在强迫症(OCD)患者的多项研究中,确定核心神经认知缺陷是具有挑战性的。反过来,这导致难以将人类研究结果转化为动物模型以剖析病理生理学。在这篇文章中,我们使用强迫症患者工作记忆任务的主要数据来说明这个问题.工作记忆缺陷已被提出作为OCD患者子集检查强迫演变的解释模型。然而,由于任务设计的可变性,调查结果喜忧参半,检查空间与口头工作记忆,和患者人群的异质性。因此,两个主要问题仍然存在:第一,强迫症患者有工作记忆障碍吗?第二,如果强迫症有工作记忆缺陷,它们会导致检查强迫吗?为了调查这些问题,我们使用口头工作记忆任务测试了19名未用药的强迫症患者和23名匹配的健康对照,该任务与经典的手指跨度任务相比增加了难度/任务负荷.与健康对照组相比,强迫症患者在这项任务上的表现没有显着差异,无论使用的结果度量(即反应时间或准确性)。探索性分析表明,尽管在工作记忆负荷最高的试验中表现正常,但具有主要怀疑/检查症状的患者子集可能会降低记忆信心。这些结果表明,应考虑检查强迫的其他病因。此外,它们是讨论的试金石,因此,帮助我们制定路线图,以增加对精神疾病中神经认知功能评估的共识。
It has been challenging to identify core
neurocognitive deficits that are consistent across multiple studies in patients with Obsessive Compulsive Disorder (OCD). In turn, this leads to difficulty in translating findings from human studies into animal models to dissect pathophysiology. In this article, we use primary data from a working memory task in OCD patients to illustrate this issue. Working memory deficiencies have been proposed as an explanatory model for the evolution of checking compulsions in a subset of OCD patients. However, findings have been mixed due to variability in task design, examination of spatial vs. verbal working memory, and heterogeneity in patient populations. Two major questions therefore remain: first, do OCD patients have disturbances in working memory? Second, if there are working memory deficits in OCD, do they cause checking compulsions? In order to investigate these questions, we tested 19 unmedicated OCD patients and 23 matched healthy controls using a verbal working memory task that has increased difficulty/task-load compared to classic digit-span tasks. OCD patients did not significantly differ in their performance on this task compared to healthy controls, regardless of the outcome measure used (i.e. reaction time or accuracy). Exploratory analyses suggest that a subset of patients with predominant doubt/checking symptoms may have decreased memory confidence despite normal performance on trials with the highest working memory load. These results suggest that other etiologic factors for checking compulsions should be considered. In addition, they serve as a touchstone for discussion, and therefore help us to generate a roadmap for increasing
consensus in the assessment of
neurocognitive function in psychiatric disorders.