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Pharmacological, experimental therapeutic, and transcranial magnetic stimulation treatments for compulsivity and impulsivity

机译:用于强制和冲动的药理,实验治疗和经颅磁刺激处理

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Obsessive-compulsive disorder (OCD) has been recently drawn apart from anxiety disorder by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) and clustered together with related disorders (eg, hoarding, hair pulling disorder, skin picking), which with it seems to share clinical and neurophysiological similarities. Recent literature has mainly explored brain circuitries (eg, orbitofrontal cortex, striatum), molecular pathways, and genes (eg, Hoxb8, Slitrk5, Sapap3) that represent the new target of the treatments; they also lead the development of new probes and compounds. In the therapeutic field, monotherapy with cognitive behavioral therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs) is recommendable, but combination or augmentation with a dopaminergic or glutamatergic agent is often adopted. A promising therapy for OCD is represented by repetitive transcranial magnetic stimulation (rTMS), which is suitable to treat compulsivity and impulsivity depending on the protocol of stimulation and the brain circuitries targeted.
机译:最近被精神障碍的诊断和统计手册,第5版(DSM-5)和与相关疾病聚集在一起(例如,囤积,头发拉动障碍,皮肤采摘)分开焦虑症(OCD)(OCD) ,它似乎似乎共享临床和神经生理相似之处。最近的文献主要探索了代表治疗新靶标的脑力(例如,Orbitofrontal Cortex,纹状体),分子途径和基因(例如,Hoxb8,Slitk5,SapaP3);他们还领导了新探针和化合物的发展。在治疗领域,具有认知行为治疗(CBT)或选择性血清素再摄取抑制剂(SSRIS)的单疗法是可建议的,但通常采用与多巴胺能或谷氨酸剂的组合或增强。对OCD的有希望的治疗由重复的经颅磁刺激(RTMS)表示,这适于根据刺激方案和靶向的脑电路来治疗强制性和冲动。

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