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| 强迫症认知灵活性减退的神经环路机制研究进展 |
| Advances in the study of neural pathways of reduced cognitive flexibility in obsessive-compulsive disorder JI Li, SUN Xiao-hong, YANG Zi-cheng, LEI Hui-meng. Department of Neurobiology, School of Basic Medicine, Capital Medical University, Beijing 100069, China |
| 投稿时间：2023-07-17 修订日期：2023-07-17 |
| DOI： |
| 中文关键词: 强迫症 认知灵活性 前额叶皮层 纹状体 丘脑 神经环路机制 |
| 英文关键词: obsessive-compulsive disorder cognitive flexibility prefrontal cortex striatum thalamus neural circuit |
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| 中文摘要: |
| 强迫症是一种以强迫性思维与刻板样行为为主要特征的致残性神经精神疾病,但目前临床治疗有效性欠佳。强迫症的发生发展与认知灵活性减退密切相关,认知灵活性减退即患者灵活转变自身心理过程和行为以适应环境变化的能力显著下降,临床研究发现前额叶皮层、纹状体和丘脑等多个脑区参与调控认知灵活性。临床非侵入性成像技术证实大脑皮层与皮层下基底神经节之间的神经环路功能障碍可能是强迫症产生的神经机制。此外,通过实验室动物模型的建立和研究,已经初步证明了细胞和分子功能障碍引发刻板样行为的神经环路的存在,进一步加深了对强迫症认知灵活性减退神经环路机制的理解,但具体机制尚未完全清楚。现今临床通过应用5-羟色胺再摄取抑制剂和认知行为疗法能够一定程度上缓解病情,针对难治性强迫症开发了一些神经外科手术疗法,但这些治疗方法副作用大,治疗风险高,效果不显著,难以满足广大患者的需求,因此在现有基础上创新开发高效治疗手段十分必要。本文旨在回顾并总结以往关于强迫症认知灵活性发生机制的研究方法和研究结论,在神经环路水平层面为强迫症引起的认知灵活性减退症状的临床治疗提供理论基础,为未来强迫症治疗方法的开发提供参考。 |
| 英文摘要: |
| Obsessive-compulsive disorder is a disabling neuropsychiatric disorder characterized by obsessive-compulsive thinking and stereotypical behavior, but the effectiveness of current clinical treatment still remain elusive. The development of OCD is closely related to reduced cognitive flexibility, which is a significant reduction in the ability of patients to flexibly shift their mental processes and behaviors to adapt to changes in the environment. Clinical non-invasive imaging techniques have confirmed that dysfunctional neural circuits between the cerebral cortex and the subcortical basal ganglia may be the neural substrate underlying OCD. In addition, the existence of neural circuits that trigger stereotype-like behavior through cellular and molecular dysfunction has been tentatively demonstrated through the establishment and study of laboratory animal models, furthering the understanding of the neural circuitry mechanisms underlying impaired cognitive flexibility in OCD, although the exact mechanisms are not yet fully understood. The use of 5-hydroxytryptamine reuptake inhibitors and cognitive-behavioral therapies have provided some relief, and some neurosurgical treatments have been developed for refractory OCD. However, these treatments have significant side effects, high treatment risks, and low efficacy, making it difficult to meet the needs of patients. The aim of this paper is to review and summarize the methods and findings of previous studies on the mechanisms underlying the development of cognitive flexibility in OCD, to provide a theoretical basis for the clinical treatment of the symptoms of reduced cognitive flexibility caused by OCD at the neural circuit level, and to provide a reference for the development of future treatments for OCD. |
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