Defining functional brain networks underlying obsessive-compulsive disorder (OCD) using treatment-induced neuroimaging changes: a systematic review of the literature.
Defining functional brain networks underlying obsessive-compulsive disorder (OCD) using treatment-induced neuroimaging changes: a systematic review of the literature.
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DOI：
10.1136/jnnp-2020-324478
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Sheth SA
中科院分区：
文献类型：
--
作者：
Bijanki KR;Pathak YJ;Najera RA;Storch EA;Goodman WK;Simpson HB;Sheth SA
大约2%-3%的人口患有强迫症（OCD）。几个脑区已被牵连在强迫症的病理生理学，但他们的各种贡献仍然不清楚。我们检查了各种治疗干预前后的结构和功能神经影像学变化，作为识别相关潜在网络的指标。我们确定了1990年至2020年的64项研究，比较了强迫症患者的治疗前和治疗后成像，包括代谢和灌注，神经化学，结构，功能和基于连接的模式。治疗类别包括药物治疗、认知行为治疗/暴露和反应预防、立体定向损伤、脑深部刺激和经颅磁刺激。尽管治疗和神经影像学方式存在异质性，但几个脑区的变化是一致的，并与治疗反应相对应。最显著的是尾状核、前扣带皮层、丘脑和前额叶皮层（PFC）区域（包括眶额皮层（OFC）、背外侧PFC（DLPFC）、腹内侧PFC（VMPFC）和腹外侧PFC（VLPFC））的代谢和灌注减少。调节皮质-纹状体-丘脑-皮质系统区域内的活性可能是各种治疗的常见治疗机制。我们确定了未来的需求和当前的知识差距，可以通过实施综合方法来缓解。未来的研究应纳入一个系统的，分析的方法来测试治疗反应的客观相关性，以更好地了解功能障碍的神经生理学机制。
Approximately 2%–3% of the population suffers from obsessive–compulsive disorder (OCD). Several brain regions have been implicated in the pathophysiology of OCD, but their various contributions remain unclear. We examined changes in structural and functional neuroimaging before and after a variety of therapeutic interventions as an index into identifying the underlying networks involved. We identified 64 studies from 1990 to 2020 comparing pretreatment and post-treatment imaging of patients with OCD, including metabolic and perfusion, neurochemical, structural, functional and connectivity-based modalities. Treatment class included pharmacotherapy, cognitive–behavioural therapy/exposure and response prevention, stereotactic lesions, deep brain stimulation and transcranial magnetic stimulation. Changes in several brain regions are consistent and correspond with treatment response despite the heterogeneity in treatments and neuroimaging modalities. Most notable are decreases in metabolism and perfusion of the caudate, anterior cingulate cortex, thalamus and regions of prefrontal cortex (PFC) including the orbitofrontal cortex (OFC), dorsolateral PFC (DLPFC), ventromedial PFC (VMPFC) and ventrolateral PFC (VLPFC). Modulating activity within regions of the cortico-striato-thalamo-cortical system may be a common therapeutic mechanism across treatments. We identify future needs and current knowledge gaps that can be mitigated by implementing integrative methods. Future studies should incorporate a systematic, analytical approach to testing objective correlates of treatment response to better understand neurophysiological mechanisms of dysfunction.
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影响因子：
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作者：
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DOI：
10.1016/j.jaac.2010.08.007
发表时间：
2010-12-01
影响因子：
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作者：
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