While considerable progress has been made in exploring the psychological, the neural, and the neurochemical dimensions of OCD separately, their interplay is still an open question, especially their changes during psychotherapy. Seventeen patients were assessed at these three levels by psychological questionnaires, fMRI, and venipuncture before and after inpatient psychotherapy. Seventeen controls were scanned at comparable time intervals. First, pre/post treatment changes were investigated for all three levels separately: symptom severity, whole-brain and regional activity, and the concentrations of cortisol, serotonin, dopamine, brain-derived neurotrophic factor (BDNF), and immunological parameters (IL-6, IL-10, TNFα). Second, stepwise linear modeling was used to find relations between the variables of the levels. The obsessive-compulsive, depressive, and overall symptom severity was significantly reduced after psychotherapy. At the neural level, the activity in the anterior cingulate cortex (ACC), in frontal regions, in the precuneus, and in the putamen had significantly decreased. No significant changes were found on the neurochemical level. When connecting the levels, a highly significant model was found that explains the decrease in neural activity of the putamen by increases of the concentrations of cortisol, IL-6, and dopamine. Multivariate approaches offer insight on the influences that the different levels of the psychiatric disorder OCD have on each other. More research and adapted models are needed.

中文翻译：

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强迫症（OCD）的多级评估揭示了神经和神经化学水平之间的关系

尽管在分别探索强迫症的心理，神经和神经化学方面已取得了很大进展，但它们之间的相互作用仍然是一个悬而未决的问题，尤其是在心理治疗期间的变化。在住院心理治疗前后，通过心理问卷，fMRI和静脉穿刺对这17个患者进行了这三个级别的评估。以可比较的时间间隔扫描十七个对照。首先，分别研究了三个水平的治疗前后变化：症状严重程度，全脑和区域活动，以及皮质醇，5-羟色胺，多巴胺，脑源性神经营养因子（BDNF）和免疫学参数（IL- 6，IL-10，TNFα）。其次，使用逐步线性建模来查找级别变量之间的关系。强迫症 心理治疗后，抑郁症和总体症状严重程度明显降低。在神经水平上，前扣带回皮质（ACC），额叶区域，早孕神经和壳核中的活性显着降低。在神经化学水平上未发现明显变化。当连接这些水平时，发现了一个高度重要的模型，该模型解释了皮质醇，IL-6和多巴胺浓度的增加，壳核神经活动的降低。多元方法提供了对强迫症不同程度的精神疾病相互影响的见解。需要更多的研究和适应的模型。在足前核和壳核中明显减少。在神经化学水平上未发现明显变化。当连接这些水平时，发现了一个高度重要的模型，该模型解释了皮质醇，IL-6和多巴胺浓度的增加，壳核神经活动的降低。多元方法提供了对强迫症不同程度的精神疾病相互影响的见解。需要更多的研究和适应的模型。在足前核和壳核中明显减少。在神经化学水平上未发现明显变化。当连接这些水平时，发现了一个高度重要的模型，该模型解释了皮质醇，IL-6和多巴胺浓度的增加，壳核神经活动的降低。多元方法提供了对强迫症不同程度的精神疾病相互影响的见解。需要更多的研究和适应的模型。多元方法提供了对强迫症不同程度的精神疾病相互影响的见解。需要更多的研究和适应的模型。多元方法提供了对强迫症不同程度的精神疾病相互影响的见解。需要更多的研究和适应的模型。