Abstract
The paper presents a concise review of investigations into the role of impaired frontal-subcortical circuits in the development of obsessive-compulsive disorder (OCD). It gives data on the frequency of neurosis-like symptoms of the OCD spectrum in neurological diseases. The development of OCD is associated with an imbalance between the activity of the direct (activating) and indirect (inhibitory) pathways of the cortico-striatal-thalamo-cortical feedback loop. These data are confirmed by the results of neuroimaging and neuropsychological studies in patients with OCD. The frequency of OCD symptoms is high in organic brain lesions. OCP may be a manifestation of neurological diseases so their timely detection is an important aspect of a neurologist's work. The treatment of patients with neurosis-like disorders of the OCD spectrum within neurological diseases requires a multidisciplinary approach with the participation of a neurologist, a psychiatrist/psychotherapist, and a psychologist. It is necessary to combine pathogenetic treatment of the underlying disease and its neurosis-like manifestations.
Highlights
The paper presents a concise review of investigations into the role of impaired frontal-subcortical circuits in the development of obsessive-compulsive disorder (OCD)
The development of OCD is associated with an imbalance between the activity of the direct and indirect pathways of the cortico-striatal-thalamo-cortical feedback loop
These data are confirmed by the results of neuroimaging and neuropsychological studies in patients with OCD
Summary
Вентральный и вентромедиальный отделы головки хвостатого ядра, вентральные и дорсомедиальные ядра таламуса. Есть данные об уменьшении уровня глутамата в поясной извилине и повышении содержания глутамата и глутамина в орбитофронтальной коре при ОКР. В одном исследовании у пациентов с ОКР отмечалось увеличение уровня глутамина и глутамата в области головки хвостатого ядра, а уменьшение выраженности симптомов на фоне лечения пароксетином приводило к снижению пика глутамина и глутамата по данным МРС [15]. Однако некоторые авторы не обнаружили изменений при проведении МРС у пациентов с ОКР [15]. Соединяющих орбитофронтальную кору и полосатое тело у животных, приводила к развитию повторяющихся поведенческих паттернов, например умывания. Вместе с тем активация латеральной орбитофронтальной коры и полосатого тела у животных с симптомами ОКР за счет делеции гена Dlgap вызывала подавление повторяющихся поведенческих паттернов [16]
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