【国家自然科学基金】_obsessive-compulsive disorder_期刊发文热词逐年推荐_20140803

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2023年国家自然科学基金心理学项目

2023年国家自然科学基金心理学项目研究专家指南1. 什么是国家自然科学基金心理学项目？国家自然科学基金心理学项目是由国家自然科学基金委员会资助的一项重要研究项目，旨在支持心理学领域的基础研究和前沿探索。

该项目以推动心理学理论与实践的创新发展为目标，鼓励心理学领域的学术机构、研究团队和个人开展具有前瞻性和原创性的研究工作。

2. 2023年国家自然科学基金心理学项目的总体要求是什么？在2023年国家自然科学基金心理学项目的申请中，申请人需要围绕心理学领域的前沿问题和热点议题，提出明确的研究目标和科学问题，并提出创新性、原创性的研究思路和方法。

申请人还需要提出明确的研究方案和可行的工作计划，充分展现团队的研究实力和研究条件。

申请人需要突出研究的学术价值和实际意义，以及成果的潜在应用价值。

3. 申请2023年国家自然科学基金心理学项目需要做哪些准备工作？要申请2023年国家自然科学基金心理学项目，首先需要对研究方向和课题进行深入的思考和前期准备。

申请人需要审视国家自然科学基金对心理学研究的资助政策和要求，明确申请条件和评审标准，并选择适合自己团队条件和研究兴趣的课题进行申请。

需要进行前期调研和文献综述，深入了解国内外相关研究进展和热点问题，为研究的前期设计和方案搭建理论基础。

另外，还需要准备详细的研究方案书和相关申请材料，包括团队的学术成果、合作单位和研究条件等方面的介绍。

4. 如何提高2023年国家自然科学基金心理学项目的申请成功率？为了提高2023年国家自然科学基金心理学项目的申请成功率，申请人需要注意以下几个方面：提高研究方案的创新性和前瞻性，突出研究的科学问题和研究思路的独特性；充分展现申请团队的学术实力和研究条件，包括团队成员的学术背景和潜力、研究设备和实验条件等方面的介绍；加强与国内外学术机构和研究团队的合作，提高研究成果的可信度和学术影响力；合理规划研究时间表和预算，展现研究的可行性和科学管理能力。

【北京市自然科学基金】_心理健康_基金支持热词逐年推荐_【万方软件创新助手】_20140729

2010年序号
科研热词 1 病因 2 处理 3 卵巢早衰
推荐指数 1 1 1
2011年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
2011年科研热词精神分裂症横断面研究鼻炎,变应性,常年性非酶抗氧化物门诊躯体症状精神卫生生物节律未服药时间护理护理心理状况心理健康年龄工作记忆家族史失眠症状卵巢储备功能下降危险因素人格中医科 mmpi 推荐指数 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2008年序号
科研热词 1 病因 2 治疗 3 卵巢早衰
推荐指数 1 1 1
2009年序号 1 2 3 4 5 6 7 8 9
科研热词青年管理人员生存质量心理咨询心理健康多agent 专家系统 sf-36 scl-90 agent
推荐指数 1 1 1 1 1 1 1 1 1
推荐指数 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 5 6
2014年科研热词评价工具海军心理健康影响因素异常心理状况危害推荐指数 1 1 1 1 1 1
2012年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
科研热词推荐指数需求 1 脑血管病患者 1 老年人 1 社区服务 1 磁共振成像 1 眶额回 1 灰质体积 1 心理健康 1 强迫障碍 1 居家养老 1 健康宣教 1 信息化 1 the orbitofrontal cortex 1 obsessive-compulsive disorder 1 magnetic resonance imaging 1 gray matter volume 1

【北京市自然科学基金】_小脑_基金支持热词逐年推荐_【万方软件创新助手】_20140729

2011年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
2011年科研热词推荐指数尸体解剖 2 颅内动脉瘤 1 静息态 1 迷路后间隙 1 迷路后入路 1 血管内治疗 1 蛋白表达 1 脑葡萄糖代谢 1 脑卒中 1 脑 1 线粒体 1 淋巴瘤/放射摄影术 1 氧化应激 1 椎动脉 1 抑郁障碍 1 急性低氧 1 小脑脑桥角 1 小脑桥脑角 1 实验性变态反应性脑脊髓炎 1 姜黄素 1 夹层 1 大鼠 1 多发性硬化 1 功能磁共振成像 1 内窥镜检查 1 内窥镜 1 体层摄影术,发射型计算机 1 二黄胶囊 1 中枢神经系统肿瘤/放射摄影术 1 α -突触核蛋白 1 chl1 1 appswe/ps1 de9双转基因小鼠 1 18氟-脱氧葡萄糖 1
2012年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
科研热词推荐指数面部疼痛 1 行为认知 1 自平衡两轮机器人 1 磁共振成像 1 眶额回 1 疼痛测定 1 灰质体积 1 操作Байду номын сангаас件反射 1 强迫障碍 1 小脑 1 基底神经节 1 原癌基因蛋白质c-los 1 三叉神经尾核 1 the orbitofrontal cortex 1 p38丝裂原活化蛋白激酶类 1 obsessive-compulsive disorder 1 magnetic resonance imaging 1 gray matter volume 1
2008年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
科研热词血管造影术脑缺血发作磁共振成像短暂性猪圆环病毒2型灌注数字减影局部尸体解剖小脑脑桥角大鼠基底动脉分布内窥镜检查免疫组化中枢神经系统解剖

加巴喷丁治疗奥氮平致不宁腿综合征1例

四川精神卫生 2021 年第 34 卷第 3 期
·案例讨论·
http：//www. psychjm. net. cn
加巴喷丁治疗奥氮平致不宁腿综合征 1 例
顾梦阅 1，狄东川 2，邱俊 1，翟金国 1，2*
（1. 济宁医学院，山东济宁 272000； 2. 济宁医学院第二附属医院，山东济宁 272000
对多巴胺功能障碍以外的潜在机制进行深入研究。既往多巴胺受体激动剂被广泛应用于 RLS 的
治疗，但长期应用可能会导致 RLS 症状恶化［9］，且存在加重精神症状的风险。加巴喷丁是一种 α2δ 钙通道配体，已被证明可以改善 RLS［10］，这类药物选择性、高亲和力地结合钙通道的 α2δ 亚型 1 蛋白，调节神经末梢的钙离子内流，从而导致兴奋性神经递质（主要是谷氨酸）减少［11］。因此，加巴喷丁可能是治疗抗精神病药物引起的 RLS 更安全的选择。［3，12］此外，国外已有报道，加巴喷丁成功治疗了氯氮平等抗精神病药物诱导的 RLS［6］。本案例中，患者先后三次在我院住院治疗，首次予以利培酮治疗，效果欠佳；后调整为氯氮平继续治疗，精神症状有所改善，但治疗过程中患者出现白细胞减少的情况；本次治疗在奥氮平达到治疗剂量的过程中，患者精神症状逐渐好转，PANSS 评分减分率>50%，考虑目前用其他抗精神病药物替代奥氮平有加剧精神症状的风险，在与患者家属讨论后，开始给患者服用加巴喷丁，效果较好。
*通信作者：翟金国，E-mail：zhaijinguo@163. com）
【摘要】本文目的是提示临床使用奥氮平过程中加强对不宁腿综合征（RLS）的识别与治疗。本文报道 1 例精神分裂症患者服用奥氮平期间出现夜间双下肢不适、控制不住地想要活动双腿、无法入睡等 RLS 症状，服用加巴喷丁后，患者症状明显改善。

自然科学基金跨模态知识融合与关联推理

自然科学基金是我国支持科学研究的重要资助项目，自然科学基金(National Natural Science Foundation of China，简称NSFC) 是我国基础研究资金最大、涵盖范围最广的科学基金，也是我国科学研究的核心力量之一。

自然科学基金致力于对我国基础科学领域的研究提供资助支持，为科学家们提供了广阔的研究评台。

跨模态知识融合与关联推理是当前自然科学基金关注的热点之一，它涉及到多学科交叉融合，对于推动我国科学研究的发展具有重要意义。

一、跨模态知识融合的概念和意义1. 跨模态知识融合的概念跨模态知识融合是指利用不同形式的信息进行融合学习，从而获取更全面、更深入的知识。

它包括文本、图像、音频等多种模态的知识，通过相互融合和关联推理，可以帮助研究者更好地理解和利用信息。

在当前信息时代，跨模态知识融合已经成为了科研领域的重要研究方向。

2. 跨模态知识融合的意义跨模态知识融合的重要性体现在多个方面，它能够帮助科研人员更全面地了解研究对象。

在医学领域，结合病人的影像数据和临床病历，可以更准确地诊断和治疗疾病。

跨模态知识融合有助于促进不同学科之间的交叉融合，推动科学研究的跨学科发展。

跨模态知识融合还可以为人工智能和智能系统的发展提供重要支持，有助于提高系统的智能水平和应用水平。

二、自然科学基金对跨模态知识融合的支持自然科学基金一直以来对于跨模态知识融合的研究给予了重要支持。

通过对相关项目的资助，自然科学基金为跨模态知识融合的研究提供了良好的发展评台，推动了相关研究的深入开展。

近年来自然科学基金资助了大量在自然语言处理、计算机视觉、机器学习等领域的跨模态知识融合研究项目，这些项目为跨学科研究提供了宝贵的经验和成果。

可以说，自然科学基金的支持为跨模态知识融合的发展注入了强大的动力。

三、我对跨模态知识融合的个人观点和理解作为一名科技工作者，我对跨模态知识融合充满信心和期待。

跨模态知识融合的发展将有助于推动信息技术和人工智能的发展，为人类社会的进步做出重要贡献。

简明国际神经精神访谈中文版MINI

简明国际神经精神访谈中文版目录译者著.................................................... （1-） .......免责声明.................................................. （）） ......记录表M丄N.中文版正文附录：M丄N.中文版信效度研究报告记录表译者注《简明国际神经精神访谈（the MINI-I nternatio nal NeuropsychiatricIn terview，M丄N.I.）》是由Sheehan和Lecrubier开发的一个简单、有效和可靠的定式访谈工具，主要用于筛查、诊断《精神障碍诊断和统计手册第四版（DSM-IV》和《国际精神障碍统计分类手册（ICD-10》xx16种轴I精神疾病和一种人格障碍，包括130个问题。

与《定式临床检查病人版（SCID-P》和《复合性国际诊断访谈表（CID）》一样，M丄N.I.xx每种诊断为一题组，大部分诊断都有排除诊断的筛查问题。

已经有研究进行了M.I.N.I.与SCID-F和CIDI的信度和效度比较，结果显示M丄N.I .具有非常可接受的信度和效度评分。

目前M.I.N丄已经被翻译为多种文字，广泛应用于临床试验和临床实践。

近年来，我国越来越多地参与国际性临床研究，基于此，在征得原作者同意后，我们将M丄N.I.英文版（2004）翻译为中文版，并进行了信效度评价，结果显示M丄N.I.中文版对抑郁发作、焦虑障碍、物质依赖、精神病性障碍的诊断与用SCID-P乍出的诊断有很高的一致性（xx,等.2009）。

M.I.N丄中文版对躁狂发作、进食障碍、反社会人格障碍、创伤后应激障碍等诊断的信度、效度还有待研究。

M丄N.I.的使用确保了诊断过程的准确性和一致性，并且可以发现潜在的精神科共病，由于访谈过程简短，问题简洁，易于被患者接受，可用在临床实践中。

衷心希望该工具能为医生的临床实践和研究提供帮助。

【国家自然科学基金】_灰质体积_基金支持热词逐年推荐_【万方软件创新助手】_20140801

2013年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
科研热词推荐指数磁共振成像 4 多发性硬化 2 首发精神分裂症患者 1 颞叶 1 阿尔茨海默病 1 铁沉积 1 重性抑郁障碍 1 轻度认知障碍 1 认知障碍 1 萎缩 1 脑萎缩 1 脑灰质体积比率 1 肌萎缩侧索硬化 1 纵向分析 1 神经环路 1 磁共振 1 特纳综合征 1 灰质 1 形态测量学 1 年龄 1 基于体素的形态测量学 1 基于体素的形态测量 1 器官测量 1 儿童 1 体质量指数 1 中央前回 1 丘脑 1 三维增强型t2*加权血管成像 1
2014年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
2014年科研热词磁共振成像高原病马朗凹陷页岩油青少年铁沉积脑损伤,慢性缘上回海洛因成瘾汉密尔顿抑郁量表抑郁症富油机制多发性硬化复发缓解型含油性加权血管成像冲动性储层中央前回 3d增强t2* 推荐指数 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
科研热词推荐指数磁共振成像 4 磁共振成像,弥散 2 基于体素的形态学分析 2 首发 1 青少年 1 阿尔茨海默病 1 重性抑郁障碍 1 逆转录pcr 1 躁狂 1 认知障碍 1 认知 1 脑缺血 1 脑白质 1 脑 1 肠道病毒 1 肌萎缩侧索硬化 1 耳聋 1 缺陷型精神分裂症 1 糖尿病 1 灰质 1 滤膜吸附法 1 氯化钠-氯化铝沉淀法 1 形态测量学 1 巢式pcr 1 增龄 1 基于体素的形态测量学分析方法(vbm) 1 双相情感障碍 1 偏执型精神分裂症 1 人体测量术 1 2型 1

国家自然科学基金英语

国家自然科学基金英语The National Natural Science Foundation of China (NSFC) was established by the State Council of the People's Republic of China in 1986. It is a state research funding agency that provides support for scientific research and technological innovation projects. The NSFC is committed to cultivating and developing the nation's scientific and technological talents and driving the development of science and technology.The NSFC is managed by the Chinese Academy of Sciences and is supervised by the Ministry of Science and Technologyof the People's Republic of China. It is a non-profit organization and is the largest public science and technology funding body in China. It is responsible for the distribution and management of funds for scientific and technological research activities.The mission of the NSFC is to support basic research and transformative projects in natural sciences, engineering,life sciences, social sciences, and humanities. NSFCprimarily supports research activities through targeted funds and grants. In addition, the NSFC researches, develops and promulgates science and technology policies and regulations, and provides guidance and advice to decision makers.The NSFC has outlined plans for the future development of basic science and technology in China. It funds major research programs, such as the Chinese Millennium Science and Technology Plan and the Chinese Aeronautical Policy and Technology Plan. It also engages in international scientific and technological exchanges and cooperation, and promotes thetraining of scientific and technical personnel.The NSFC is working diligently to promote the development of science and technology in China and to advance the work of Chinese scientists and academics. Its commitment to basic research, technology development and the development of scientific and technical personnel will help ensure a bright future for Chinese science and technology.。

国家自然科学基金心理学

国家自然科学基金心理学心理学作为一门研究人类心理和行为的科学，旨在揭示人类思维、情感和行为背后的原因和规律。

国家自然科学基金作为中国科学研究的重要支持机构，也在心理学领域发挥着重要的作用。

本文将介绍国家自然科学基金对心理学研究的支持和其在推动心理学发展方面的重要贡献。

一、国家自然科学基金的背景和意义国家自然科学基金是中国科学研究的重要支持机构，成立于1986年，致力于促进自然科学和技术的发展。

作为国家级项目资助机构，国家自然科学基金在支持心理学研究方面扮演着重要的角色。

心理学研究旨在深入了解人类的思维、情感和行为，为社会发展提供科学依据和指导。

因此，对心理学研究的支持具有重要的意义。

二、国家自然科学基金在心理学研究中的支持国家自然科学基金广泛支持心理学研究的多个领域和方向，包括但不限于人格心理学、认知心理学、社会心理学、发展心理学等。

国家自然科学基金通过项目资助的方式，为心理学研究提供了重要的经费和资源支持。

这种支持有助于推动心理学研究的深入发展，为心理学理论的建立和应用提供了重要的支撑。

三、国家自然科学基金在心理学研究中的贡献1.推动心理学学科的发展国家自然科学基金资助的心理学研究项目，推动了心理学学科的发展。

这些项目的开展不仅促进了心理学理论的建立和完善，同时也提升了心理学研究的学术水平和科研能力。

通过多年的支持，国家自然科学基金在心理学学科的发展中发挥了重要的作用。

2.促进科学研究成果的转化应用国家自然科学基金支持的心理学研究项目，不仅在学术领域具有重要价值，同时也对社会有着积极的影响。

一些心理学研究成果通过国家自然科学基金的资助得以转化应用于教育、医疗、管理等领域，为社会提供了有益的心理健康服务和指导。

这些成果的转化应用，充分体现了国家自然科学基金在推动心理学研究对社会发展的积极贡献。

3.培养心理学人才国家自然科学基金资助的心理学研究项目，积极培养了大量的心理学研究人才。

这些人才在国内外心理学研究领域具有重要地位和影响力，为国内心理学研究队伍的壮大和学科建设做出了重要贡献。

【国家自然科学基金】_基于体素的形态测量学_基金支持热词逐年推荐_【万方软件创新助手】_20140730

2014年序号 1 2 3
2014年科研热词阿尔茨海默病轻度认知功能障碍基于体素的形态测量学推荐指数 1 1 1
2010年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
科研热词推荐指数磁共振成像 3 人体测量术 2 首发 1 青少年 1 重性抑郁障碍 1 脑 1 肌萎缩侧索硬化 1 耳聋 1 缺陷型精神分裂症 1 磁共振成像,弥散 1 灰质 1 形态测量学 1 多系统萎缩 1 基于体素的形态测量学分析方法(vbm) 1 基于体素的形态学分析 1
2008年序号 1 2 3 4
科研热词记忆障碍磁共振成像应激障碍,创伤后岛叶
推荐指数 1 1 1 1
2009年序号 1 2 3 4 5 6 7 8 9
科研热词脑结构缺陷型精神分裂症空间标准化磁共振成像白质基于体素的形态测量学基于体素的形态学分析创伤后应激障碍
推荐指数 1 1 1 1 1 1 1 1 1
2012年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 17 18 19
科研热词推荐指数磁共振成像 5 脑 3 形态测量学 2 体素 2 阿尔茨海默病 1 轻度认知障碍 1 视神经脊髓炎 1 眶额回 1 灰质体积 1 强迫障碍 1 工作记忆 1 对比研究 1 基于形变的形态测量学 1 基于张量的形态测量学 1 基于体素的形态学测量方法 1 the orbitofrontal cortex 1 obsessive-compulsive disorder 1 magnetic resonance imaging 1 gray matter volume 1
2011年序号 1 2 3 4 5 6 7 8 9 10 11 12

【国家自然科学基金】_模拟水_基金支持热词逐年推荐_【万方软件创新助手】_20140730

Байду номын сангаас
推荐指数 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2009年序号 1 2 3 4 5 6 7 8 9 10 11 12
科研热词非线性半拉格朗日附加质量计算模型矩形空心墩相变水下平均余弦有限元法平均散射次数太湖动水压力分段有理函数方法 grapes模式
科研热词酸性矿山废水根际黏度高岭土饮用水风载长度尺度重金属重力流质量守恒表孔泄流药物自升式钻井平台腐蚀失重腐殖酸脱盐缩尺比精神分裂症童年创伤碳酸盐岩碱化度硫磺颗粒相对渗透率曲线相对渗透率相互影响电吸附环境水力学湍流模型混凝效果混凝海流载荷浮式管型浮力活性炭纤维波浪载荷污水水造粒工艺水稻品种水稻水生植物水流模拟水模拟模型试验梦标量平流枯草芽孢杆菌有机组分质量分数曲面型x宽尾墩数字岩心数值计算数值模拟
2013年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
2008年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
科研热词黄铜质量矩阵腐蚀背景误差协方差混流式水轮机水轮机水平误差函数水力机械模拟水杭州湾悬浮物浓度固有频率固有振型变分资料同化反射光谱光电化学人工神经网络二维正交小波
数值分析. 微观渗流底泥再悬浮实验水槽孔隙网络模型威胁复合絮凝剂土壤酶活吸附动力学双孔隙网络半拉格朗日升尺度模拟化学需要量(cod) 功能失调性态度分层取水净化作用储层参数低渗透油藏下泄水温 semxrd rngκ ~ε 紊流模型 prm方案 grapes全球预报系统 clsvof法 20号钢

【国家自然科学基金】_社会认知神经科学_基金支持热词逐年推荐_【万方软件创新助手】_20140801

推荐指数 3 3 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2011年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
科研热词社会认知神经科学事件相关电位自我空间工作记忆文化性别差异客体工作记忆黄芩素黄芩阿尔采末病选择性干扰距离赌博任务语义加工词汇识别记忆认知调节认知加工机制认知共情计算机辅助拼接计算机辅助复原言语编码补偿说行为血浆色氨酸自我攻击信念iat 耗竭老化羟色胺结果评价空间选择性注意积极情景线索离合词神经精神疾病神经机制短语知觉表征甲骨文汉语句子汉语汉字构词法能产性构式来源记忆机能推论朝向早期断乳方向数量空间关系数字化处理抑郁症状情绪分享
53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93
2010年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52

【国家自然科学基金】_模糊层次分析法(fahp)_基金支持热词逐年推荐_【万方软件创新助手】_20140802

2011年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
2013年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37
科研热词模糊层次分析法系泊作业定量风险分析双船近距离作业高校政工集群行为防控体系重要度遗传算法软件过程评估因子评价模型蒙特卡洛法船舶电力系统综合评价维修策略稀土封存储备福州市电弧炉灾害事件武进区模糊综合评价模糊层次分析法(fahp) 材料性能易用性易发程度指标体系岩溶塌陷层次分析基尼系数城镇建设用地整治储备矿种选择信息熵低碳经济产品平台 gis d-s证据理论
科研热词推荐指数模糊层次分析法 12 高层管理团队 1 风险评价 1 风险优先级排序 1 预警指标体系 1 集对分析 1 长白山国家级自然保护区 1 配电自动化系统 1 软件项目 1 软件可信性评估模型 1 评价指标体系 1 评价指标 1 证据理论 1 艾比湖流域 1 航班延误 1 脆弱 1 综合评价指标 1 综合评价 1 综合安全评价模型 1 组织因素 1 系统功能论 1 粗糙集 1 生态系统健康 1 生境评价 1 熵 1 火电厂安全性评价 1 滑坡 1 治理方案 1 水资源承载力 1 模糊综合评判 1 模糊层次分析 1 模糊多指标决策 1 整合 1 指标体系 1 影响度 1 实体行为 1 多目标决策 1 城市基础设施 1 可信软件 1 可信度评估 1 分布式gis 1 冬季 1 典型区 1 健康评价 1 信息安全等级 1 人因 1 东北马鹿 1 三角模糊数互补判断矩阵 1 三峡 1 d-s证据理论 1 d-s合成 1

【国家自然科学基金】_注意警觉_基金支持热词逐年推荐_【万方软件创新助手】_20140802

科研热词认知受损警觉胖负面身体自我注意警觉注意网络测验注意网络注意维持抑郁执行控制情绪定向
推荐指数 1 1 1 1 1 1 1 1 1 1 1
2011年序号 1 2 3 4 5 6 7 8 9 10 11 12
2011年科研热词额顶网络通道转换视空间注意脑损害竞争模型注意警觉注意解脱注意网络测试注意偏向多感觉整合外显/内隐自尊同激活模型推荐指数 1 1 1 1 1 1 1 1 1 1 1 1
2013年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
科研热词推荐指数视空间注意 3 经颅磁刺激 2 注意网络测试 2 后顶叶 2 前额叶 2 首发精神分裂症 1 额顶环路 1 针刺 1 重复经颅磁刺激 1 返回抑制 1 足三里穴 1 认知障碍 1 认知功能 1 线索-靶子任务 1 空间注意网络 1 神经抑制 1 短阵快速脉冲刺激 1 特质焦虑 1 注意警觉 1 注意解脱 1 注意回避 1 注意偏向 1 暴力游戏 1 持续短阵快速脉冲经颅磁刺激 1 抑制 1 情绪线索 1 儿童 1 2型糖尿病 1
2014年序号 1 2 3 4 5
2014年科研热词警觉度脑电脑功能状态监测空间选择注意稳态视觉诱发电位推荐指数 1 1 1 1 1
2012年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
科研热词推荐指数认知 3 注意网络 2 注意偏向 2 饮酒者 1 青少年 1 错误监测 1 负面身体自我 1 脑损害 1 肺疾病 1 线索提示任务 1 眼动 1 甲状腺功能亢进症 1 注意警觉 1 注意网络测验 1 注意网络测试 1 注意缺陷 1 注意维持 1 注意力 1 注意 1 时间进程 1 慢性阻塞性 1 慢性 1 强迫症 1 低自尊 1 事件相关电位技术 1 习惯化倾向 1 乒乓球 1 ptsd 1 p1 1 obsessive-compulsive disorder 1 n2pc 1 error monitoring 1 attention network 1

【国家自然科学基金】_认知损伤_基金支持热词逐年推荐_【万方软件创新助手】_20140801

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2009年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106
107 108 109 110 111 112 113
camkⅱα brain injuries aβ 相关结合蛋白 app转基因小鼠 acalculia 2型 "语义一致性加重复"范式
推荐指数 6 5 4 3 3 3 3 2 2 2 2 2 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2008年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52

以正念为基础的认知行为疗法对强迫症患者的效果

·心理治疗与心理咨询·以正念为基础的认知行为疗法对强迫症患者的效果*刘兴华韩开雷徐慰（北京市学习与认知重点实验室，首都师范大学心理系，北京100048通信作者：刘兴华xinghua_liu@）【摘要】目的：探讨以正念为基础的认知行为疗法对强迫症患者的干预效果。

方法：采用多基线个案实验设计，先后对6例患者进行以正念为基础的认知行为治疗，采用耶鲁－布朗强迫量表（YBOCS）、症状自评量表（SCL-90）、五因素正念度量表（FFMQ）来进行治疗前、治疗后及治疗结束3个月后的追踪评估，其中YBOCS采用周测施测。

结果：多基线个案设计的图形观察分析表明，治疗后所有患者的强迫症状有明显减轻的趋势，其治疗效果在追踪期得到了维持。

Wilcoxon相关样本检验发现，患者SCL-90的躯体化、强迫症、抑郁和焦虑因子分及YBOCS总分、强迫思维分量表分、强迫行为分量表分均是后测低于前测，而FFMQ的观察、描述、正念行动和不判断得分均是后测高于前测。

结论：以正念为基础的认知行为疗法治疗强迫症有效，未来需要采用大样本随机对照研究进一步探索该疗法的效果。

【关键词】强迫症；正念；认知行为疗法；多基线个案设计中图分类号：R749.055，RR749.79文献标识码：A文章编号：1000－6729（2011）012－0915－06doi：10.3969/j.issn.1000－6729.2011.12.007（中国心理卫生杂志，2011，25（12）：915－920.）Effectiveness of mindfulness-based cognitive behavioral therapy on patients withobsessive-compulsive disorderLIU Xing-Hua，HAN Kai-Lei，XU WeiBeijing Learning and Cognition Laboratory，Department of Psychology，Capital Normal University，Beijing100048，ChinaCorresponding author:LIU Xing-Hua，xinghua_liu@【Abstract】Objective:To investigate effectiveness of the Mindfulness-based cognitive-behavioral treatment (MBCBT)on6obsessive-compulsive disorder(OCD)patients.Methods:With single-case multiple-baseline de-sign，6OCD patients received MBCBT.The Symptom Checklist90(SCL-90)，Yale-Brow Obssesive CompulsiveScale(YBOCS)and the Five Facet Mindfulness Questionnaire(FFMQ)were adopted as measurements.Amongthese measurements，the data of YBOCS were collected weekly.Results:From the figures，obsessive-compulsivesymptoms of all patients tended to decrease and these gains were maintained at follow-up.Wilcoxon test found thatpatients＇post-treatment scores were significant lower than pre-treatment scores in sub-scales of Somatization，Ob-sessive-Compulsive，Depression and Anxiety of SCL-90，and in sub-scales of Compulsions，Obsessions，and totalscores of YBOCS.Patients＇post-treatment scores were significant higher than pre-treatment scores in sub-scales ofObserving，Describing，Acting with awareness and Non-judging of FFMQ.Conclusion:Mindfulness-based cogni-tive-behavioral treatment may be effective for these OCD patients，and further investigations with randomization andcontrolled conditions are needed.【Key words】obsessive-compulsive disorder(OCD);mindfulness;cognitive-behavioral treatment;cases *基金项目：国家自然科学基金（30900411），北京市优秀人才培养资助项目（2009D005016000012），中国科学院心理健康重点实验室经费资助（KLMH2011G01）study with multiple baseline design(Chin Ment Health J，2011，25(12):915－920.)普通人群中强迫症的患病率高达2% 3%［1］。

【国家自然科学基金】_形态测量学_基金支持热词逐年推荐_【万方软件创新助手】_20140730

2014年序号 1 2 3 4 5 6 7 8
2014年科研热词阿尔茨海默病轻度认知功能障碍蜻蜓聚类分析翅基于体素的形态测量学几何形态测量学 pca 推荐指数 1 1 1 1 1 1 1 1
推荐指数 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
2010年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
2012年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
科研热词推荐指数磁共振成像 5 脑 3 线性判别分析 2 形态测量学 2 小哺乳动物 2 分类鉴定 2 几何形态测量学 2 体素 2 阿尔茨海默病 1 重新定位 1 轻度认知障碍 1 视神经脊髓炎 1 莫霍面起伏 1 眶额回 1 灰质体积 1 强迫障碍 1 工作记忆 1 山西地震带 1 对比研究 1 大地水准面异常 1 基于形变的形态测量学 1 基于张量的形态测量学 1 基于体素的形态学测量方法 1 地震构造 1 地球物理解释 1 地壳均衡状态 1 the orbitofrontal cortex 1 obsessive-compulsቤተ መጻሕፍቲ ባይዱve disorder 1 magnetic resonance imaging 1 gray matter volume 1 egm2008地球重力位模型 1
科研热词形态测量学齿冠基底面积重力异常分解近代华北人莫霍面臼齿脑结构缺陷型精神分裂症空间标准化磁地方时磁共振成像相对齿尖基底面积白质流体静力学椎孔径线极光电集流月球月海盆地成人密度模型定量病理多尺度分析增生基于体素的形态测量学基于体素的形态学分析创伤后应激障碍内部结构伪亚暴人体测量学亚暴乳腺导管中同北方地区 lane-emden方程 ae指数

Obsessive-compulsivedisorder

397Similarly, despite the occasional overlap, the symptoms of obsessive-compulsive disorder differ clearly from the fears and worries seen in other anxiety disorders, from the ruminations characteristic of mood disorders, and from the delusions of psychotic disorders.Obsessive-compulsive or stereotypic symptoms are an intrinsic component of many disorders, including autism, Tourette’s syndrome, and frontal lobe lesions. Conversely, some disorders have a restricted focus on symptoms that can be seen in obsessive-compulsive disorder. For example, patients with body dysmorphic disorder (concerns about imagined ugliness) and hypochondriasis (concerns about imagined illness) have somatic obsessions and compulsions. Disorders with overlapping characteristics and psychobiology to obsessive-compulsive disorder fall within a putative spectrum of obsessive-compulsive disorders.15 EpidemiologyThe Epidemiological Catchment Area study16provided the first epidemiological data for obsessive-compulsive disorder that were based on a nationally representative sample and reliable diagnostic criteria. Obsessive-compulsive disorder was the fourth most prevalent psychiatric disorder, with a lifetime prevalence of 2·5%.16 Results of a cross-national study1with similar methods showed that prevalence did not differ by much across many different populations. A review17of community studies suggested that despite some concerns about the validity of the diagnosis of obsessive-compulsive disorder in the Epidemiological Catchment Area study, obsessive-compulsive disorder is not uncommon in adults18and children,19with many findings showing a prevalence similar to that recorded in the Epidemiological Catchment Area study.The male to female ratio of obsessive-compulsive disorder is roughly the same, by contrast with many other anxiety and mood disorders, in which prevalence is higher in females than males. Age of onset in obsessive-compulsive disorder has a bimodal distribution. In some patients, this disorder starts at puberty or earlier; juvenile onset obsessive-compulsive disorder is especially common in males, and has other distinguishing characteristics such as greater familiality and relation to tic disorders.20Other patients can have later onset, for example, after pregnancy, miscarriage, or parturition.21,22Results of epidemiological studies23are consistent with those of clinical work showing that obsessive-compulsive disorder has a high comorbidity with other anxiety and mood disorders. These findings also suggest that some patients with obsessive-compulsive disorder have impulsive features, including symptoms of childhood conduct disorder and an increased rate of suicide attempts.23Although acute episodes of obsessive-compulsive disorder have been documented, the illness is generally chronic.24Furthermore, obsessive-compulsive disorder is associated with substantial direct and indirect costs,25 which are compounded by an absence of recognition, and by underdiagnosis and inappropriate treatment. Patients might be too embarrassed to visit a clinician, or might not be aware that help is available; in one survey,26the lag time from symptom onset to correct diagnosis was 17 years.Panel 1:DSM-IV diagnostic criteria for obsessive-compulsive disorder*A Either obsessions or compulsionsObsessions as defined by:Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distressThe thoughts, impulses, or images that are not simply excessive worries about real-life issuesThe person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralise them with some other thought or actionThe person recognises that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion) Compulsions as defined by:Repetitive behaviours (eg, hand-washing, ordering, checking) or mental acts (eg, praying, counting, repeating words silently) that the person feels driven to do in response to an obsession, or according to rules that must be applied rigidly The behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviours or mental acts either are not connected in a realistic way with what they are designed to neutralise or prevent or are clearly excessiveB At some point during the course of the disorder, the person has:Recognised that the obsessions or compulsions are excessive or unreasonable. (Note: this definition does not apply to children)C The obsessions or compulsions:Cause marked distressAre time consuming (take longer than 1 h a day),Or greatly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationshipsD If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it—eg, Preoccupation with food in the presence of an eating disorder; Hair pulling in the presence of trichotillomania;Concern with appearance in the presence of body dysmorphic disorder;Preoccupation with drugs in the presence of a substance use disorder;Preoccupation with having a serious illness in the presence of hypochondriasis;Preoccupation with sexual urges or fantasies in the presence of a paraphilia;Or guilty ruminations in the presence of major depressive disorder)E The disturbance is not due to the direct physiological effects of a substance (eg, a drug of abuse, a medication) or a general medical conditionSpecify if:with poor insight: if, for most of the time during the current episode, the person does not recognise that the obsessions and compulsions are excessive or unreasonable*Adapted from reference 4.Panel 2: Subgroups of obsessions and compulsionsin obsessive-compulsive disorderObsessions CompulsionsContamination concerns Washing, bathing, showeringHarm to self/others, Checking, praying, asking forsexual/religious concerns reassuranceSymmetry, precision concerns Arranging, orderingSaving concerns HoardingAmericanPsychiatricAssociationAssessmentSince patients frequently conceal their symptoms,27it is important to be aware of the possible presentation of obsessive-compulsive disorder in many medical settings, and to screen patients routinely using questions for obsessions (“Do you have unpleasant thoughts that keep coming into your mind, even though you don’t want them?”) and compulsions (“Do you have to do things over and over, even though you don’t want to?”). In dermatology clinics, for example, washing rituals are frequent. Patients presenting for cosmetic surgery sometimes have somatic concerns, patients in general medical clinics can have symptoms of hypochondriasis, neurology patients with involuntary movement disorders (Tourette’s syndrome, Sydenham’s chorea, Huntington’s disorder) or cortico-striatal-thalamic-cortical lesions may have comorbid obsessive-compulsive disorder, children can have obsessive-compulsive disorder after streptococcal infection, and pregnant women can have de novo or increased obsessive-compulsive disorder symptoms.To assess obsessive-compulsive disorder, a thorough psychiatric history and examination should be taken to investigate symptoms of this and comorbid disorders, and to allow a differential diagnosis from other anxiety, mood, and psychotic disorders. A general medical history and examination should also be obtained; comorbid tics are not uncommon and should be assessed, and in some patients, symptoms of obsessive-compulsive disorder begin after infection.28Indications for special investigations such as structural brain imaging might include late onset, atypical symptoms, or severe treatment refractoriness.The severity of symptoms can be measured with several rating scales including the Yale-Brown obsessive-compulsive scale,29which is sufficiently user-friendly to be easily administered in clinical practice, and the reliability and validity of this scale have made it the gold standard in randomised controlled trials of obsessive-compulsive disorder. The scale has also been adapted for use in children and adolescents.It may be useful to inquire about the patient’s own explanation for their disorder—what are their theories about its cause and treatment? Patients with scrupulosity, for example, could see their symptoms in religious terms.30 Some patients have a view that unconscious conflict is a cause of symptoms. Being aware of such models, and offering an alternative perspective, is a key step in starting treatment. Consumer advocacy groups31and internet groups32can usefully contribute to such psychoeducation. PathogenesisNeuroanatomyThe earliest indication that obsessive-compulsive disorder is mediated by specific neuronal circuits probably came from work showing an association between post-encephalitis parkinsonian and obsessive-compulsive symptoms together with striatal lesions.33Symptoms of obsessive-compulsive disorder have also been docu-mented in various neurological disorders with striatal involvement, including Tourette’s syndrome, Sydenham’s chorea, Huntington’s disorder, and Parkinson’s disorder.34 Conversely, patients with obsessive-compulsive disorder can have abnormalities in a broad series of measures and paradigms used in neuropsychiatric (eg, neurological soft signs, olfactory identification, evoked potentials, prepulse inhibition, intracortical inhibition) and neuropsychological (eg, executive function, visual memory function) studies,34,35These abnormalities areconsistent with cortico-striatal-thalamic-cortical dysfunc-tion and impaired inhibition, and some evidence suggests that they are specific to obsessive-compulsive disorder.36 Advances in brain imaging have, however, provided the most persuasive neuroanatomical data for obsessive-compulsive disorder.37In some studies, structural imaging has shown abnormalities such as decreased volume or increased grey matter density in cortico-striatal-thalamic-cortical circuits. Functional imaging has consistently shown that obsessive-compulsive disorder is characterised by increased activity in orbitofrontal cortex, cingulate, and striatum at rest, and especially during exposure to feared stimuli (figure 1). The application of molecular imaging methods to obsessive-compulsive disorder is at an early stage,38but lends support to structural and functional findings.Other regions of the brain might also play a part in obsessive-compulsive disorder. For example, temporal dysfunction has been associated with obsessive-compulsive disorder,39,40and there is some evidence of amygdala involvement in obsessive-compulsive disorder.41 Imaging research in children has supported the involvement of cortico-striatal-thalamic-cortical circuits in obsessive-compulsive disorder, and could ascertain the evolution of brain abnormalities in different regions over time.42Pharmacotherapy and behavioural therapy can both normalise activity in cortico-striatal-thalamic-cortical circuits43(figure 2). These data have crucial implications for an integrated view of the mind and body. Baseline activity differentially predicts response to pharmaco-therapy and to psychotherapy,44so that different methods may be effective via different mechanisms. Neurosurgical interruption of cortico-striatal-thalamic-cortical circuits can also reduce symptoms45and decrease striatal volume.46NeurochemistryThe serotonin system is probably involved in mediation of obsessive-compulsive disorder. The earliest evidence for such a mechanism was the finding that clomipramine, a tricyclic antidepressant that is mainly a serotonin reuptake inhibitor, was effective in treatment of obsessive-compulsive disorder.47Administration of clomipramine was accompanied by a decrease in concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid in the cerebrospinal fluid of patients with obsessive-compulsive disorder.48Figure 1: Increased activity in orbitofrontal cortex and caudate in patients with obsessive-compulsive disorderReproduced with permission of the University of Stellenbosch.Results of studies49of static measures of serotonergic function in obsessive-compulsive disorder have, however, been inconsistent, and other work has focused on more informative dynamic measures. Thus, for example, administration of the serotonin (5-HT) agonist m-chlorophenylpiperazine (mCPP) has been accompanied by exacerbation of obsessive-compulsive disorder symptoms and a blunted neuroendocrine response. After treatment with a serotonin reuptake inhibitor, behavioural and neuroendocrine responses to mCPP seem to be normal.This work leads to questions about the role of specific 5-HT subreceptors in obsessive-compulsive disorder.Effects of mCPP on the postsynaptic 5-HT2C receptor,for example, may be especially relevant.50,51Preclinicaland clinical data also suggest that the 5-HT1D terminalautoreceptor plays an important part; desensitisation of this receptor in the orbitofrontal cortex needs high duration and high dose administration of serotonin reuptake inhibitors.52Preliminary challenge,53 pharmacological,54genetic,55and imaging56data lendsupport to a role for 5-HT1D in obsessive-compulsivedisorder.Although work on the role of the serotonin system in mediation of obsessive-compulsive disorder is important, to date no specific abnormality in the serotonin system has been identified as a cause. Indeed, many other systems, including glutamate neurotransmission,57some neuropeptides,58and gonadal steroids22,59also play a part. Ultimately, the role of second and third messenger pathways in obsessive-compulsive disorder will need to be delineated.60–62One cortico-striatal-thalamic-cortical neurotransmitter system that could be especially important in mediation of obsessive-compulsive disorder in some patients is dopamine.63In preclinical studies, administration of dopamine agonists leads to stereotypic behaviour, whereas in human beings, such agents can exacerbate symptoms and tics of obsessive-compulsive disorder. Conversely, dopamine blockers are used in treatment of Tourette’s syndrome, one of the spectrum of obsessive-compulsive disorders. Furthermore, augmentation of serotonin reuptake inhibitors with such agents can be useful in treatment-refractory obsessive-compulsive disorder.Neurogenetics4Early work suggesting that obsessive-compulsive disorder has a familial component has been confirmed by more recent rigorous studies64in which investigators used structured diagnostic interviews of probands and controls. Also, results of some studies65have shown a genetic relation between obsessive-compulsive disorder and Tourette’s. Patients with symptoms of obsessive-compulsive disorder but a family history of Tourette’s can have neurobiological dysfunction more similar to Tourette’s than to primary obsessive-compulsive disorder.66Attention has begun to focus on the possibility that functional genetic polymorphisms have a role in the pathogenesis of obsessive-compulsive disorder.67Early work suggested a sexually dimorphic association with low activity in catechol-O-methyltransferase (COMT) alleles, but subsequent reports have been inconsistent.68Another sexually dimorphic association, with an allele of the monoamine oxidase-A (MAO-A) gene, also deserve further investigation.Work on polymorphisms of serotonin system genes such as the serotonin transporter has also been published, but to date has not proved consistent.69Early data for the 5-HT1Dpolymorphism55is especially interesting in view of other evidence that the terminal autoreceptor has an important role in mediation of obsessive-compulsive disorder, but remains to be replicated.Recent work has also focused on dopaminergic polymorphisms, indicating that alleles were distributed differently in patients with obsessive-compulsive disorder with and without tics.70Such work could ultimately provide the basis for a rational approach to delineation of the heterogeneity of obsessive-compulsive disorder, including differences in characteristics of the disease and treatment response.NeuroimmunologyEarly reports of an association between obsessive-compulsive disorder and Sydenham’s chorea were confirmed in a systematic investigation,71leading to consideration of whether some cases of obsessive-compulsive disorder resulted from autoimmune processes that disrupted cortico-striatal-thalamic-cortical circuits. Indeed, the term autoimmune neuropsychiatric disorder associated with streptococcal infections, or PANDAS, has been coined to describe children who have acute onset of obsessive-compulsive disorder symptoms with or without tics after streptococcal infection.28This contribution was followed by a series of studies72 exploring various aspects of an autoimmune hypothesis of obsessive-compulsive disorder. Patients with PANDAS, for example, have abnormal striatal volume on brain imaging. Furthermore, their obsessive-compulsive disorder and tic symptoms respond to immunomodulatory interventions such as plasma exchange and intravenous immunoglobulin. Long-term follow-up showed continued improvement of symptoms for most patients, especially when antibiotic prophylaxis had been effective in prevention of recurrent streptococcal infections.A next step in work on the autoimmune hypothesis of obsessive-compulsive disorder is to establish the precise immunological mechanisms. In some studies,73 expression of D8/17, aB lymphocyte antigen and marker of susceptibility to development of sequelae after streptococcal infection, was increased in patients with obsessive-compulsive disorder. Furthermore, someFigure 2: Normalisation of cortico-striatal-thalamic-cortical circuits by either pharmacotherapy or psychotherapy in obsessive-compulsive disorderYellow lines are the serotonergic neurons originating in the raphe, and projecting widely to cortico-striatal-thalamic-cortical circuits and other regions. Reproduced with permission of the University of Stellenbosch.investigators74have shown evidence of several immune dysfunctions in obsessive-compulsive disorder, including abnormal autoantibodies.The putative association between immune dysfunctions and obsessive-compulsive disorder needs further study to determine its specificity (versus other disorders),75its frequency (compared with other possible striatal insults), and its relation to other psychobiological factors (such as genetic variables).76Nevertheless, such work has already strengthened the present view of obsessive-compulsive disorder as a neuropsychiatric disorder, and could ultimately lead to identification of at-risk children and of new treatments.NeuroethologyDevelopment of animal models that can be used to help search for new pharmacotherapeutic agents for obsessive-compulsive disorder remains an important goal for the future. In the interim, however, many investigators have suggested that symptoms of obsessive-compulsive disorder are redolent of animal stereotypies (repetitive non-functional motor behaviour), that the striatum is a repository for patterned motor sequences, and that the neurochemistry mediating stereotypies overlaps with that of obsessive-compulsive disorder.77An intriguing set of animal models is that found in veterinary behavioural practice.78Acral lick dermatitis in dogs, for example, is characterised by repetitive licking of the paws that is reminiscent of some cases of obsessive-compulsive disorder in which the hands are licked rather than washed. The disorder is more common in some canine families than others, and its pharmacotherapy response profile is very similar to that of obsessive-compulsive disorder.79Other findings77suggest a role for environmental factors in promotion of stereotypies. Stereotypic behaviour can, for example, be induced by confinement or by emotional deprivation. Interestingly, primates raised under conditions of deprivation have abnormalities in striatal architecture.80The selective serotonin reuptake inhibitor fluoxetine is more effective than placebo in the pharmacotherapy of stereotypies in primates who are emotionally deprived.81Indeed, an ethological perspective (one that is affected by studies of animal behaviour) has generated several hypotheses about obsessive-compulsive disorder. Although speculative, these hypotheses are valuable in that they help to supplement work on the proximate mechanisms of obsessive-compulsive disorder, with ideas about its evolutionary underpinnings. One thought-provoking set of research has focused on disgust;82fear and disgust are mediated by different pathways—although the amygdala is crucial in mediation of fear in many anxiety disorders, cortico-striatal-thalamic-cortical and other circuits could be responsible for impairments in disgust processing in obsessive-compulsive disorder. IntegrationMuch evidence emphasises the role of cortico-striatal-thalamic-cortical circuits in mediation of obsessive-compulsive disorder. Further work is, however, needed to establish the exact origins and nature of such dysfunction; such research needs to incorporate a broad range of data, including neuroanatomical, neuro-chemical, neurogenetic, neuroimmunological, and neuroethological variables. Until then, attempts can be made to integrate what is known about the role of cortico-striatal-thalamic-cortical circuits in general with an understanding of obsessive-compulsive disorder.An early neuroanatomical hypothesis, for example, was that caudate abnormalities were associated with cognitive symptoms (such as are apparent in obsessive-compulsive disorder), whereas putamen dysfunction led to sensorimotor symptoms (such as the tics of Tourette’s).37 However, results of imaging studies42suggest that many cortico-striatal-thalamic-cortical circuits are involved in obsessive-compulsive disorder. Possibly, specific projec-tion fields or cell types are involved in specific kinds of symptoms.Certainly, cortico-striatal-thalamic-cortical circuits have a role in mediation of development, maintenance, and selection of procedural strategies.83,84Ventral cortico-striatal-thalamic-cortical circuits have a central role in recognition of stimuli that are behaviourally significant (and in error detection) and in regulation of autonomic and goal-directed responses (including response inhibition and suppression of negative emotion),37,85,86and might therefore be especially important in obsessive-compulsive disorder.Perhaps obsessive-compulsive disorder results from an inability to inhibit procedural strategies mediated by cortico-striatal-thalamic-cortical circuits from intruding into consciousness. Such a view is consistent with three observations. First, the limited number of symptom themes in obsessive-compulsive disorder and their apparent evolutionary importance. Second, dysfunction of cortico-striatal-thalamic-cortical circuits in obsessive-compulsive disorder, with activation of temporal rather than striatal regions during implicit cognition.87And third, the role of the serotonin system in cortico-striatal-thalamic-cortical circuits, since the serotonin system is thought to play an important part in mediation of inhibitory processes.PharmacotherapyIntroduction of selective serotonin reuptake inhibitors provided the potential for agents that are not only effective for obsessive-compulsive disorder, but that also have a better safety and tolerability profile than does clomipramine. Indeed, all available serotonin selective reuptake inhibitors are effective and well tolerated in randomised controlled studies of obsessive-compulsive disorder,88and several are also effective in obsessive-compulsive disorder in children.89By contrast, despite occasional positive trials, agents from other drug classes (monoamine oxidase inhibitors, benzodiazepines, dopamine blockers) have not consistently been effective in monotherapy of obsessive-compulsive disorder.Results of meta-analyses90,91of obsessive-compulsive disorder trials suggest that less selective agents such as clomipramine have a greater effect size than do more selective agents. However, the methods of these meta-analyses had many limitations, and, to date results of all head-to-head studies have suggested equivalence in efficacy and tolerability of serotonin reuptake inhibitors in obsessive-compulsive disorder.88Some agents with substantial serotonin reuptake inhibition (eg, venlafaxine), might also be effective in obsessive-compulsive disorder, but have not yet been rigorously studied. Inositol, an agent that acts directly at a second messenger level, has been used mainly in research settings.Few investigators have done fixed-dose studies of serotonin reuptake inhibitors in obsessive-compulsive disorder, and these have not always yielded similar conclusions. Nevertheless, a general impression, supported by clinical consensus,92,93is that a serotonin reuptake inhibitor trial of long duration (10–12 weeks) and high dose (increasing gradually, at 2–4 weeklyintervals, to maximum recommended dose) should be prescribed (panel 3). Early side-effects might even be positive predictors of response.94However, several negative predictors have been described, including hoarding symptoms, comorbid tics, and schizotypal personality disorder—consistent with evidence that the dopamine system is important in their mediation. Although response to treatment does not necessarily imply remission of symptoms,95it could be associated with a large improvement in quality of life. After poor response to an adequate trial, options include changing to a different serotonin reuptake inhibitor (a usual first step) or augmentation (most relevant when there is part response). The best evidence for augmentation of serotonin reuptake inhibitors is for low doses of dopamine blockers; earlier work was undertaken with traditional neuroleptics96and more recent work has confirmed the value of better tolerated new generation antipsychotic agents97in adults.Combinations of antidepressants have been useful in some studies of adults (controlled) and children (uncontrolled). Various augmenting agents from other classes (eg, lithium, buspirone, pindolol, inositol) have also been assessed in controlled trials of adult obsessive-compulsive disorder, but to date, findings have been negative or inconsistent. In patients resistant to treatment, several monotherapy and augmentation approaches can be considered, but to date perhaps most data support use of intravenous clomipramine in adults.98 Pharmacotherapy in obsessive-compulsive disorder should be maintained for at least a year.92The possibility that some patients maintain responses at a lower dose must be weighed against the possibility that reinstatement of treatment after relapse can be associated with a poorer response.99Once the decision is made to discontinue the drugs, it would seem reasonable to do this gradually (eg, decreasing dose by 25% every few months). PsychotherapyPsychoanalytical treatment for obsessive-compulsive neurosis was suggested by Freud,3and for a long time was thought to be an effective approach to management. However, despite the contribution of investigators in delineation of the characteristics and psychology of obsessive-compulsive disorder, at present, insufficient data support use of psychoanalytical treatment. Behavioural therapy was the first psychotherapy for which careful empirical support was obtained,100and is useful in obsessive-compulsive disorder in adults and children. An important component of behavioural therapy is exposure to the feared stimuli. The precise way in which exposure results in normalisation of cortico-striatal-thalamic-cortical circuitry remains, however, to be fully understood.Cognitive interventions might also have a role in treatment of obsessive-compulsive disorder.101Consensus ratings suggested that several belief domains are important in obsessive-compulsive disorder, including inflated responsibility; overimportance of thoughts; excessive concern about the importance of controlling thoughts; and overestimation of threat.102Cognitive approaches are as effective as exposure procedures.103In practice, a cognitive-behavioural approach is often used, administered individually or in groups,104with the contexts ranging from self-help computer instruction through to treatment in an intensive care unit.105Because symptoms of obsessive-compulsive disorder can greatly affect the patient’s family, assessment of such an effect and inclusion of the patient’s partner or family in development of a treatment strategy would seem appropriate in some cases.106Unfortunately, few investigators have assessed how best to sequence or combine pharmacotherapy and psychotherapy for obsessive-compulsive disorder. Nevertheless, from a theoretical viewpoint, integration of different approaches could be useful.107In clinical practice, it would seem sensible to encourage patients who are on drugs to also understand and adhere to the principles of cognitive-behavioural therapy, and the results of several studies lend support to this idea.108,109 The spectrum of obsessive-compulsive disordersDisorders that overlap with obsessive-compulsive disorder are postulated to lie on an obsessive-compulsive disorder spectrum of conditions. Several different approaches to such a spectrum have been formulated.110 Freud postulated that there was a spectrum from obsessive-compulsive personality to obsessive-compulsive neurosis to psychosis. Although this idea is no longer popular, there is still an interest in patients with obsessive-compulsive disorder and poor insight, and in psychotic patients with comorbid obsessive-compulsive disorder.111,112More recently, attempts to characterise the obsessive-compulsive disorder spectrum have emphasised neuro-biological findings, including neurogenetic approaches113 in which obsessive-compulsive disorder might be related to Tourette’s, pharmacotherapeutic dissection approach-es that emphasise the range of disorders that respond selectively to serotonin reuptake inhibitors,114and neuroanatomical approaches that postulate a spectrum of striatal disorders.115Another approach has been to highlight the distinction between compulsive and impulsive disorders. Compulsive disorders such as body dysmorphic disorder are characterised by exaggerated harm concerns, impulsive disorders involve underestimation of risk, and some disorders such as Tourette’s have both compulsive and impulsive features. Such a contrast is clearly overly simplistic, but could have some heuristic value (for example, compulsive disorders have features of increased frontal and serotonergic activity, whereas impulsive disorders have features of decreased frontal and serotonergic function).116Part of the value of delineating a putative spectrum of obsessive-compulsive disorders, is that assessment and treatment of some disorders closely follows that of obsessive-compulsive disorder. Body dysmorphic disorder, for example, has many features in common with obsessive-compulsive disorder, and responds to both serotonin reuptake inhibitors and cognitive-behaviour treatment.117Furthermore, obsessive-compulsive or stereotypic symptoms in various disorders can also respond to serotonin reuptake inhibitors.118However, disorders that lie at the more impulsive end of thePanel 3:Recommended dose ranges of serotonin selective reuptake inhibitors for obsessive-compulsive disordersDrug Dose range Citalopram20–60 mg/day Fluoxetine20–60 mg/day Fluvoxamine50–300 mg/day Paroxetine20–50 mg/day Sertraline50–200 mg/day。

【国家自然科学基金】_辅助运动区_基金支持热词逐年推荐_【万方软件创新助手】_20140803

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2012年序号 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
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