NEUROBIOLOGY OF OBSESSIVE-COMPULSIVE HOARDING

强迫性囤积症的神经生物学

• 批准号: 7369454
• 负责人: SANJAYA SAXENA
• 金额: $ 0.51万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7369454
• 关键词: NEUROBIOLOGY; OBSESSIVE; COMPULSIVE; HOARDING

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. 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.

该子项目是利用 NIH/NCRR 资助的中心拨款提供的资源的众多研究子项目之一。子项目和研究者 (PI) 可能已从另一个 NIH 来源获得主要资金，因此可以在其他 CRISP 条目中得到体现。列出的机构是中心的机构，不一定是研究者的机构。尽管标准诊断分类将强迫症 (OCD) 视为单一诊断实体，但很明显 OCD 存在几种不同的症状亚型。强迫症症状的主要因素是： 1） 强烈的强迫性强迫症； 2）对排列和重复强迫症的对称性痴迷； 3）污染强迫症和清洁强迫症； 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。但由于几乎所有先前的强迫症研究都将具有不同症状模式的患者分组在一起，因此尚不清楚强迫症症状因素在病理生理学方面是否彼此不同。 20% - 42% 的强迫症患者存在囤积/储蓄症状，这是一种离散的临床综合征的一部分，包括信息处理缺陷和决策困难。它可能导致严重残疾，并且是强迫症标准治疗反应不佳的有力预测因素。需要更好地了解强迫性囤积症的神经生物学，才能开发出针对这种综合症的更有效的治疗方法。然而，尽管其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。 我们研究小组的初步功能性神经影像数据表明，强迫性囤积综合征患者的前扣带回和后扣带回葡萄糖代谢率显着低于正常对照和非囤积强迫症患者，并且扣带回代谢与强迫性囤积/储蓄症状的严重程度呈负相关。拟议研究的目的是在一项更明确的研究中通过前瞻性选择更大、更同质的受试者样本来确认和扩展这些初步发现，并确定与强迫性囤积综合症相关的结构性神经解剖学和神经认知异常。本研究将比较年龄和性别匹配的 24 名强迫性囤积症患者、24 名非囤积症强迫症患者和 24 名正常对照组，使用 [18F]-氟脱氧葡萄糖正电子发射断层扫描 (FDG-PET) 测量脑葡萄糖代谢，使用定量磁共振成像测量区域脑体积和形态，并使用神经心理学测试测量认知能力 血清素再摄取抑制剂（SRI）标准化治疗前后的缺陷。长期目标是在更好地了解强迫性囤积症病理生理学的基础上，开发更有效的治疗方法。