强迫症决策功能的神经机制和评估

Neural mechanism and evaluation of decision-making function in obsessive-compulsive disorder

强迫症是一种复杂的慢性致残性神经精神障碍,从神经生物学基础而言,其与大脑的一些重要脑区如眶额皮质、前扣带皮层有关。同时,神经影像学研究也表明与决策功能相关的脑区有眶额皮质、背外侧前额叶等。由此可见,强迫症与决策功能有一定的神经生物学相关性。决策功能受损是强迫症的典型临床表现,而且强迫症的发病与异常决策功能也有相关性。通常决策可分为风险模糊下决策和风险明确下决策,常用的评估前者的任务主要是爱荷华博弈任务,评估后者的有色子任务等。该文对强迫症中决策功能的神经机制和评估进行综述。

Obsessive-compulsive disorder （OCD） is a chronic, disabling, mental disorder, which has been linked to significant abnormalities in certain brain areas, including the orbital frontal cortex and the anterior cingulate cortex. Neuroimaging studies have also shown that brain areas related to the decision-making function include the orbital frontal cortex and the dorsal prefrontal lobes. Furthermore, the association between OCD and decisionmaking function has been consistently demonstrated from a neurobiological perspective. Clinically, impaired decision-making ability is commonly observed in OCD patients, and there is a correlation between OCD and abnormal decision function. Decision-making tasks are typically divided into two types, decision-making under risk and decision-making under ambiguity, with the former commonly evaluated using the Iowa Gambling Task （IGT） and the latter using the Game of Dice Task （GDT）. In this article the neural mechanism and evaluation methods of decision making in OCD were reviewed.