Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder
Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder
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DOI：
10.1016/s0193-953x(05)70181-7
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发表时间：
2000-09-01
影响因子：
1.7
通讯作者：
Rauch, SL
中科院分区：
文献类型：
--
作者：
Saxena, S;Rauch, SL
神经影像学的进步使人们对强迫症的神经生物学有了更深入的了解，并提供了强有力的证据表明，强迫症的病理生理学与沿着特定的额叶-皮层下脑回路的功能异常有关。功能性神经影像学研究，包括单光子发射计算机断层扫描，正电子发射断层扫描，磁共振波谱和功能性磁共振成像，提供了最新的审查和分析。还审查了基础科学文献的功能性神经解剖学的皮质基底神经节丘脑皮质电路，并将这些信息与神经影像学数据在强迫症，提出了一个理论模型的大脑调解的强迫症症状和治疗反应。功能性神经影像学研究表明，强迫症的症状是由眶额皮层下回路的过度活跃介导的，这可能是由直接和间接纹状体-苍白球通路之间的张力不平衡引起的。5-羟色胺能药物可能通过间接与直接眶额皮层下通路改变张力的相对平衡来改善强迫症症状，治疗降低了症状状态下存在的整个回路的活性。
Advances in neuroimaging have led to a greater understanding of the neurobiology of obsessive-compulsive disorder, providing strong evidence that its pathophysiology involves abnormal functioning along specific frontal-subcortical brain circuits. An updated review and analysis of the functional neuroimaging studies, including single photon emission computed tomography, positron emission tomography, magnetic resonance spectroscopy, and functional magnetic resonance imaging, is provided. Also reviewed is the basic science literature on the functional neuroanatomy of corticobasal gangliathalamocortical circuits, and this information is integrated with neuroimaging data in obsessive-compulsive disorder to present a theoretic model of brain mediation of obsessive-compulsive disorder symptoms and response to treatment. Functional neuroimaging studies indicate that obsessive-compulsive disorder symptoms are mediated by hyperactivity in orbitofrontal-subcortical circuits that may be caused by an imbalance of tone between direct and indirect striatopallidal pathways. Serotonergic drugs may ameliorate obsessive-compulsive disorder symptoms by changing the relative balance of tone through the indirect versus direct orbitofrontal-subcortical pathways, with therapy decreasing activity in the overall circuit that exists in the symptomatic state.