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Zwangsstörungen - Hirnareale und neurologische Veränderungen



Zwangsstörungen

"It can be assumed that several malfunctioning processes are altered within the OCD: 1) error recognition; and, 2) emotion and motivation. (...) Functional imaging research in humans has shown an increased functional activity in the OFC, ACC, head of the caudate nucleus and thalamus in OCD patients. (...) Observations are suggestive of the responsibility of 5HT neurotransmission in the dysfunction of the frontal-subcortical loops that emanate from the OFC and ACC. However, several lines of research suggest that the dopamine system, with which 5HT interacts, may play a major role in the expression of OC symptoms." Q

"During a 'stop' task, (adolescent boys) with OCD showed reduced activation in right orbitofrontal cortex, thalamus and basal ganglia; inhibition failure elicited mesial frontal underactivation. Task switching and interference inhibition were associated with attenuated activation in frontal, temporoparietal and cerebellar regions." Q

"We detected significant reduction of GM (gray matter) in the inferior frontal gyrus, the medial frontal gyrus, the insula, the cingulate gyrus, and the superior temporal gyrus of OCD patients. A significant increase in GM density was observed in the postcentral gyrus, the thalamus, and the putamen." Q

"In patients with OCD, structural and volumetric abnormalities have been identified (...) both in the prefrontal region and in the basal ganglia (striatum, thalamus, amygdala). The dysfunction of these regions (...) can be described as dopaminergic hyperfunction in the PFC and serotonergic hypofunction in the basal ganglia. The dysfunction of the so-called 'cortico-striato-thalamic' loops is strongly linked to the symptoms of OCD, where the dopamine is the most dominant neurotransmitter." Q
Betroffene Region Neurologische Veränderungen
Postzentraler Gyrus "Patients with obsessions/checking rituals showed severer memory deficits and decreased activity in the postcentral gyrus than patients with cleanliness/washing rituals." Q

Significant increase in gray matter density in the postcentral gyrus Q
Cuneus Greater activation in the cuneus during a two-back task Q
Inselrinde Greater activation in the left insula during a two-back task Q

Significant reduction of gray matter in the insula Q
Orbitofrontaler Kortex Increased functional activity in the OFC Q

Reduced activation in right orbitofrontal cortex during a 'stop' task in adolescent boys Q

"Right orbitofrontal cortex activity showed a significant positive correlation with Y-BOCS scores in OCD. Q
Dorsolateraler PFC Greater activation in the right dorsolateral prefrontal cortex during a two-back task Q
Temporallappen Greater activation in the left superior temporal gyrus during a two-back task Q

Significant reduction of gray matter in the superior temporal gyrus Q
Hippocampus The mean left and right hippocampal volumes of patients with refractory OCD were smaller. OCD severity was related to the left hippocampus. Duration of illness was correlated with the hippocampus. Q
Amygdala The mean amygdala volumes of patients with refractory OCD were smaller. OCD severity was not correlated with amygdala volumes. Duration of illness was correlated with the left amygdala. Q
Anteriores Cingulum Increased functional activity in the ACC Q

Significant reduction of gray matter in the cingulate gyrus Q

Right-sided high-frequency stimulation via a lead placed in the anterior limb of the internal capsule was associated with activation of the ACC Q
Basalganglien Reduced activation in the basal ganglia during a 'stop' task in adolescent boys Q

Serotonergic hypofunction in the basal ganglia Q
Nucleus caudatus Increased functional activity in the head of the caudate nucleus Q

Right-sided high-frequency stimulation via a lead placed in the anterior limb of the internal capsule was associated with activation of the ipsilateral head of the caudate Q
Putamen Significant increase in gray matter density in the putamen Q
Thalamus Increased functional activity in the thalamus Q

Reduced activation in the thalamus during a 'stop' task in adolescent boys Q

Significant increase in gray matter density in the thalamus Q

Right-sided high-frequency stimulation via a lead placed in the anterior limb of the internal capsule was associated with activation of the medial thalamus Q

Hyperactive cortico-striato-thalamic loops Q
Cerebellum Right-sided high-frequency stimulation via a lead placed in the anterior limb of the internal capsule was associated with activation of the contralateral cerebellum Q

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