Disrupted Cortico-Striato-Thalamo-Cortical Circuitry and Sleep Disturbances in Obsessive-Compulsive Spectrum, Chronic Tic, and Attention-Deficit/Hyperactivity Disorders.

IF 2.5 4区 医学 Q2 PSYCHIATRY
Margaret D Hall, Kevin S Gipson, Shih Yee-Marie Tan Gipson, Mary K Colvin, Stephanie T T Nguyen, Erica Greenberg
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引用次数: 0

Abstract

Abstract: The bidirectional relationship between sleep and obsessive-compulsive spectrum disorders (OCSDs), chronic tic disorders (CTDs), and attention-deficit/hyperactivity disorder (ADHD) is not well understood. To better treat individuals with these co-occurring sleep and developmental neuropsychiatric conditions, it is necessary to determine the common neural underpinnings to then target with treatment. Research has implicated dysregulated cortico-striatal-thalamo-cortical (CSTC) neurocircuitry in the development of CTDs, OCSDs, and ADHD. We review current literature to assess the state of knowledge about the neurocircuitry of OCSDs, CTDs, and ADHD, and their related sleep disturbances. Our review consistently implicates CSTC-pathway disruptions in OCSDs, CTDs, and ADHD, as well as dopamine and GABA dysregulation, primary neurotransmitters in CSTC circuitry, in sleep disorders. In addition, we highlight reports of subjective poor sleep and insomnia in adults with OCSDs, CTDs, and ADHD, and sleep movement disorders in adults with CTDs. The limited sleep research on youth with these conditions has demonstrated some similar findings. Unfortunately, much of the current research to date has not employed polysomnographic methods for objective sleep-related assessments. Future research should further clarify the neural association between these neuropsychiatric conditions and sleep disturbances to better guide potential therapeutic targets. Determining the most effective treatments for subjective sleep-related complaints in patients with these conditions will be crucial, particularly for determining treatment course-whether to prioritize treatment of the underlying condition, the specific sleep symptoms, or both simultaneously.

强迫性谱系、慢性抽动和注意力缺陷/多动障碍患者的皮质-纹状体-丘脑-皮质回路紊乱和睡眠障碍。
摘要:睡眠与强迫症(ocsd)、慢性抽动障碍(CTDs)、注意缺陷/多动障碍(ADHD)之间的双向关系尚不清楚。为了更好地治疗患有这些睡眠和发育性神经精神疾病的个体,有必要确定共同的神经基础,然后针对治疗目标。研究表明,皮质-纹状体-丘脑-皮质(CSTC)神经回路失调与CTDs、ocsd和ADHD的发展有关。我们回顾了目前的文献,以评估对ocsd、CTDs和ADHD及其相关睡眠障碍的神经回路的认识状况。我们的综述一致表明,在ocsd、CTDs和ADHD中,CSTC通路中断,以及睡眠障碍中CSTC回路中的主要神经递质多巴胺和GABA失调。此外,我们重点报道了强迫症、CTDs和ADHD成人的主观睡眠不良和失眠,以及CTDs成人的睡眠运动障碍。对患有这些疾病的青少年进行的有限的睡眠研究也证明了一些类似的发现。不幸的是,到目前为止,目前的许多研究都没有采用多导睡眠图方法进行客观的睡眠相关评估。未来的研究应进一步阐明这些神经精神疾病与睡眠障碍之间的神经关联,以更好地指导潜在的治疗靶点。确定对这些患者主观睡眠相关抱怨的最有效治疗方法将是至关重要的,特别是确定治疗过程——是优先治疗潜在疾病,特定睡眠症状,还是同时治疗两者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.50
自引率
0.00%
发文量
67
审稿时长
>12 weeks
期刊介绍: The Harvard Review of Psychiatry is the authoritative source for scholarly reviews and perspectives on important topics in psychiatry. Founded by the Harvard Medical School''s Department of Psychiatry, the Harvard Review of Psychiatry features review papers that summarize and synthesize the key literature in a scholarly and clinically relevant manner. Topics covered include: Schizophrenia and related disorders; Mood disorders; Personality disorders; Substance use disorders; Anxiety; Neuroscience; Psychosocial aspects of psychiatry; Ethics; Psychiatric education; and much more. In addition, a Clinical Challenges section presents a case with discussion from a panel of experts. Brief reviews are presented in topic-specific columns that include Cross-Cultural Psychiatry, History of Psychiatry, Ethics, and others.
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