1
|
Tosta CL, Silote GP, Fracalossi MP, Sartim AG, Andreatini R, Joca SRL, Beijamini V. S-ketamine reduces marble burying behaviour: Involvement of ventromedial orbitofrontal cortex and AMPA receptors. Neuropharmacology 2019; 144:233-243. [DOI: 10.1016/j.neuropharm.2018.10.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/23/2018] [Accepted: 10/28/2018] [Indexed: 12/19/2022]
|
2
|
Zhong Z, Zhao T, Luo J, Guo Z, Guo M, Li P, Sun J, He Y, Li Z. Abnormal topological organization in white matter structural networks revealed by diffusion tensor tractography in unmedicated patients with obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2014; 51:39-50. [PMID: 24440373 DOI: 10.1016/j.pnpbp.2014.01.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 01/06/2014] [Accepted: 01/07/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder defined by recurrent thoughts, intrusive and distressing impulses, or images and ritualistic behaviors. Although focal diverse regional abnormalities white matter integrity in specific brain regions have been widely studied in populations with OCD, alterations in the structural connectivities among them remain poorly understood. OBJECTIVE The aim was to investigate the abnormalities in the topological efficiency of the white matter networks and the correlation between the network metrics and Yale-Brown Obsessive-Compulsive Scale scores in unmedicated OCD patients, using diffusion tensor tractography and graph theoretical approaches. METHODS This study used diffusion tensor imaging and deterministic tractography to map the white matter structural networks in 26 OCD patients and 39 age- and gender-matched healthy controls; and then applied graph theoretical methods to investigate abnormalities in the global and regional properties of the white matter network in these patients. RESULTS The patients and control participants both showed small-world organization of the white matter networks. However, the OCD patients exhibited significant abnormal global topology, including decreases in global efficiency (t = -2.32, p = 0.02) and increases in shortest path length, Lp (t = 2.30, p = 0.02), the normalized weighted shortest path length, λ (t = 2.08, p=0.04), and the normalized clustering coefficient, γ (t = 2.26, p = 0.03), of their white matter structural networks compared with healthy controls. Further, the OCD patients showed a reduction in nodal efficiency predominately in the frontal regions, the parietal regions and caudate nucleus. The normalized weighted shortest path length of the network metrics was significantly negatively correlated with obsessive subscale of the Yale-Brown Obsessive-Compulsive Scale (r = -0.57, p = 0.0058). CONCLUSIONS These findings demonstrate the abnormal topological efficiency in the white matter networks in OCD patients.
Collapse
Affiliation(s)
- Zhaoxi Zhong
- Department of Clinical Psychology, Beijing Key Laboratory for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Tengda Zhao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Jia Luo
- Department of Clinical Psychology, Beijing Key Laboratory for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Zhihua Guo
- Department of Clinical Psychology, Beijing Key Laboratory for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Meng Guo
- Department of Clinical Psychology, Beijing Key Laboratory for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Ping Li
- Department of Clinical Psychology, Beijing Key Laboratory for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Jing Sun
- School of Medicine and Griffith Health Institute, Griffith University, Q4222, Australia
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.
| | - Zhanjiang Li
- Department of Clinical Psychology, Beijing Key Laboratory for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
| |
Collapse
|
3
|
Drago A, Serretti A. Focus on HTR2C: A possible suggestion for genetic studies of complex disorders. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:601-37. [PMID: 18802918 DOI: 10.1002/ajmg.b.30864] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
HTR2C is one of the most relevant and investigated serotonin receptors. Its role in important brain structures such as the midbrain, the lateral septal complex, the hypothalamus, the olfactory bulb, the pons, the choroid plexus, the nucleus pallidus, the striatum and the amygdala, the nucleus accumbens and the anterior cingulated gyrus candidate it as a promising target for genetic association studies. The biological relevance of these brain structures is reviewed by way of the focus on HTR2C activity, with a special attention paid to psychiatric disorders. Evidence from the genetic association studies that dealt with HTR2C is reviewed and discussed alongside the findings derived from the neuronatmic investigations. The reasons for the discrepancies between these two sets of reports are discussed. As a result, HTR2C is shown to play a pivotal role in many different psychiatric behaviors or psychiatric related disrupted molecular balances, nevertheless, genetic association studies brought inconsistent results so far. The most replicated association involve the feeding behavior and antipsychotic induced side effects, both weight gain and motor related: Cys23Ser (rs6318) and -759C/T (rs3813929) report the most consistent results. The lack of association found in other independent studies dampens the clinical impact of these reports. Here, we report a possible explanation for discrepant findings that is poorly or not at all usually considered, that is that HTR2C may exert different or even opposite activities in the brain depending on the structure analyzed and that mRNA editing activity may compensate possible genetically controlled functional effects. The incomplete coverage of the HTR2C variants is proposed as the best cost-benefit ratio bias to fix. The evidence of brain area specific HTR2C mRNA editing opens a debate about how the brain can differently modulate stress events, and process antidepressant treatments, in different brain areas. The mRNA editing activity on HTR2C may play a major role for the negative association results.
Collapse
Affiliation(s)
- Antonio Drago
- Institute of Psychiatry, University of Bologna, Italy
| | | |
Collapse
|
4
|
What functional neurosurgery can offer to psychiatric patients: a neuropsychiatric perspective. SURGICAL NEUROLOGY 2009; 71:337-42, discussion 343. [PMID: 19249581 DOI: 10.1016/j.surneu.2008.08.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Accepted: 08/25/2008] [Indexed: 11/23/2022]
|
5
|
Rapid effects of brief intensive cognitive-behavioral therapy on brain glucose metabolism in obsessive-compulsive disorder. Mol Psychiatry 2009; 14:197-205. [PMID: 18180761 PMCID: PMC2893580 DOI: 10.1038/sj.mp.4002134] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Brief intensive cognitive-behavioral therapy (CBT) using exposure and response prevention significantly improves obsessive-compulsive disorder (OCD) symptoms in as little as 4 weeks. However, it has been thought that much longer treatment was needed to produce the changes in brain function seen in neuroimaging studies of OCD. We sought to elucidate the brain mediation of response to brief intensive CBT for OCD and determine whether this treatment could induce functional brain changes previously seen after longer trials of pharmacotherapy or standard CBT. [(18)F]-fluorodeoxyglucose positron emission tomography brain scans were obtained on 10 OCD patients before and after 4 weeks of intensive individual CBT. Twelve normal controls were scanned twice, several weeks apart, without treatment. Regional glucose metabolic changes were compared between groups. OCD symptoms, depression, anxiety and overall functioning improved robustly with treatment. Significant changes in normalized regional glucose metabolism were seen after brief intensive CBT (P=0.04). Compared to controls, OCD patients showed significant bilateral decreases in normalized thalamic metabolism with intensive CBT but had a significant increase in right dorsal anterior cingulate cortex activity that correlated strongly with the degree of improvement in OCD symptoms (P=0.02). The rapid response of OCD to intensive CBT is mediated by a distinct pattern of changes in regional brain function. Reduction of thalamic activity may be a final common pathway for improvement in OCD, but response to intensive CBT may require activation of dorsal anterior cingulate cortex, a region involved in reappraisal and suppression of negative emotions.
Collapse
|
6
|
Berlin HA, Hamilton H, Hollander E. Experimental therapeutics for refractory obsessive-compulsive disorder: translational approaches and new somatic developments. ACTA ACUST UNITED AC 2008; 75:174-203. [DOI: 10.1002/msj.20045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
7
|
Buchsbaum MS, Hollander E, Pallanti S, Baldini Rossi N, Platholi J, Newmark R, Bloom R, Sood E. Positron emission tomography imaging of risperidone augmentation in serotonin reuptake inhibitor-refractory patients. Neuropsychobiology 2006; 53:157-68. [PMID: 16707915 DOI: 10.1159/000093342] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Accepted: 03/02/2006] [Indexed: 11/19/2022]
Abstract
We studied 15 nondepressed patients with obsessive-compulsive disorder (OCD) who were nonresponders to serotonin reuptake inhibitors with an additive trial of risperidone. Positron emission tomography with (18)F-deoxyglucose and magnetic resonance imaging was obtained at baseline and following 8 weeks of either risperidone or placebo in a double-blind parallel group design. Risperidone treatment was associated with significant increases in relative metabolic rate in the striatum, cingulate gyrus, the prefrontal cortex, especially in the orbital region, and the thalamus. Four of 9 patients who received risperidone showed clinical improvement (CGI score of 1 or 2 at 8 weeks) while none of the 6 patients who received placebo showed improvement. Patients with low relative metabolic rates in the striatum and high relative metabolic rates in the anterior cingulate gyrus were more likely to show a clinical response. These metabolic predictors of clinical response are consistent with earlier PET studies showing similar prediction when either neuroleptics or serotonin reuptake inhibitor treatments are administered individually. Our results are consistent with a frontostriatal circuit change related to both dopaminergic and serotonergic systems and with the presence of psychopharmacological subtypes within OCD.
Collapse
|
8
|
Husted DS, Shapira NA. A review of the treatment for refractory obsessive-compulsive disorder: from medicine to deep brain stimulation. CNS Spectr 2004; 9:833-47. [PMID: 15520607 DOI: 10.1017/s109285290000225x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This article provides an overview of the etiology, epidemiology, and first-line treatment options for obsessive-compulsive disorder (OCD). The subject of treatment-resistant and treatment-refractory OCD is then discussed, including a definition of these often-debated terms, and the latest treatment options delineated. This includes a review of the latest research concerning the pharmacological agents that have been studied as monotherapy or augmenting agents for the treatment of OCD, the use of experimental medications and procedures, treatment with reversible, minimally invasive procedures, such as vagal nerve stimulation and transcranial magnetic stimulation, invasive but the potentially reversible deep brain stimulation, and irreversible lesioning with ablative psychosurgery. A discussion of the role of psychotherapy in the treatment of OCD is also included.
Collapse
Affiliation(s)
- David S Husted
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL 32610-0256, USA.
| | | |
Collapse
|
9
|
Abstract
Psychosurgical procedures have been used for the treatment of intractable mental illness for more than 50 years. With improvements in surgical techniques, including new implantable stimulators, advances in functional neuroimaging, and progress in our fundamental understanding of the pathophysiology of mental illness there is a renewed interest in neurosurgical treatment of refractory psychiatric illness. This article will review the history of psychosurgery and recent developments in surgical techniques and implantable devices used in this context. The results of psychosurgery for the treatment of several psychiatric conditions and neuropsychiatric symptoms will be presented, including obsessive-compulsive disorder, Tourette's syndrome, depression, anxiety, aggression, self-injurious behavior, and schizophrenia. Lastly, a perspective on the current and future role of psychosurgery for the treatment of mental illnesses will be discussed.
Collapse
Affiliation(s)
- C Alan Anderson
- Neurology B-182, University of Colorado Health Sciences Center, 4200 East Ninth Avenue, Denver, CO 80262, USA.
| | | |
Collapse
|
10
|
Abstract
Traumatic brain injury ( TBI) neuropsychiatric sequelae are a significant cause of morbidity in TBI victims. Among the recognized sequelae are anxiety, obsessions, compulsions and obsessive-compulsive disorder (OCD). This review addresses the emergence of OCD and OCD symptoms after TBI with an emphasis on neural circuits that underlie OCD symptom expression that may be affected by the injury. Current studies suggest that post-TBI emergent psychopathology, including OCD, is influenced by underlying sub-clinical diathesis, brain injury lesions sites, environmental stressors and the rehabilitation process. Pre-morbid status can be obtained by structured psychiatric interviews, and TBI brain lesions can be defined with advanced neuroimaging techniques. This information along with the management of family and environmental stressors and the enhanced clinical identification of symptoms of anxiety and OCD can be used in the rehabilitation process to improve prognosis after TBI.
Collapse
Affiliation(s)
- Marco A Grados
- Johns Hopkins University School of Medicine, Baltimore, Maryland 21211, USA.
| |
Collapse
|
11
|
Rauch SL. Neuroimaging and neurocircuitry models pertaining to the neurosurgical treatment of psychiatric disorders. Neurosurg Clin N Am 2003; 14:213-23, vii-viii. [PMID: 12856489 DOI: 10.1016/s1042-3680(02)00114-6] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Neurocircuitry models of obsessive-compulsive disorder (OCD) and major depression (MD) are described, focusing on relevant supporting neuroimaging data. Corticostriatothalamocortical circuitry is implicated in OCD. In MD, the relation between "dorsal" and "ventral" cortical compartments is emphasized; the amygdala, hippocampus, and pregenual anterior cingulate are implicated in the pathophysiology of MD and are potential targets for treatment. The neuroanatomy of psychiatric neurosurgical procedures and related neuroimaging findings are reviewed. Finally, anticipated future directions of research in this field are discussed.
Collapse
Affiliation(s)
- Scott L Rauch
- Psychiatric Neuroscience Program, Massachusetts General Hospital-East, Bldg. 149, 13th Street, Room 9130, Charlestown, MA 02129, USA.
| |
Collapse
|
12
|
Chang JW, Kim CH, Lee JD, Chung SS. Single photon emission computed tomography imaging in obsessive-compulsive disorder and for stereotactic bilateral anterior cingulotomy. Neurosurg Clin N Am 2003; 14:237-50. [PMID: 12856491 DOI: 10.1016/s1042-3680(03)00006-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In conclusion, the present study suggests that SPECT, using a sophisticated SPM analysis method, may be useful as a potential diagnostic tool for OCD and a possible predictor of treatment outcome for OCD patients undergoing bilateral anterior cingulotomy. The anterior cingulate gyrus seems to be an important structure in the pathogenesis of OCD symptoms. Furthermore, our operative technique of anterior cingulotomy, featuring a larger lesion, seems to be effective in ameliorating the symptoms of OCD without causing any serious complications.
Collapse
Affiliation(s)
- Jin Woo Chang
- BK21 Project for Medical Science, Yonsei University College of Medicine, Yonsei University College of Medicine, Seoul, Korea.
| | | | | | | |
Collapse
|
13
|
Kim CH, Chang JW, Koo MS, Kim JW, Suh HS, Park IH, Lee HS. Anterior cingulotomy for refractory obsessive-compulsive disorder. Acta Psychiatr Scand 2003; 107:283-90. [PMID: 12662251 DOI: 10.1034/j.1600-0447.2003.00087.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This study was designed to prospectively investigate the efficacy and cognitive adverse effects of stereotactic bilateral anterior cingulotomy as a treatment for refractory obsessive-compulsive (OCD) patients for 12 months. METHOD Patients were eligible if they had severe OCD and rigorous treatments had been unsuccessful. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Clinical Global Impression (CGI) and neuropsychological tests were used to assess the efficacy and cognitive changes of cingulotomy before and 12 months after operation. RESULTS The mean improvement rate of the Y-BOCS scores achieved from baseline was 36.0%. Out of 14 patients six met responder criteria; 35% or higher improvement rate on Y-BOCS and CGI improvement of very much or much better at 12-month follow-up. There was no significant cognitive dysfunction after cingulotomy. CONCLUSION Anterior cingulotomy shows few cognitive adverse effects, with about half of the OCD patients demonstrating significant symptomatic improvement.
Collapse
Affiliation(s)
- C-H Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | | | | | |
Collapse
|
14
|
Abstract
OBJECTIVE To briefly describe the novel non-drug physical interventions currently in use in the investigation and treatment of neuropsychiatric disorders regarding their efficacy and potential future applications. METHODS A systematic review of the literature concerning transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), vagus nerve stimulation (VNS) and neurosurgery for mental disorders (NMD) was conducted using Medline and literature known to the authors. RESULTS A summary of each procedure is provided giving a succinct overview of efficacy, current applications and possible future indications. CONCLUSION Novel and innovative physical interventions are currently being used to study brain function in health and disease. In particular, TMS has quickly established itself as a useful investigational tool and is emerging as a possible antidepressant therapy. Similarly, VNS has been applied successfully in the management of intractable epilepsy and is undergoing evaluation in the management of patients with treatment-resistant depression. DBS has shown significant promise in the treatment of Parkinson's disease and may have use in the management of obsessive-compulsive disorder. Finally, neurosurgical procedures for the treatment of mental disorders have been sufficiently refined to stage a comeback, although rigorous scientific study of their efficacy and indications is still necessary.
Collapse
Affiliation(s)
- Gin S Malhi
- School of Psychiatry, University of New South Wales, Sydney, Australia.
| | | |
Collapse
|