Brain-behavior relationships in obsessive-compulsive disorder.
Brain-behavior relationships in obsessive-compulsive disorder.
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DOI：
10.1053/scnp.2001.21833
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发表时间：
2001-04-01
期刊：
影响因子：
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通讯作者：
Brody, A L
中科院分区：
文献类型：
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作者：
Saxena, S;Bota, R G;Brody, A L
神经影像学的进步使人们对强迫症（OCD）的大脑行为关系有了更深入的了解。本文提供了一个最新的审查和分析的结构和功能的神经影像学研究在强迫症发表的日期，并讨论了如何从各种类型的神经影像学研究的证据已被合成，以产生和测试有关这些关系的假设。我们还回顾了皮质-基底节-丘脑-皮质回路的功能性神经解剖学的基础科学文献，并将这些信息与强迫症的神经影像学数据相结合，提出了强迫症症状和治疗反应的脑介导的理论模型。两者合计，神经影像学研究表明，强迫症症状介导的眶额皮层下回路，这可能是由于直接和间接纹状体苍白球通路之间的张力失衡的过度活跃。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，从而降低存在于症状状态下的整个回路的活性，从而改善强迫症症状。
Advances in neuroimaging have led to a greater understanding of brain-behavior relationships in obsessive-compulsive disorder (OCD). This article provides an updated review and analysis of the structural and functional neuroimaging studies in OCD published to date and discusses how evidence from various types of neuroimaging studies has been synthesized to generate and test hypotheses regarding these relationships. We also review the basic science literature on the functional neuroanatomy of cortico-basal ganglia-thalamo-cortical circuits and integrate this information with neuroimaging data in OCD, to present a theoretical model of brain mediation of OCD symptoms and response to treatment. Taken together, neuroimaging studies indicate that OCD symptoms are mediated by hyperactivity in orbitofrontal-subcortical circuits, which may be attributable to an imbalance of tone between direct and indirect striato-pallidal pathways. Serotonergic drugs may ameliorate OCD symptoms by changing the relative balance of tone through the indirect versus direct orbitofrontal-subcortical pathways, thereby decreasing activity in the overall circuit that exists in the symptomatic state.