Neurobiology of Obsessive-Compulsive Hoarding

强迫性囤积症的神经生物学

• 批准号: 6820855
• 负责人: SANJAYA SAXENA
• 金额: $ 50.14万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6820855
• 关键词: aggression; behavioral /social science research tag; brain electrical activity; brain metabolism; brain morphology; cingulate gyrus; clinical research; cognition; decision making; glucose metabolism; human subject; magnetic resonance imaging; neural information processing; neurobiology; neuropsychological tests; neuropsychology; obsessive compulsive disorder; positron emission tomography; serotonin inhibitor

DESCRIPTION (provided by applicant): Although standard diagnostic classifications consider obsessive-compulsive disorder (OCD) to be a single diagnostic entity, it has become clear that several different symptom subtypes of OCD exist. The principal OCD symptom factors are: 1) aggressive obsessions with checking compulsions; 2) symmetry obsessions with arranging and repeating compulsions; 3) contamination obsessions with cleaning compulsions; and 4) hoarding/saving symptoms. These symptom factors show different genetic inheritance, comorbidity, and treatment response. But since virtually all prior studies of OCD have grouped patients with diverse symptom patterns together, it is not known whether OCD symptom factors differ from one another in terms of pathophysiology. Hoarding/saving symptoms, found in 20% - 42% of OCD patients, are part of a discrete clinical syndrome that includes information-processing deficits and difficulty with decision-making. It can cause severe disability and is a strong predictor of poor response to standard treatments for OCD. A better understanding of the neurobiology of compulsive hoarding is required to develop more effective treatments for this syndrome. Yet, despite its common occurrence and clinical significance, no study to date has investigated the neurobiology of obsessive-compulsive hoarding in humans. Pilot functional neuroimaging data from our research team suggest that patients with the compulsive hoarding syndrome have significantly lower rates of glucose metabolism in the anterior and posterior cingulate gyrus than normal controls and non-hoarding OCD patients, and that cingulate metabolism is negatively correlated with the severity of compulsive hoarding/saving symptoms. The objectives of the proposed research are to confirm and extend these preliminary findings in a more definitive study with a larger and more homogeneous sample of subjects selected prospectively, and also to identify structural neuroanatomical and neurocognitive abnormalities associated with the compulsive hoarding syndrome. This study will compare age- and sex-matched groups of 24 compulsive hoarders, 24 non-hoarding OCD patients, and 24 normal Controls, using [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) to measure cerebral glucose metabolism, quantitative magnetic resonance imaging to measure regional brain volumes and morphology, and neuropsychological testing to measure cognitive deficits, before and after standardized treatment with a serotonin reuptake inhibitor (SRI). The long-term goal is to develop more effective treatments for compulsive hoarding, based on an improved understanding of its pathophysiology.

描述（由申请人提供）：虽然标准诊断分类认为强迫症（OCD）是一个单一的诊断实体，但很明显，强迫症存在几种不同的症状亚型。强迫症的主要症状有：1)攻击性强迫伴检查性强迫；2)对排列和重复强迫的对称迷恋；3)污染强迫症与清洁强迫症；4)囤积/储蓄症状。这些症状因素表现出不同的遗传、合并症和治疗反应。但是，由于几乎所有先前的强迫症研究都将不同症状模式的患者分组在一起，因此不知道强迫症症状因素在病理生理方面是否彼此不同。囤积/储蓄症状在20% - 42%的强迫症患者中发现，是一种独立的临床综合征的一部分，包括信息处理缺陷和决策困难。它会导致严重的残疾，是强迫症标准治疗效果不佳的一个强有力的预测指标。我们需要更好地了解强迫性囤积症的神经生物学，以开发出更有效的治疗方法。然而，尽管它的常见现象和临床意义，迄今为止还没有研究调查人类强迫性囤积症的神经生物学。