scholarly journals Role of Glutamatergic System in Obsessive-Compulsive Disorder with Possible Therapeutic Implications

2017 ◽  
Vol 51 (06) ◽  
pp. 229-242 ◽  
Author(s):  
Přemysl Vlček ◽  
Jakub Polák ◽  
Martin Brunovský ◽  
Jiří Horáček

AbstractObsessive-compulsive disorder (OCD) is a chronic psychiatric illness and 1 of the most common anxiety disorders with the prevalence of 3%. Although its pathogenesis remains unclear, the traditional model focused on alternations in the serotonin system. Selective serotonin reuptake inhibitors provide the most effective treatment; however, as much as 40–60% of patients do not respond to antidepressants therapy. Thus, attention has shifted towards other neurotransmitter systems and related neuroanatomical structures. Recently, there is extensive evidence showing a key role of glutamate pathways abnormalities within the cortico-striatal-thalamo-cortical circuitry and temporal lobes in OCD pathogenesis. In this review, we link together the existent neuroanatomical, neurophysiological, and neuropsychological evidence to argue for potential benefits of adjuvant treatment with glutamatergic agents, especially memantine. By a targeted de-excitation effect on the glutamatergic system in the temporal lobes and connected brain regions, memantine might further alleviate OCD symptoms. This effect should be even more pronounced in certain subtypes of patients with specific cognitive deficits and maladaptive compensatory memory processes (e.g., checkers).

1998 ◽  
Vol 173 (S35) ◽  
pp. 13-20 ◽  
Author(s):  
H. G. Baumgarten ◽  
Z. Grozdanovic

Background Serotonin may play a role in the pathophysiology of obsessive-compulsive disorder (OCD) because of the anti-obsessional effect of selective serotonin reuptake inhibitors (SSRJs).Method The literature is reviewed on knowledge of the role of serotonergic neurons in brain function, studies on monoamine metabolites in cerebrospinal fluid (CSF), various stress neuropeptides, neuroendocrine and behavioural challenge after administration of direct and indirect serotomimetic compounds, and neuroanatomical data on brain circuits organising behaviour.Results In most of the OCD cases analysed, CSF 5-hydroxyindoleacetic acid and homovanillic acid concentrations do not significantly differ from age-corrected controls. However, a relationship appears to exist between pre-treatment levels of these metabolites and clinical response to drugs acting on the serotonin transporter. Abnormalities in CSF arginine vasopressin, corticotropin-releasing hormone, oxytocin and somatostatin levels have been reported in OCD. Long-term treatment with high-doses of clomipramine, fluvoxamine, and fluoxetine tend to correct these neuropeptide abnormalities.Conclusions We hypothesise that continuous treatment with SSRJs alters serotonin turnover and neuropeptide expression patterns in OCD-entertaining functional forebrain/midbrain circuits.


CNS Spectrums ◽  
1999 ◽  
Vol 4 (S3) ◽  
pp. 35-40 ◽  
Author(s):  
Fritz Hohagen

AbstractObsessive-compulsive disorder (OCD) has long been considered a treatment-refractory mental condition. Neither pharmacologic nor psychodynamic therapy has been proven to treat OCD effectively. Yet the prognosis for OCD has changed dramatically in recent years with the introduction of behavior therapy and the use of selective serotonin reuptake inhibitors (SSRIs). Many studies have shown that behavior therapy, especially exposure with response prevention, and SSRIs reduce obsessive-compulsive symptoms significantly. Still, many unanswered questions—including the role of cognitive therapy in the treatment of OCD, exposure therapy vs multimodal behavioral therapy, individual versus group therapy, outcome predictors in adults, adolescents, and children, and the role of combination treatment using an SSRI and cognitive-behavioral therapy—remain. This article will explore these issues as well as suggest directions for further research into OCD.


2019 ◽  
Vol 52 (04) ◽  
pp. 203-204
Author(s):  
Anton J.M. Loonen ◽  
Svetlana A. Ivanova

AbstractRecently, in a review article in this journal, Vlček and colleagues described the putative role played by the glutamatergic system in obsessive-compulsive disorder (OCD) and how this might explain the effects of certain treatments. They describe a neuroanatomical model, which includes a specific role of the amygdala-hippocampus complex (AHC) and would complete the classic cortico-striatal-thalamo-cortical (CSTC) mechanism of OCD. The role of the AHC can perhaps be better understood when considering its ancient relationship to the rest of the forebrain of mammals. This leads to distinguishing between primary (lamprey-like), secondary (amphibian-like) and tertiary (mammal-like) parts of the forebrain including amygdaloid, ventral extrapyramidal and dorsal extrapyramidal systems, respectively. A specific role in OCD may be played by the habenula-projecting part of the pallidum, which evaluated the result of behaviour in human’s earliest vertebrate ancestors. The addition of these primary relationship to the authors’ description could be fruitful when planning the future research, as suggested by them.


2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Fatemeh Baratzadeh ◽  
Sepideh Elyasi ◽  
Amir Hooshang Mohammadpour ◽  
Sofia Salari ◽  
Amirhossein Sahebkar

Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric disorder that has a significant effect on the quality of life. The most effective treatment for OCD is the combination of selective serotonin reuptake inhibitors (SSRI) with cognitive behavior therapy (CBT). However, several adverse effects have been linked with this usual pharmacotherapy, and it is unsuccessful in many patients. The exact pathophysiology of OCD is not completely known, though the role of oxidative stress in its pathogenesis has been proposed recently. This review presents an overview of animal and human studies of antioxidant treatment for OCD. The use of antioxidants against oxidative stress is a novel treatment for several neurodegenerative and neuropsychiatric disorders. Among antioxidants, NAC was one of the most studied drugs on OCD, and it showed a significant improvement in OCD symptoms. Thus, antioxidants could be promising as an adjuvant treatment for OCD. However, a limited number of human studies are conducted on these agents, and for better judgment, human studies with a large sample size are necessary.


2019 ◽  
pp. 1-13 ◽  
Author(s):  
Qing Zhao ◽  
Tingting Xu ◽  
Yuan Wang ◽  
Dandan Chen ◽  
Qiang Liu ◽  
...  

AbstractBackgroundThe pathophysiology of obsessive-compulsive disorder (OCD) remains unclear despite extensive neuroimaging work on the disorder. Exposure to medication and comorbid mental disorders can confound the results of OCD studies. The goal of this study was to explore differences in brain functional connectivity (FC) within the cortico-striato-thalamo-cortical (CSTC) loop of drug-naïve and drug-free OCD patients and healthy controls (HCs).MethodsA total of 29 drug-naïve OCD patients, 22 drug-free OCD patients, and 25 HCs matched on age, gender and education level underwent functional magnetic resonance imaging scanning at resting state. Seed-based connectivity analyses were conducted among the three groups. The Yale Brown Obsessive Compulsive Scale and clinical inventories were used to assess the clinical symptoms.ResultsCompared with HCs, the drug-naïve OCD patients had reduced FC within the limbic CSTC loop. In the drug-naïve OCD participants, we also found hyperconnectivity between the supplementary motor area and ventral and dorsal putamen (p < 0.05, corrected for multiple comparisons).ConclusionsExposure to antidepressants such as selective serotonin reuptake inhibitors may affect the function of some brain regions. Future longitudinal studies could help to reveal the pharmacotherapeutic mechanisms in these loops.


2017 ◽  
Vol 7 (2) ◽  
pp. 7-25
Author(s):  
Karolina Diallo

Pupil with Obsessive-Compulsive Disorder. Over the past twenty years childhood OCD has received more attention than any other anxiety disorder that occurs in the childhood. The increasing interest and research in this area have led to increasing number of diagnoses of OCD in children and adolescents, which affects both specialists and teachers. Depending on the severity of symptoms OCD has a detrimental effect upon child's school performance, which can lead almost to the impossibility to concentrate on school and associated duties. This article is devoted to the obsessive-compulsive disorder and its specifics in children, focusing on the impact of this disorder on behaviour, experience and performance of the child in the school environment. It mentions how important is the role of the teacher in whose class the pupil with this diagnosis is and it points out that it is necessary to increase teachers' competence to identify children with OCD symptoms, to take the disease into the account, to adapt the course of teaching and to introduce such measures that could help children reduce the anxiety and maintain (or increase) the school performance within and in accordance with the school regulations and curriculum.


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