Obsessive-compulsive disorder: beyond segregated cortico-striatal pathways.
Obsessive-compulsive disorder: beyond segregated cortico-striatal pathways.
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DOI：
10.1016/j.tics.2011.11.003
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发表时间：
2012-01
影响因子：
19.9
通讯作者：
Rauch SL
中科院分区：
文献类型：
--
作者：
Milad MR;Rauch SL
强迫症 (OCD) 影响约 2-3% 的人口，其特征是反复出现的侵入性想法（强迫观念）和重复的行为或精神行为（强迫行为），通常是对强迫观念或相关焦虑的反应。在过去的几十年里，强迫症病理生理学的流行模型主要集中在皮质纹状体回路上。然而，最近的神经影像学证据表明，除了皮质纹状体回路之外，外侧和内侧眶额皮质、背侧前扣带皮层和杏仁核皮质回路也参与了该疾病的病理生理学。在这篇综述中，我们详细阐述了强迫症的病理生理学特征，超越了经典的平行皮质纹状体通路，并认为这一证据表明，除了行为抑制之外，恐惧消退可能在强迫症中受到损害。
Obsessive-compulsive disorder (OCD) affects ∼2-3% of the population and is characterized by recurrent intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions), typically performed in response to obsessions or related anxiety. In the past few decades, the prevailing models of OCD pathophysiology have focused on cortico-striatal circuitry. More recent neuroimaging evidence, however, points to critical involvement of the lateral and medial orbitofrontal cortices, the dorsal anterior cingulate cortex and amygdalo-cortical circuitry, in addition to cortico-striatal circuitry, in the pathophysiology of the disorder. In this review, we elaborate proposed features of OCD pathophysiology beyond the classic parallel cortico-striatal pathways and argue that this evidence suggests that fear extinction, in addition to behavioral inhibition, may be impaired in OCD.