Reduced orbitofrontal-striatal activity on a reversal learning task in obsessive-compulsive disorder
Reduced orbitofrontal-striatal activity on a reversal learning task in obsessive-compulsive disorder
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DOI：
10.1001/archpsyc.63.11.1225
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发表时间：
2006-11-01
影响因子：
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通讯作者：
Veltman, Dick J.
中科院分区：
文献类型：
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作者：
Remijnse, Peter L.;Nielen, Marjan M. A.;Veltman, Dick J.
内容：眶额皮层-纹状体回路对动机行为具有重要作用，根据目前的强迫症神经生物学模型，该回路被认为参与了强迫症的病理生理过程。然而，在强迫症中的这种神经回路的参与还没有在认知激活成像paradigm.Objective直接测试过：为了确定在认知挑战过程中强迫症患者的眶额皮层和腹侧纹状体是否表现出异常的神经活动。设计：在一次事件中，20名未接受药物治疗的强迫症患者和27名健康对照者进行了反向学习任务，相关的功能磁共振成像实验，使用对OFC信号敏感的扫描序列。这种设计允许调查的神经相关的奖励和惩罚的接收，以及“情感转换”，即改变行为的逆转强化contingencies.Results：强迫症患者表现出受损的任务最终结果反映的正确反应相对于对照组的数量减少，但表现出足够的行为上收到的惩罚和关于情感转换。在奖励结果中，与对照组相比，患者的右侧内侧和外侧眶额皮层以及右侧尾状核（腹侧纹状体边界区）的反应性降低。在情感转换过程中，患者招募左后眶额皮层，双侧岛叶皮层，双侧背外侧和双侧前额叶皮层在较小程度上比对照组。没有发现患者表现出增加活动相对于控制，并没有差异激活观察到惩罚在一个直接的组comparation.Conclusions：这些数据显示行为障碍伴随着异常的OFC-纹状体和背侧前额叶活动强迫症的逆转学习任务，解决这个电路的功能。这些发现不仅证实了以前的报告，背侧前额叶功能障碍的强迫症，但也提供了证据，参与的OFC纹状体回路的病理生理强迫症。
Context: The orbitofrontal cortex (OFC)-striatal circuit, which is important for motivational behavior, is assumed to be involved in the pathophysiology of obsessive-compulsive disorder (OCD) according to current neurobiological models of this disorder. However, the engagement of this neural loop in OCD has not been tested directly in a cognitive activation imaging paradigm so far.Objective: To determine whether the OFC and the ventral striatum show abnormal neural activity in OCD during cognitive challenge.Design: A reversal learning task was employed in 20 patients with OCD who were not receiving medication and 27 healthy controls during an event-related functional magnetic resonance imaging experiment using a scanning sequence sensitive to OFC signal. This design allowed investigation of the neural correlates of reward and punishment receipt as well as of "affective switching," ie, altering behavior on reversing reinforcement contingencies.Results: Patients with OCD exhibited an impaired task end result reflected by a reduced number of correct responses relative to control subjects but showed adequate behavior on receipt of punishment and with regard to affective switching. On reward outcome, patients showed decreased responsiveness in right medial and lateral OFC as well as in the right caudate nucleus (border zone ventral striatum) when compared with controls. During affective switching, patients recruited the left posterior OFC, bilateral insular cortex, bilateral dorsolateral, and bilateral anterior prefrontal cortex to a lesser extent than control subjects. No areas were found for which patients exhibited increased activity relative to controls, and no differential activations were observed for punishment in a direct group comparison.Conclusions: These data show behavioral impairments accompanied by aberrant OFC-striatal and dorsal prefrontal activity in OCD on a reversal learning task that addresses this circuit's function. These findings not only confirm previous reports of dorsal prefrontal dysfunction in OCD but also provide evidence for the involvement of the OFC-striatal loop in the pathophysiology of OCD.