Lecture
The pathophysiological nature of neurotic states according to I. P. Pavlov. The foundations for understanding the pathophysiological nature of neurotic states were laid by I. P. Pavlov. He created an experimental model of neurotic disorders, which stands as an achievement of Russian physiological science. Drawing on the theory of conditioned reflexes, the scientist was the first to show that states resembling neurotic ones can be observed in animals (dogs) under exposure to stimuli excessive in intensity or duration, as well as during a «clash» - a collision of two conditioned reflexes or the development of very fine differentiations, which causes a breakdown of higher nervous activity as a result of overstrain of the basic nervous processes of excitation and inhibition.
Based on such model concepts, I. P. Pavlov justified the identification of different types of neuroses and their prevalence depending on the types of human higher nervous activity (in modern terminology - depending on the profile of hemispheric relations). According to I. P. Pavlov, hysteria occurs more often in representatives of the artistic (right-hemispheric) type, obsessive-compulsive neurosis - in individuals of the thinking (left-hemispheric) type, and neurasthenia - in individuals of the intermediate type. The scientist considered foci of stagnant excitation to be the basis of obsessions, which is consistent with modern data on the contribution of residual-organic CNS lesions to the development of obsessive-compulsive disorders. I. P. Pavlov's ideas were creatively developed by his students and followers.
Anokhin's competitive theory. According to P. K. Anokhin, in contrast to I. P. Pavlov's views, the central mechanism underlying the origin of neuroses is not the struggle between the basic nervous processes of excitation and inhibition, but the competition between two systems of excitation mediating two integral yet mutually exclusive types of activity. Conditioned inhibition, according to P. K. Anokhin, arises as a result of the collision of two systems of excitation. This interpretation of the pathophysiological basis for the development of neurotic states is more consistent with modern neurophysiological concepts of the leading role of inhibitory systems (and above all the systems of lateral and recurrent inhibition) in organizing the integral adaptive activity of the organism. According to these concepts, different forms of neurotic disorders can hypothetically be linked to the depletion of inhibitory systems at the level of intracortical (inter- and intrahemispheric) or cortico-subcortical (above all cortico-limbic) interaction.
Modern data on the electroencephalographic correlates of the functional state of the brain indicate an increased degree of activation (i.e., a deficit of inhibition) at the level of the cortex and the limbic-reticular structures of the brain, manifested as EEG desynchronization, suppression of the -rhythm, increased -activity, and low-amplitude - and -waves in neurotic and anxiety disorders. Important evidence for the validity of concepts regarding the «depletion» of inhibitory systems as the pathophysiological basis of neurotic disorders is the high effectiveness of tranquilizers and antidepressants in their treatment, i.e., drugs that modulate GABAergic inhibition by acting on the serotonergic and noradrenergic synaptic systems.
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