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Neurobiologie der Zwangsstörung

Neurobiology of obsessive-compulsive disorder

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Zusammenfassung

Die neurobiologische Forschung der vergangenen Jahrzehnte hat erheblich zum Verständnis der pathophysiologischen Grundlagen der Zwangsstörung und damit indirekt auch zur Optimierung der verschiedenen Therapiestrategien beigetragen. Eine Vielzahl funktionell-bildgebender Studien weist auf eine Funktionsstörung frontostriataler Netzwerke hin, die in einem orbitofrontostriatalen Modell der Zwangsstörung zusammengefasst werden kann. Es wird eine Dysfunktion parallel angelegter frontostriataler Verbindungen postuliert, die mit einem Ungleichgewicht zwischen direkten und indirekten Rückkopplungsschleifen zu einer Disinhibition thalamokortikaler Aktivität führt. Neurochemische Studien haben gezeigt, dass die Zwangsstörung mit Veränderungen zentral modulatorischer Transmittersysteme, insbesondere des Serotonin- und Dopaminsystems verbunden ist, die direkt oder indirekt zu der Dysregulation der neuronalen Netzwerke beitragen dürften. Die Aufklärung serotonerger und dopaminerger Veränderungen und deren Interaktionen sind unter pharmakotherapeutischen Gesichtspunkten von besonderem Interesse.

Summary

In the last few decades, neurobiological research has considerably improved the understanding of the pathophysiological basis of obsessive-compulsive disorder (OCD), indirectly contributing to the improvement of diverse therapy strategies. A number of functional imaging studies have indicated functional deficits in frontostriatal networks, which can be subsumed in an orbitofrontal model of obsessive-compulsive disorder. A dysfunction is postulated in parallel frontostriatal circuits, leading to an imbalance in direct and indirect feedback loops and a disinhibition of thalamocortical activity. Neurochemical studies have shown that OCD is linked to changes of the central modulatory transmitter system, especially, the serotonin and dopamine system, which probably contribute to a direct and indirect dysregulation in various neural networks. Pharmacologically, the elucidation of these serotonergic and dopaminergic alterations and their interactions are of special interest.

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  1. Klinik für Psychiatrie und Psychotherapie der, Ludwig-Maximilians-Universität, Nußbaumstr. 7, 80336, München, Deutschland

    S. Karch &  O. Pogarell

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  2. O. Pogarell
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Correspondence to O. Pogarell.

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Karch, S., Pogarell, O. Neurobiologie der Zwangsstörung. Nervenarzt 82, 299–307 (2011). https://doi.org/10.1007/s00115-010-2964-1

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