Skip to main content
SpringerLink
Log in

Neurobiologische Korrelate der Psychotherapie von Zwangsstörungen

Neurobiological correlates of the psychotherapy of obsessive-compulsive disorders

  • Originalien
  • Published:
Psychotherapeut Aims and scope Submit manuscript

Zusammenfassung

Der vorliegende Beitrag beschreibt neben dem Störungsbild und seinen Unterformen (Kontrollzwänge, Waschzwänge mit Infektionsängsten, Horten und Sammeln, Symmetriezwänge und Rituale) die wesentlichen neuropsychologischen Funktionsbeeinträchtigungen sowie die neuronalen Netzwerke, in denen zwangsspezifische Auffälligkeiten gefunden wurden. Es handelt sich dabei um eine Erweiterung frontostriatothalamofrontaler Schaltkreise. Trotz des frühen Starts der neurobiologischen Psychotherapieforschung bei Zwangsstörungen ist die Zahl der Studien bisher noch recht überschaubar. Sie werden beschrieben und auch Perspektiven für eine integrierte neurobiologische und psychologische Prozessforschung aufgezeigt. Zusammen mit Psychotherapie lassen sich in Zukunft das Neurofeedback mit Echtzeit-fMRT und die nichtinvasive Neuromodulation evtl. zu vielversprechenden Kombinationsansätzen ausbauen.

Abstract

Obsessive-compulsive disorders are associated with different neuropsychological impairments concerning executive functions, error monitoring, decision making and other basic functionalities. Contemporary neurocircuitry models emphasize the dysfunction of the fronto-striato-thalamo-cortical network related to parietal regions, the orbitofrontal cortex, the anterior cingulate cortex and other limbic structures. In brief, studies on the functional neuroanatomy of psychotherapy effects realized by positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are reported. Perspectives concern combined process-outcome research with repeated neuroimaging and highly resolved (daily) self-ratings focussing the nonlinear dynamics of psychotherapeutic change processes. New therapeutic approaches could explore the combination of psychotherapy with fMRI-based real-time neurofeedback and noninvasive neuromodulation with coordinated reset stimulation focusing on the desynchronization of pathologically oversynchronized neural populations and networks.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  • Baxter LR Jr, Schwartz JM, Bergman KS et al (1992) Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder. Arch Gen Psychiatry 49:681–689

    Article  PubMed  Google Scholar 

  • Brody AL, Saxena S, Schwartz JM et al (1998) FDG-PET predictors of response to behavioral therapy and pharmacotherapy in obsessive-compulsive disorder. Psychiatry Res 84:1–6

    Article  PubMed  Google Scholar 

  • Buchheim A, Viviani R, Kessler H et al (2012) Changes in prefrontal-limbic function in major depression after 15 months of long-term psychotherapy. PLoS ONE 7:e33745

    Article  PubMed  Google Scholar 

  • Freyer T, Klöppel S, Tüscher O et al (2011) Frontostriatal activation in patients with obsessive-compulsive disorder before and after cognitive behavioral therapy. Psychol Med 41:207–216

    Article  PubMed  Google Scholar 

  • Friedlander L, Desrocher M (2006) Neuroimaging studies of obsessive-compulsive disorder in adults and children. Clin Psychol Rev 26:32–49

    Article  PubMed  Google Scholar 

  • Friston KJ, Harrison L, Penny WD (2003) Dynamic causal modelling. NeuroImage 19:1273–1302

    Article  PubMed  Google Scholar 

  • Greisberg S, McKay D (2003) Neuropsychology of obsessive-compulsive disorder: a review and treatment implications. Clin Psychol Rev 23:95–117

    Article  PubMed  Google Scholar 

  • Haken H, Schiepek G (2010) Synergetik in der Psychologie. Selbstorganisation verstehen und gestalten, 2. Aufl. Hogrefe, Göttingen

  • Kathmann N (2007) Neuropsychologie der Zwangsstörung. Hogrefe, Göttingen

  • Kuelz AK, Hohagen F, Voderholzer U (2004) Neuropsychological performance in obsessive-compulsive disorder: a critical review. Biol Psychol 65:185–236

    Article  PubMed  Google Scholar 

  • Kwon JS, Jang JH, Choi JS, Kang DH (2009) Neuroimaging in obsessive compulsive disorder. Expert Rev Neurother 9:255–269

    Article  PubMed  Google Scholar 

  • Mataix-Cols D, Conceicao do Rosario-Campos M, Leckman JF (2005) A multidimensional model of obsessive-compulsive disorder. Am J Psychiatry 162:228–238

    Article  PubMed  Google Scholar 

  • Mathiak K, Weiskopf N (2011) Neurofeedback mit Echtzeit-fMRT. In: Schiepek G (Hrsg) Neurobiologie der Psychotherapie, 2. Aufl. Schattauer, Stuttgart, S 593–605

  • Menzies L, Chamberlain SR, Laird AR et al (2008) Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisited. Neurosci Biobehav Rev 32:525–549

    Article  PubMed  Google Scholar 

  • Nabeyama M, Nakagawa A, Yoshiura T et al (2008) Functional MRI study of brain activation alternations in patients with obsessive-compulsive disorder after symptom improvement. Psychiatry Res 163:236–247

    Article  PubMed  Google Scholar 

  • Nakao T, Nakagawa A, Yoshiura T et al (2005) Brain activation of patients with obsessive-compulsive disorder during neuropsychological and symptom provocation tasks before and after symptom improvement: A functional magnetic resonance imaging study. Biol Psychiatry 57:901–910

    Article  PubMed  Google Scholar 

  • Nakatani E, Nakgawa A, Ohara Y et al (2003) Effects of behavior therapy on regional cerebral blood flow in obsessive-compulsive disorder. Psychiatry Res 124:113–120

    Article  PubMed  Google Scholar 

  • Nestadt G, Lan T, Samuels J et al (2000a) Complex segregation analysis provides compelling evidence for a major gene underlying obsessive-compulsive disorder and for heterogenetics by sex. Am J Human Gen 67:1611–1616

    Article  Google Scholar 

  • Nestadt G, Samuels J, Riddle M et al (2000b) A family study of obsessive-compulsive disorder. Arch Gen Psychiatry 57:358–363

    Article  PubMed  Google Scholar 

  • Popovych OV, Tass PA (2010) Synchronization control of interacting oscillatory ensembles in mixed nonlinear delayed feedback. Phys Rev E Stat Nonlin Soft Matter Phys 82:026204

    Article  PubMed  Google Scholar 

  • Saxena S, Gorbis E, O’Neill J et al (2009) Rapid effects of brief intensive cognitive-behavioral therapy on brain glucose metabolism in obsessive-compulsive disorder. Mol Psychiatry 14:197–205

    Article  PubMed  Google Scholar 

  • Schiepek G, Tominschek I, Karch S et al (2009) A controlled single case study with repeated fMRI measurements during the treatment of a patient with obsessive-compulsive disorder: testing the nonlinear dynamics approach to psychotherapy. World J Biol Psychiatry 10:658–668

    Article  PubMed  Google Scholar 

  • Schiepek G, Karch S, Heinzel S (2011a) Die neurowissenschaftliche Erforschung der Psychotherapie. In: Schiepek G (Hrsg) Neurobiologie der Psychotherapie, 2. Aufl. Schattauer, Stuttgart, S 1–34

  • Schiepek G, Zellweger A, Kronberger H et al (2011b) Psychotherapie. In: Schiepek G (Hrsg) Neurobiologie der Psychotherapie, 2. Aufl. Schattauer, Stuttgart, S 567–592

  • Schiepek G, Tominschek I, Heinzel S et al (2012) Discontinuous patterns in the psychotherapy process of obsessive-compulsive disorder: converging results from repeated functional MRI and daily self-reports (eingereicht)

  • Schlösser RGM, Wagner G, Schachtzabel C et al (2010) Fronto-cingulate effective connectivity in obsessive-compulsive disorder: a study with fMRI and dynamic causal modelling. Hum Brain Mapp 31:1834–1850

    Article  PubMed  Google Scholar 

  • Schwartz JM, Stoessel PW, Baxter LR et al (1996) Systematic changes in cerebral glucose metabolic rate after successful behavior modification treatment of obsessive-compulsive disorder. Arch Gen Psychiatry 53:109–113

    Article  PubMed  Google Scholar 

  • Tass PA, Hauptmann C (2007) Therapeutic modulation of synaptic connectivity with desynchronizing brain stimulation. Int J Psychophysiol 64:53–61

    Article  PubMed  Google Scholar 

  • Tass PA, Adamchic I, Freund HJ et al (2012) Counteracting tinnitus by acoustic coordinated reset neuromodulation. Restaur Neurol Neurosci (im Druck)

Download references

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Paracelsus Medizinische Privatuniversität, Institut für Synergetik und Psychotherapieforschung, Universitätsklinikum/Christian-Doppler-Klinik, Ignaz Harrer Str. 79, 5020, Salzburg, Österreich

    Günter Schiepek

  2. Klinik für Psychiatrie und Psychotherapie, Ludwig-Maximilians-Universität, München, Deutschland

    Susanne Karch & Oliver Pogarell

  3. Tagklinik Westend, München, Deutschland

    Igor Tominschek

Authors
  1. Günter Schiepek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susanne Karch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Igor Tominschek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Oliver Pogarell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Günter Schiepek.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schiepek, G., Karch, S., Tominschek, I. et al. Neurobiologische Korrelate der Psychotherapie von Zwangsstörungen. Psychotherapeut 57, 234–240 (2012). https://doi.org/10.1007/s00278-012-0904-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00278-012-0904-1

Schlüsselwörter

Keywords

Search

Navigation