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      Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder.

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          Abstract

          An important challenge in mental health research is to translate findings from cognitive neuroscience and neuroimaging research into effective treatments that target the neurobiological alterations involved in psychiatric symptoms. To address this challenge, in this review we propose a heuristic neurocircuit-based taxonomy to guide the treatment of obsessive-compulsive disorder (OCD). We do this by integrating information from several sources. First, we provide case vignettes in which patients with OCD describe their symptoms and discuss different clinical profiles in the phenotypic expression of the condition. Second, we link variations in these clinical profiles to underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider behavioral, pharmacological, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions. Finally, we suggest methods of testing this neurocircuit-based taxonomy as well as important limitations to this approach that should be considered in future research.

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          Author and article information

          Journal
          Mol Psychiatry
          Molecular psychiatry
          Springer Science and Business Media LLC
          1476-5578
          1359-4184
          September 2021
          : 26
          : 9
          Affiliations
          [1 ] Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. lizzieshephard@usp.br.
          [2 ] Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK. lizzieshephard@usp.br.
          [3 ] Department of Psychiatry, The New York University School of Medicine, New York, NY, USA.
          [4 ] Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
          [5 ] Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.
          [6 ] Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands.
          [7 ] Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
          [8 ] Department of Psychiatry OCD Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
          [9 ] SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.
          [10 ] SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
          [11 ] Center for OCD and Related Disorders, New York State Psychiatric Institute and the Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
          [12 ] Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. ecmiguel@usp.br.
          Article
          10.1038/s41380-020-01007-8 NIHMS1676820
          10.1038/s41380-020-01007-8
          8260628
          33414496
          f05527e7-d7de-4386-b78d-6a93570f26a3
          © 2021. The Author(s), under exclusive licence to Springer Nature Limited part of Springer Nature.

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