An exploratory study of the neural mechanisms of decision making in compulsive hoarding.
An exploratory study of the neural mechanisms of decision making in compulsive hoarding.
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强迫性囤积决策神经机制的探索性研究。
DOI：
10.1017/s0033291708003371
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发表时间：
2009
影响因子：
6.9
通讯作者：
Maltby,N
中科院分区：
文献类型：
--
作者：
Tolin,DF;Kiehl,KA;Worhunsky,P;Book,GA;Maltby,N
背景先前的研究已经提出了与强迫性囤积相关的独特的神经活动模式。然而，到目前为止，还没有研究检查过囤积症状患者在决定是否保留或丢弃物品时的实际过程。越来越多的临床数据和实验精神病理学研究表明，囤积与决策能力受损有关;因此，了解囤积症患者决策异常的神经基础是很重要的。方法12名被诊断为强迫性囤积症的成年患者，其中17%也符合强迫症（OCD）的标准，和12名匹配的健康对照者进行功能性磁共振成像（fMRI），同时决定是否丢弃带到实验室的个人纸质物品（例如垃圾邮件）以及不属于他们的对照物品。项目保存或销毁后，每个decision.ResultsWhen决定是否保留或丢弃个人的财产，强迫囤积参与者表现出过度的血流动力学活动，在外侧眶额皮质和海马旁回。在囤积参与者中，决定保持个人财产与更大的活动，在上级颞回，颞中回，内侧额回，前扣带皮层，中央前回，小脑比决定放弃个人positions.ConclusionsThese结果提供了部分支持的决策过程的并发症的基础上出现的强迫囤积模型。他们还认为，强迫性囤积的特点可能是在奖励的处理和奖励的偶然性的变化，特别是当这些被认为是惩罚的焦点赤字。
BackgroundPrior studies have suggested unique patterns of neural activity associated with compulsive hoarding. However, to date no studies have examined the process of making actual decisions about whether to keep or discard possessions in patients with hoarding symptoms. An increasing body of clinical data and experimental psychopathology research suggests that hoarding is associated with impaired decision making; therefore, it is important to understand the neural underpinnings of decision-making abnormalities in hoarding patients.MethodTwelve adult patients diagnosed with compulsive hoarding, 17% of whom also met criteria for obsessive–compulsive disorder (OCD), and 12 matched healthy controls underwent functional magnetic resonance imaging (fMRI) while making decisions about whether or not to discard personal paper items (e.g. junk mail) brought to the laboratory as well as control items that did not belong to them. Items were either saved or destroyed following each decision.ResultsWhen deciding about whether to keep or discard personal possessions, compulsive hoarding participants displayed excessive hemodynamic activity in lateral orbitofrontal cortex and parahippocampal gyrus. Among hoarding participants, decisions to keep personal possessions were associated with greater activity in superior temporal gyrus, middle temporal gyrus, medial frontal gyrus, anterior cingulate cortex, precentral gyrus, and cerebellum than were decisions to discard personal possessions.ConclusionsThese results provide partial support for an emerging model of compulsive hoarding based on complications of the decision-making process. They also suggest that compulsive hoarding may be characterized by focal deficits in the processing of reward and changes in reward contingencies, particularly when these are perceived to be punishing.