Schizotypy and smooth pursuit eye movements as potential endophenotypes of obsessive-compulsive disorder
Schizotypy and smooth pursuit eye movements as potential endophenotypes of obsessive-compulsive disorder
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DOI：
10.1007/s00406-018-0899-x
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发表时间：
2019-03-01
影响因子：
4.7
通讯作者：
Wagner, Michael
中科院分区：
文献类型：
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作者：
Bey, Katharina;Meyhoefer, Inga;Wagner, Michael
强迫症（OCD）患者表现出额-纹状体回路功能障碍，这意味着相应的眼功能缺陷，包括平滑追踪眼球运动（SPEM）。然而，SPEM缺陷的证据并不确定，一些研究报告速度增加减少，而另一些研究则没有发现强迫症患者有任何SPEM功能障碍。有趣的是，类似精神病的特征一再与强迫症和受损的SPEM有关。在这里，我们检查了一个大样本的n=168例强迫症患者，n=93未受影响的一级亲属和n=171健康对照组，以调查是否升高水平的automotypy和SPEM赤字代表潜在的内表型的强迫症。我们应用了一个SPEM任务与高要求的预测追求，是更敏感的评估执行功能障碍比一个标准的任务与连续的视觉反馈，作为目标空白的情节把基底神经节和前额叶参与的需求增加。此外，我们还研究了强迫症患者及其亲属的脑型和SPEM表现之间的关系。结果表明，强迫症患者和未受影响的亲属在标准或预测性SPEM中均没有表现出缺陷。然而，患者和亲属都表现出高水平的神经质，在未服药和无抑郁症的强迫症患者的标准试验中，神经质与速度增益显著相关。这些发现突出了强迫症的候选内在表型的作用，并增加了越来越多的证据，在强迫症的易感人格特质。此外，完整的增益可能代表了区分强迫症和精神分裂症患者群体的关键特征。
Patients with obsessive-compulsive disorder (OCD) show dysfunctions of the fronto-striatal circuitry, which imply corresponding oculomotor deficits including smooth pursuit eye movements (SPEM). However, evidence for a deficit in SPEM is inconclusive, with some studies reporting reduced velocity gain while others did not find any SPEM dysfunctions in OCD patients. Interestingly, psychosis-like traits have repeatedly been linked to both OCD and impaired SPEM. Here, we examined a large sample of n=168 patients with OCD, n=93 unaffected first-degree relatives and n=171 healthy control subjects to investigate whether elevated levels of schizotypy and SPEM deficits represent potential endophenotypes of OCD. We applied a SPEM task with high demands on predictive pursuit that is more sensitive to assess executive dysfunctions than a standard task with continuous visual feedback, as episodes of target blanking put increased demands on basal ganglia and prefrontal involvement. Additionally, we examined the relation between schizotypy and SPEM performance in OCD patients and their relatives. Results indicate that OCD patients and unaffected relatives do not show deficient performance in either standard or predictive SPEM. Yet, both patients and relatives exhibited elevated levels of schizotypy, and schizotypy was significantly correlated with velocity gain during standard trials in unmedicated and depression-free OCD patients. These findings highlight the role of schizotypy as a candidate endophenotype of OCD and add to the growing evidence for predisposing personality traits in OCD. Furthermore, intact gain may represent a key characteristic that distinguishes the OCD and schizophrenia patient populations.