强迫症执行功能障碍的神经机制研究进展

Research progress on neural mechanism of executive dysfunction in obsessive-compulsive disorder

执行功能障碍是强迫症的重要特征。神经影像学和基因研究表明,强迫症患者皮质-纹状体-丘脑-皮质回路、顶叶、小脑等脑区的功能异常,以及5-羟色胺、谷氨酸系统中的基因变异,可能是导致患者执行功能障碍的原因。但由于强迫症的异质性和执行功能的复杂性,目前关于强迫症执行功能障碍的神经机制尚未得出一致的结论。整合强迫症执行功能障碍的神经机制和基因模式,有助于加深对强迫症发病机制的理解;结合神经影像和遗传学研究结果确定标志物,有助于为强迫症执行功能障碍的识别和干预提供新方向。现对强迫症执行功能障碍的脑结构、脑功能的神经机制以及基因研究展开综述。

Executive dysfunction is an important feature of obsessive-compulsive disorder(OCD).Neuroimaging and genetic studies have shown that the functional abnormalities in cortico-striatal-thalamocortical circuits, parietal lobes, cerebellum and other brain regions, as well as genetic variants in serotonin and glutamate systemsin patients with OCD, may lead to their executive dysfunction. However, due to the heterogeneity of OCD and the complexity of executive function, no consistent conclusions have been drawn about the neural mechanism of executive dysfunction in OCD. Integrating the neural mechanisms and genetic patterns of executive dysfunction in OCD will help deepen the understanding of the pathogenesis of OCD;combining neuroimaging and genetic findings to identify markers will help provide new directions in the identification and intervention of executive dysfunction in OCD. This article reviews the brain structure, neural mechanism of brain function and genetic research of executive dysfunction in OCD.