Altered olfactory processing and increased insula activity in patients with obsessive-compulsive disorder: An fMRI study.
Altered olfactory processing and increased insula activity in patients with obsessive-compulsive disorder: An fMRI study.
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DOI：
10.1016/j.pscychresns.2017.01.012
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发表时间：
2017-04-30
期刊：
影响因子：
--
通讯作者：
Goodman W
中科院分区：
文献类型：
--
作者：
Berlin HA;Stern ER;Ng J;Zhang S;Rosenthal D;Turetzky R;Tang C;Goodman W
与健康对照组相比，强迫症（OCD）患者对恶心诱导图像的激活增加。我们探讨是否这种厌恶反应也存在于嗅觉领域进行了第一次功能磁共振成像研究的嗅觉强迫症。在15名强迫症和15名HC参与者中使用功能磁共振成像研究了对愉快和不愉快气味（与无味空气）的神经激活。强迫症参与者（与HC相比）对难闻气味（与无味空气相比）的左前额叶激活增加，这与他们的厌恶敏感性和对这些气味的不愉快和强度的评级呈正相关。强迫症参与者（与HC相比）表现出尾状核和左前、后丘脑对愉快气味的激活增加（与无味空气相比），这与他们的强迫症症状严重程度、特质焦虑、厌恶感频率和气味强度等级呈正相关。强迫症参与者对愉快和不愉快的气味都有增加的前额叶激活，这与他们的强迫症症状，焦虑，厌恶敏感性和厌恶感的频率有关。强迫症患者可能有一个负面的认知偏见，并经历所有的刺激，无论效价，比健康人更不愉快。这些发现进一步阐明了强迫症的神经基础，并可能有助于更有效的治疗。
Obsessive-compulsive disorder (OCD) patients show increased insula activation to disgust-inducing images compared to healthy controls (HC). We explored whether this disgust reactivity was also present in the olfactory domain by conducting the first fMRI study of olfaction in OCD. Neural activation in response to pleasant and unpleasant odors (vs. unscented air) was investigated in 15 OCD and 15 HC participants using fMRI. OCD participants (vs. HC) had increased left anterior insula activation to unpleasant odors (vs. unscented air), which positively correlated with their disgust sensitivity and ratings of the unpleasantness and intensity of those odors. OCD participants (vs. HC) showed increased activation of caudate nucleus and left anterior and posterior insula to pleasant odors (vs. unscented air), which positively correlated with their OCD symptom severity, trait anxiety, frequency of feeling disgust, and odor intensity ratings. OCD participants had increased anterior insula activation to both pleasant and unpleasant odors, which correlated with their OCD symptoms, anxiety, disgust sensitivity, and frequency of feeling disgust. OCD patients might have a negative cognitive bias and experience all stimuli, regardless of valence, as being more unpleasant than healthy people. These findings further elucidate the neural underpinnings of OCD and may contribute to more effective treatments.