24 research outputs found

    Neurose Obsessivo-Compulsiva: fundamentos clínicos e cognitivo-comportamentais

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    Obsessive Compulsive Disorder as a functional interhemispheric imbalance at the thalamic level

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    Obsessive Compulsive Disorder (OCD) involves failures in two main inhibitory processes, namely cognitive (obsessions) and behavioral (compulsions). Recent research has supported two cortical-subcortical pathways on OCD pathogenesis: (a) the frontostriatal loop (dorsolateral-caudate-striatum-thalamus) responsible for impairments of behavioral inhibition; (b) the orbitofrontal loop (orbitofrontal, medial prefrontal and cingulate) responsible for impairments with cognitive inhibitory processes. These failures in both cognitive and motor inhibitory systems may mediate several neuropsychological deficits in these patients, namely memory, attention, planning and decision making. But are those deficits related to specific hemispheric effects, namely functional imbalance between hemispheres? In this article we hypothesize that: (1) OCD patients have an inter-hemispheric functional imbalance, probably due to inadequate filtering at the thalamic level; (2) the restoration of inter-hemispheric balance, will be correlative to symptomatic improvement

    Las alteraciones de morfologia de la sustancia blanca y gris en el trastorno obsesivo compulsivo

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    Background: While the ethio-pathogenesis of Obsessive-Compulsive disorder (OCD) remains unknown, there is increased evidence of widespread structural alterations in both white and gray matter in OCD patients that include, but are not restricted, to abnormalities in cortic-ostriatal-thalamo-cortical (CSTC) regions. The objective of this study was to test the existence of structural alterations in both white and gray matter in a sample of OCD patients when compared with a group of non-clinical matched controls (NCC), using voxel-based morphometry (VBM). Method: Fifteen patients with OCD and 15 NCC underwent MRI structural scanning. Results: Frontal (increased gray matter in the middle frontal gyrus) and subcortical regions (increased white matter in the pallidum) were found to be affected in patients. Additionally, temporal parietal regions were also found to be affected and highly correlated with OCD symptom severity (decrease of gray matter in the superior parietal lobe and white matter in the angular and superior temporal gyri). Conclusions: These alterations may be associated with prominent OCD symptoms, such as difficulties with inhibitory control (pallidum, angular gyrus), executive functioning (middle frontal gyris), compulsive checking (superior temporal gyrus) and visual-spatial deficits (superior parietal lobe).Antecedentes: mientras que la etiopatogenia del trastorno obsesivo-compulsivo (TOC) sigue siendo desconocida, hay una mayor evidencia en las personas que sufren este trastorno de alteraciones estructurales que incluyen, pero no se limitan, a anormalidades en regiones cortico-estriado-tálamo-corticales (CSTC). El objetivo de este estudio fue comprobar la existencia de alteraciones estructurales tanto en la materia blanca como en la materia gris en una muestra de pacientes con TOC en comparación con un grupo de controles no clínicos (NCC), utilizándose para ello análisis morfométricos basados en “voxel” (VBM). Método: quince pacientes con TOC y quince NCC fueron estudiados mediante resonancia magnética estrutural. Resultados: se encontraron alteraciones en los pacientes en regiones frontales (aumento de la materia gris en la circunvolución frontal media) y subcorticales (aumento de la materia blanca en el pallidum). Además, también se encontraron afectadas regiones témporo-parietales con una alta correlación con la gravedad de los síntomas del TOC (disminución de la materia gris en el lóbulo parietal superior y de la materia blanca en las circunvoluciones temporales angular y superior). Conclusiones: las alteraciones encontradas pueden estar asociados con síntomas predominantes en el TOC, como difi cultades en el control inhibitorio (pallidum, giro angular), función ejecutiva (circunvolución frontal media), verifi caciones compulsivas (circunvolución temporal superior) y défi cit visual-espacial (lóbulo parietal superior).Oscar F. Gonsalves was funded by the Brazilian National Counsel for Scientific and Technological Development (CNPq) as a Special Visiting Researcher of the Science Without Borders program (grant number: 401143/2014-7). This study was partially conducted at the Neuropsychophysiology Lab from the Psychology Research Centre (UID/PSI/01662/2013), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653). This work was also supported by the Portuguese Foundation for Science and Technology (FCT) and European Union (FSE-POPH) with two individual grants (SFRH/BPD/86041/2012 and SFRH/BPD/86027/2012).info:eu-repo/semantics/publishedVersio

    Perfeccionismo no transtorno obsessivo-compulsivo e nos transtornos alimentares

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    OBJETIVO: Este estudo tem dois objetivos principais. Primeiro, avaliar as dimensões do perfeccionismo no transtorno obsessivo-compulsivo e nos transtornos alimentares em comparação com duas amostras controle: psiquiátrica (depressão/ansiedade) e não clínica. Segundo, avaliar se o perfeccionismo é um traço de personalidade especificamente relacionado com estas diferentes condições clínicas. MÉTODO: 39 pacientes com transtorno obsessivo-compulsivo, 24 com transtornos alimentares, 65 com um diagnóstico de depressão e/ou ansiedade (todos estes pacientes encontravam-se em regime de ambulatório) e 70 controles não clínicos completaram a versão portuguesa da Multidimensional Perfectionism Scale. RESULTADOS: Comparativamente à amostra não clínica, todas as amostras clínicas apresentaram níveis significativamente mais elevados na Multidimensional Perfectionism Scale total, no Perfeccionismo Auto-Orientado e no Perfeccionismo-Socialmente-Prescrito. Não houve diferenças estatisticamente significativas no Perfeccionismo-Auto-Orientado e na Multidimensional Perfectionism Scale total nas três amostras clínicas. No entanto, a amostra com transtornos alimentares apresentou níveis significativamente mais elevados de Perfeccionismo-Socialmente-Prescrito, comparativamente à transtornos alimentares e à amostra psiquiátrica (depressão/ansiedade). CONCLUSÃO: O perfeccionismo revelou estar associado a uma grande variedade de condições psicopatológicas. Contudo, as diferenças encontradas entre a amostra de transtornos alimentares, de transtorno obsessivo-compulsivo e a psiquiátrica no Perfeccionismo-Socialmente-Prescrito necessitam de investigação subsequente no sentido de clarificar a especificidade desta dimensão com os transtornos alimentares

    Obsessive compulsive disorder as a functional interhemispheric imbalance at the thalamic level

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    Obsessive Compulsive Disorder (OCD) involves failures in two main inhibitory processes, namely cognitive (obsessions) and behavioral (compulsions). Recent research has supported two cortical–subcortical pathways on OCD pathogenesis: (a) the frontostriatal loop (dorsolateral-caudate–striatum–thalamus) responsible for impairments of behavioral inhibition; (b) the orbitofrontal loop (orbitofrontal, medial prefrontal and cingulate) responsible for impairments with cognitive inhibitory processes. These failures in both cognitive and motor inhibitory systems may mediate several neuropsychological deficits in these patients, namely memory, attention, planning and decision making. But are those deficits related to specific hemispheric effects, namely functional imbalance between hemispheres? In this article we hypothesize that: (1) OCD patients have an inter-hemispheric functional imbalance, probably due to inadequate filtering at the thalamic level; (2) the restoration of inter-hemispheric balance, will be correlative to symptomatic improvement

    Brain activation of the defensive and appetitive survival systems in obsessive compulsive disorder

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    Several studies have shown that basic emotions are responsible for a significant enhancement of early visual processes and increased activation in visual processing brain regions. It may be possible that the cognitive uncertainty and repeated behavioral checking evident in Obsessive Compulsive Disorder (OCD) is due to the existence of abnormalities in basic survival circuits, particularly those associated with the visual processing of the physical characteristics of emotional-laden stimuli. The objective of the present study was to test if patients with OCD show evidence of altered basic survival circuits, particularly those associated with the visual processing of the physical characteristics of emotional stimuli. Fifteen patients with OCD and 12 healthy controls underwent functional magnetic resonance imaging acquisition while being exposed to emotional pictures, with different levels of arousal, intended to trigger the defensive and appetitive basic survival circuits. Overall, the present results seem to indicate dissociation in the activity of the defense and appetitive survival systems in OCD. Results suggest that the clinical group reacts to basic threat with a strong activation of the defensive system mobilizing widespread brain networks (i.e., frontal, temporal, occipital-parietal, and subcortical nucleus) and blocking the activation of the appetitive system when facing positive emotional triggers from the initial stages of visual processing (i.e., superior occipital gyrus)

    Empathy, creativity, and feelings using a modern board game: A learning experience valued by physiotherapy students

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    This study aimed at understanding how physiotherapy students perceive a modern board game experience as an opportunity to train socioemotional skills. Twenty physiotherapy students participated in a learning experience using the Telestration game and were assessed in terms of: game-based self-perceived experience; game’s serious dimension. The facilitator’s perceptionswere also accounted for. Students learned creative expression skills (85% students characterized a true/strong creative experience; 90% expressed a strong feeling of “freedom of experimentation”) and were considered immersed and emotionally involved (significant association between understanding game’s serious purposes and emotional relationship with experience, p-value=0.01). Telestration was classified as a relevant learning method for other serious purposes (>50% students revealed inttention to use Telestration for other serious purposes). Therefore, physiotherapy students self-rated this experience with the Telestration game as significant for learning relevant socioemotional skills. Additionally, facilitator’s perceptions confirmed that they were perfectly immersed and emotionally involved in this learning experience. Future studies in this topic are needed, including larger samples and students from different health courses. Future studies in this topic are needed, including larger samples and students from different health courses.info:eu-repo/semantics/publishedVersio
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