Translational neuroimaging research in pediatric obsessive-compulsive disorder.
Obsessive-compulsive disorder (OCD) is a significant public health problem. Selective serotonin reuptake inhibitors (SSRIs) are the only FDA-approved medications for OCD. However, SSRIs are of limited efficacy in clinical practice. Given the persistence of symptoms and levels of treatment response, it is clear that the serotonin paradigm of OCD does not fully account for the neurobiology of the disorder, and that further translational research is needed. In this review, the glutamate hypothesis of pediatric OCD is explored, the neuroimaging evidence reviewed, and the translational impact highlighted. The traditional strategy of going from pharmacology to pathophysiology has failed to show real progress in our understanding of the neurobiology of psychiatric illness and, while still in the early stages, this work demonstrates the clear benefit of approaching psychiatric illness from the opposite direction.
MacMaster
Frank P
FP
Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA. fmacmast@med.wayne.edu
D027322:Amino Acid Transport System X-AG / Q000235:genetics; D000818:Animals; D003952:Diagnostic Imaging; D004195:Disease Models, Animal; D018698:Glutamic Acid / Q000235:genetics / Q000378:metabolism; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008954:Models, Biological; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000188:drug therapy; D010372:Pediatrics; D011110:Polymorphism, Genetic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D057170:Translational Research, Biomedical
D027322:Amino Acid Transport System X-AG; D018698:Glutamic Acid; D017367:Selective Serotonin Reuptake Inhibitors