RESEARCH ARTICLE


Glutamatergic Synaptic Dysfunction and Obsessive-Compulsive Disorder



Jonathan T Ting, Guoping Feng*
Department of Neurobiology, Duke University Medical Center, Durham, NC 27710, USA


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© Ting and Feng; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Neurobiology, Box 3209, Duke University Medical Center, 401F Bryan Research Building, Research Drive, Durham, NC 27710, USA; Tel: 919-668-1657; Fax: 919-668-1891; E-mail: feng@neuro.duke.edu


Abstract

Obsessive-compulsive disorder (OCD) is a debilitating neuropsychiatric condition estimated to afflict 1-3% of the world population. The estimated financial impact in the treatment and management of OCD is in the billions of dollars annually in the US alone. At present there is a marked lack of evidence on the specific causes of OCD. Current hypotheses largely focus on the serotonin (5-HT) system on the basis of the effectiveness of selective serotonin reuptake inhibitors (SSRIs) in alleviating symptoms of patients with OCD, yet a considerable fraction of patients are non-responsive or minimally responsive to these agents. Despite this fact, SSRIs have remained the primary pharmacological treatment avenue for OCD. In recent years, multiple lines of evidence have implicated glutamatergic synaptic dysfunction within the cortico-striatal-thalamo-cortical (CSTC) brain circuit in the etiology of OCD and related disorders, thereby prompting intensified effort in the development and evaluation of agents that modulate glutamatergic neurotransmission for the treatment of OCD. With this in mind, here we review the following topics with respect to synaptic dysfunction and the neural circuitry underlying OCD: (1) evidence supporting the critical involvement of the CSTC circuit, (2) genetic studies supporting the involvement of glutamatergic dysfunction, (3) insights from genetic animal models of OCD, and (4) preliminary findings with glutamatergic neurotransmission-modulating agents in the treatment of OCD. Given the putative mechanistic overlap between OCD and the broader OC-spectrum of disorders, unraveling the synaptic basis of OCD has potential to translate into more effective treatments for an array of poorly understood human disorders.

Keywords: OCD, Glutamate, Glutamatergic, Direct pathway, Indirect pathway, Striatonigral, Striatopallidal, CSTC, Fronto-subcortical, Synapse, Neurotransmission, Genetics, SAPAP3, Riluzole, Tourette’s syndrome, Trichotillomania, Neuropsychiatric disorder, SSRI, N-acetylcysteine, Memantine, Orbitofrontal cortex, SLC1A1, GRIN2B, NMDA receptor, D-cycloserine, Corticostriatal, Cortico-striatal.