has been challenging to identify core neurocognitive deficits that are consistent across multiple studies in patients with Obsessive Compulsive Disorder (OCD). In turn, this leads to difficulty in translating findings from human studies into animal models to dissect pathophysiology. In this article, we use primary data from a working memory task in OCD patients to illustrate this issue. Working memory deficiencies have been proposed as an explanatory model for the evolution of checking compulsions in a subset of OCD patients. However, findings have been mixed due to variability in task design, examination of spatial vs. verbal working memory, and heterogeneity in patient populations. Two major questions therefore remain: first, do OCD patients have disturbances in working memory? Second, if there are working memory deficits in OCD, do they cause checking compulsions?. In order to investigate these questions, we tested 19 unmedicated OCD patients and 23 matched healthy controls using a verbal working memory task that has increased difficulty/task-load compared to classic digit-span tasks. OCD patients did not significantly differ in their performance on this task compared to healthy controls, regardless of the outcome measure used (i.e. reaction time or accuracy). Exploratory analyses suggest that a subset of patients with predominant doubt/checking symptoms may have decreased memory confidence despite normal performance on trials with the highest working memory load. These results suggest that other etiologic factors for checking compulsions should be considered. In addition, they serve as a touchstone for discussion, and therefore help us to generate a roadmap for increasing consensus in the assessment of neurocognitive function in psychiatric disorders.
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