Причины невроза

ПРИ психическом расстройстве, называемом неврозом страха, больной страдает от повторяющихся приступов беспричинного ужаса. Это заболевание поражает от 2 до 5% населения, женщин — в два раза чаше, чем мужчин; среди сердечных больных оно встречается у 10—14%. Человек обычно испытывает чувство сильной тревоги, которое часто сопровождается бредом, оцепенением, покалыванием в конечностях, ощущениями удушья и давления в груди, учащенным сердцебиением. Нередко приступам паники сопутствуют сильная дрожь и обильное потоотделение. До сих пор такие явления обычно рассматривались и лечились либо как чисто психическое расстройство, либо как последствия гипервентиляции.

Недавно сотрудники отделения психиатрии Медицинской школы Вашингтонского университета Э. Рай- ман, Ф. Кевин Батлер и Э. Робинс совместно с М. Рейчлом и П. Гершковичем из отдела неврологии и нейрохирургии Маллинкродтовского института радиологии обнаружили физиологическое отклонение в организме, которое четко коррелировало с неврозом страха: наблюдался неравномерный приток крови к парагиппокампальному гирусу — одному из участков мозга, который, как считают, отвечает за возникновение бессонницы, чувства страха и тревоги.

Отправной точкой исследователям послужил тот давно известный факт, что при введении в кровь лактата натрия (натриевой соли молочной кислоты, образующейся в мышцах при физической нагрузке) у людей, страдающих неврозом страха, болезненные симптомы усиливаются.

Испытуемым, добровольно принимавшим участие в экспериментах, вводили лактат, содержавший радиоактивную метку, что давало возможность получить картину мозга методом позитронной томографии. Как отмечает Рейчл, у больных, у которых лактат усиливал симптомы невроза, приток крови к определенным участкам мозга в правом и левом полушариях был неодинаков. У людей, не страдавших этим заболеванием, такой разницы не наблюдалось.

В статье, опубликованной в журнале ”Nature“, исследователи высказывают предположение, что это указывает на физиологическую аномалию мозга у людей, больных неврозом страха. Рейчл также замечает, что «разница в притоке крови к левому и правому полушариям мозга, возможно, связана с разницей в интенсивности метаболизма. На первый взгляд это не имеет отношения к эмоциям, однако активность клеток мозга дол

жна зависеть от кровоснабжения, поскольку в мозгу кислород не запасается». Рейчл считает, что имеет смысл исследовать гематоэнцефалический барьер — сеть капилляров, стенки которых стоят на пути проникновения веществ из крови к клеткам мозга: «Возможно, у людей, страдающих паническими расстройствами, дефектен гематоэнцефалический барьер, из- за чего лактат может проникать к клеткам мозга. Мы собираемся также измерить потребление кислорода клетками мозга с тем, чтобы связать интенсивность притока крови с активностью нервных клеток».

 

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