101
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Wang YM, Cai XL, Zhang RT, Wang Y, Madsen KH, Sørensen TA, Møller A, Cheung EFC, Chan RCK. Searchlight classification based on Amplitude of Low Frequency Fluctuation and functional connectivity in individuals with obsessive-compulsive symptoms. Cogn Neuropsychiatry 2019; 24:322-334. [PMID: 31451062 DOI: 10.1080/13546805.2019.1658575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Investigating obsessive-compulsive symptoms in subclinical populations provides a useful framework for understanding the early development of obsessive-compulsive spectrum disorders. The present study aimed to apply searchlight classification analysis on resting-state functional magnetic resonance imaging data to identify potential brain markers in subclinical individuals with obsessive-compulsive symptoms. METHODS In this observational study, 40 college students with high obsessive-compulsive symptom scores and 40 with low obsessive-compulsive symptom scores were recruited from universities in China. We conducted searchlight classification and comparison analysis between the two groups based on Amplitude of Low Frequency Fluctuation (ALFF), fraction ALFF (fALFF) and resting-state functional connectivity using searchlight classification. RESULTS We found that the highest accuracy rate in differentiating between the two groups was 85.00%. Significant discriminating features included the ALFF of the left medial superior frontal gyrus and the functional connectivity between the right thalamus and the bilateral medial superior frontal gyrus, and the right putamen, as well as the functional connectivity between the left caudate and the right insula. CONCLUSIONS These findings highlight the specific and distinguishing brain functional abnormalities associated with obsessive-compulsive symptoms.
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Affiliation(s)
- Yong-Ming Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Sino-Danish College, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China.,Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
| | - Xin-Lu Cai
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Sino-Danish College, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China.,Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
| | - Rui-Ting Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
| | - Kristoffer Hougaard Madsen
- Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark.,Department of Applied Mathematics and Computer Science, Technical University of Denmark , Kongens Lyngby , Denmark
| | - Thomas Alrik Sørensen
- Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Centre for Cognitive Neuroscience, Department of Communication and Psychology, Aalborg University , Aalborg , Denmark
| | - Arne Møller
- Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Department of Nuclear Medicine and PET Centre, Aarhus University Hospital , Aarhus , Denmark
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region , Hong Kong , PR People's Republic of China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Sino-Danish College, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China.,Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
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102
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Takashima S, Najman FA, Ramos RT. Disruption of volitional control in obsessive-compulsive disorder: Evidence from the Bereitschaftspotential. Psychiatry Res Neuroimaging 2019; 290:30-37. [PMID: 31260827 DOI: 10.1016/j.pscychresns.2019.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 11/19/2022]
Abstract
In the context of controversies involving possible abnormalities in the volition and action control in obsessive-compulsive disorder (OCD), the current study examined electroencephalographic correlates of automatic and volitional brain processes involved in the genesis of spontaneous movements in individuals diagnosed with OCD. For this, the amplitudes of early and late Bereitschaftspotential (early BP and late BP) from 12 patients and 12 controls were obtained while they performed spontaneous button presses under different levels of volitional experience. In the first condition, participants were distracted from their motor actions by a mental task (automatic condition) and in the second condition they were instructed to attending to their own intention to move (willed condition). The results corroborate previous report that the attention to (and, presumably, the awareness of) intention to act accounts for the expression of significant portion of the late BP in healthy individuals. More relevantly, the increased late BP in willed condition in relation to automatic condition was not present in the OCD group. Neither groups nor conditions affected the early BP. In sum, the current findings suggest the existence of abnormalities in the brain activities associated with the establishment of volitional control in OCD patients.
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Affiliation(s)
- Shiro Takashima
- Department of Psychiatry, LIM 23, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | - Fernando Araujo Najman
- Instituto de Matematica e Estatistica, RIDC NeuroMat, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Renato Teodoro Ramos
- Department of Psychiatry, LIM 23, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR; Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Canada
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103
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Hu X, Zhang L, Bu X, Li H, Li B, Tang W, Lu L, Hu X, Tang S, Gao Y, Yang Y, Roberts N, Gong Q, Huang X. Localized Connectivity in Obsessive-Compulsive Disorder: An Investigation Combining Univariate and Multivariate Pattern Analyses. Front Behav Neurosci 2019; 13:122. [PMID: 31249515 PMCID: PMC6584748 DOI: 10.3389/fnbeh.2019.00122] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 05/20/2019] [Indexed: 02/05/2023] Open
Abstract
Recent developments in psychoradiological researches have highlighted the disrupted organization of large-scale functional brain networks in obsessive-compulsive disorder (OCD). However, whether abnormal activation of localized brain areas would affect network dysfunction remains to be fully characterized. We applied both univariate analysis and multivariate pattern analysis (MVPA) approaches to investigate the abnormalities of regional homogeneity (ReHo), an index to measure the localized connectivity, in 88 medication-free patients with OCD and 88 healthy control subjects (HCS). Resting-state functional magnetic resonance imaging (RS-fMRI) data of all the participants were acquired in a 3.0-T scanner. First, we adopted a traditional univariate analysis to explore ReHo alterations between the patient group and the control group. Subsequently, we utilized a support vector machine (SVM) to examine whether ReHo could be further used to differentiate patients with OCD from HCS at the individual level. Relative to HCS, OCD patients showed lower ReHo in the bilateral cerebellum and higher ReHo in the bilateral superior frontal gyri (SFG), right inferior parietal gyrus (IPG), and precuneus [P < 0.05, family-wise error (FWE) correction]. ReHo value in the left SFG positively correlated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score (r = 0 0.241, P = 0.024) and obsessive subscale (r = 0.224, P = 0.036). The SVM classification regarding ReHo yielded an accuracy of 78.98% (sensitivity = 78.41%, specificity = 79.55%) with P < 0.001 after permutation testing. The most discriminative regions contributing to the SVM classification were mainly located in the frontal, temporal, and parietal regions as well as in the cerebellum while the right orbital frontal cortex was identified with the highest discriminative power. Our findings not only suggested that the localized activation disequilibrium between the prefrontal cortex (PFC) and the cerebellum appeared to be associated with the pathophysiology of OCD but also indicated the translational role of the localized connectivity as a potential discriminative pattern to detect OCD at the individual level.
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Affiliation(s)
- Xinyu Hu
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Xuan Bu
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Bin Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wanjie Tang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoxiao Hu
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Shi Tang
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Yanchun Yang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Neil Roberts
- Clinical Research Imaging Centre (CRIC), The Queen's Medical Research Institute (QMRI), University of Edinburgh, Edinburgh, United Kingdom
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
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104
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Xu T, Zhao Q, Wang P, Fan Q, Chen J, Zhang H, Yang Z, Stein DJ, Wang Z. Altered resting-state cerebellar-cerebral functional connectivity in obsessive-compulsive disorder. Psychol Med 2019; 49:1156-1165. [PMID: 30058519 DOI: 10.1017/s0033291718001915] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The role of the cerebellum in obsessive-compulsive disorder (OCD) has drawn increasing attention. However, the functional connectivity between the cerebellum and the cerebral cortex has not been investigated in OCD, nor has the relationship between such functional connectivity and clinical symptoms. METHODS A total of 27 patients with OCD and 21 healthy controls (HCs) matched on age, sex and education underwent magnetic resonance imaging (MRI). Seed-based connectivity analyses were performed to examine differences in cerebellar-cerebral connectivity in patients with OCD compared with HCs. Associations between functional connectivity and clinical features in OCD were analyzed. RESULTS Compared with HCs, OCD patients showed significantly decreased cerebellar-cerebral functional connectivity in executive control and emotion processing networks. Within the OCD group, decreased functional connectivity in an executive network spanning the right cerebellar Crus I and the inferior parietal lobule was positively correlated with symptom severity, and decreased connectivity in an emotion processing network spanning the left cerebellar lobule VI and the lingual gyrus was negatively correlated with illness duration. CONCLUSIONS Altered functional connectivity between the cerebellum and cerebral networks involved in cognitive-affective processing in patients with OCD provides further evidence for the involvement of the cerebellum in the pathophysiology of OCD, and is consistent with impairment in executive control and emotion regulation in this condition.
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Affiliation(s)
- Tingting Xu
- Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,PR China
| | - Qing Zhao
- Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,PR China
| | - Pei Wang
- Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,PR China
| | - Qing Fan
- Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,PR China
| | - Jue Chen
- Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,PR China
| | - Haiyin Zhang
- Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,PR China
| | - Zhi Yang
- Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,PR China
| | - Dan J Stein
- Department of Psychiatry and South African Medical Research Council Unit on Risk & Resilience in Mental Disorders,University of Cape Town,Cape Town,South Africa
| | - Zhen Wang
- Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,PR China
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Sathappan AV, Luber BM, Lisanby SH. The Dynamic Duo: Combining noninvasive brain stimulation with cognitive interventions. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:347-360. [PMID: 30312634 DOI: 10.1016/j.pnpbp.2018.10.006] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 12/21/2022]
Abstract
Pharmacotherapy, psychotherapy, and non-invasive brain stimulation (NIBS)1 each show efficacy in the treatment of psychiatric disorders; however, more efficacious interventions are needed as reflected by an overall unmet need in mental health care. While each modality has typically been studied and developed as a monotherapy, in practice they are typically used in combination. Research has begun to emerge studying the potential synergistic actions of multi-modal, combination therapies. For example, NIBS combined with rehabilitation strategies have demonstrated some success for speech and motor rehabilitation in stroke patients. In this review we present evidence suggesting that combining NIBS with targeted, cognitive interventions offers a potentially powerful new approach to treating neuropsychiatric disorders. Here we focus on NIBS studies using transcranial direct current stimulation (tDCS)2 and transcranial magnetic stimulation (TMS)3 given that these modalities are relatively safe, noninvasive, and can be performed simultaneously with neurocognitive interventions. We review the concept of "state dependent" effects of NIBS and highlight how simultaneous or sequential cognitive interventions could help optimize NIBS therapy by providing further control of ongoing neural activity in targeted neural networks. This review spans a range of neuropsychiatric disorders including major depressive disorder, schizophrenia, generalized anxiety, and autism. For each disorder, we emphasize neuroanatomical circuitry that could be engaged with combination therapy and critically discuss the literature that has begun to emerge. Finally, we present possible underlying mechanisms and propose future research strategies that may further refine the potential of combination therapies.
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Affiliation(s)
- Aakash V Sathappan
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Bruce M Luber
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
| | - Sarah H Lisanby
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
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106
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Zheng H, Jia F, Han H, Wang S, Guo G, Quan D, Li G, Huang H. Combined fluvoxamine and extended-release methylphenidate improved treatment response compared to fluvoxamine alone in patients with treatment-refractory obsessive-compulsive disorder: A randomized double-blind, placebo-controlled study. Eur Neuropsychopharmacol 2019; 29:397-404. [PMID: 30595354 DOI: 10.1016/j.euroneuro.2018.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 11/30/2018] [Accepted: 12/16/2018] [Indexed: 01/04/2023]
Abstract
More effective, tolerable interventions for treatment-refractory obsessive-compulsive disorder (OCD) are needed. Preliminary findings encourage optimism that methylphenidate augmentation may be of benefit in the treatment of OCD. To test modulator methylphenidate (MPH) of extended-release formulations (MPH-ER) a safe and effective add-on therapy for refractory OCD, a pilot randomized, placebo-controlled, double-blind trial was conducted at an outpatient, single-center academic setting. Participants included 44 adults with serotonin reuptake inhibitor (SRI) treatment-refractory OCD and receiving a stable fluvoxamine pharmacotherapy with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores higher than 20. Data were analyzed in the intention-to-treat sample. All subjects were randomized into two parallel groups to receive fluvoxamine (250 mg daily) plus MPH-ER (36 mg daily) or fluvoxamine (250 mg daily) plus identical placebo tablets under double-blind conditions and followed for 8 weeks. Forty-four patients (29 [66%] men), with a mean (SD) age of 24.7 (6) years participated; with a mean (SD) duration of episode 5.7 (3) were randomized and forty-one finished the trial. In the intention-to-treat analysis, the improvement in the Y-BOCS total score and Y-BOCS obsession subscale score was more prominent in the fluvoxamine and MPH-ER group compared with those receiving placebo (P < .001). Additionally, cumulative response rates were higher in the MPH-ER vs placebo groups (59% vs 5%; P < .001). MPH-ER was well tolerated; No subjects dropped out due to side effects. In summary, combined treatment with MPH-ER demonstrated an enhanced clinical rate of response compared to placebo. Further trials should examine MPH-ER efficacy in a larger sample.
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Affiliation(s)
- Huirong Zheng
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Affliated School of Medicine of South China University of Technology, No. 123 Huifu Xi Road, Guangzhou 510180, Guangdong, PR China.
| | - Fujun Jia
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Affliated School of Medicine of South China University of Technology, No. 123 Huifu Xi Road, Guangzhou 510180, Guangdong, PR China
| | - Hongying Han
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, PR China
| | - Shibin Wang
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Affliated School of Medicine of South China University of Technology, No. 123 Huifu Xi Road, Guangzhou 510180, Guangdong, PR China
| | - Guangquan Guo
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Affliated School of Medicine of South China University of Technology, No. 123 Huifu Xi Road, Guangzhou 510180, Guangdong, PR China
| | - Dongming Quan
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Affliated School of Medicine of South China University of Technology, No. 123 Huifu Xi Road, Guangzhou 510180, Guangdong, PR China
| | - Gang Li
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Affliated School of Medicine of South China University of Technology, No. 123 Huifu Xi Road, Guangzhou 510180, Guangdong, PR China
| | - Huiyan Huang
- Pharmacy Department of Guangdong General Hospital, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, PR China
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Gowda SM, Narayanaswamy JC, Hazari N, Bose A, Chhabra H, Balachander S, Bhaskarapillai B, Shivakumar V, Venkatasubramanian G, Reddy YCJ. Efficacy of pre-supplementary motor area transcranial direct current stimulation for treatment resistant obsessive compulsive disorder: A randomized, double blinded, sham controlled trial. Brain Stimul 2019; 12:922-929. [PMID: 30808612 DOI: 10.1016/j.brs.2019.02.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 01/28/2019] [Accepted: 02/10/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND A significant proportion of obsessive compulsive disorder (OCD) patients do not respond to specific serotonin reuptake inhibitors (SSRIs). There is a need to evaluate novel treatment options for OCD. OBJECTIVE In this double blinded, randomized, sham controlled study, we investigated the efficacy of add-on transcranial direct current stimulation (tDCS) in reducing the symptoms in SSRI-resistant OCD patients by employing anodal pre-supplementary motor area (pre-SMA) stimulation. METHOD Twenty-five patients with DSM-IV OCD having persistent symptoms despite adequate and stable treatment with at least one SSRI were randomly allocated to receive 20 min of verum (active) 2-mA tDCS or sham stimulation twice daily on 5 consecutive days [anode over Pre-SMA; cathode over right supra-orbital area]. Response to treatment was defined as at least 35% reduction in the Yale-Brown Obsessive-Compulsive Scale (YBOCS) total score along with a Clinical Global Impression - Improvement (CGI-I) score of 1 (very much improved) or 2 (much improved). RESULTS The response rate was significantly greater in the verum tDCS(4 out of 12) compared to sham-tDCS (0 out of 13) [Fisher's exact test, p = 0.04]. Repeated measures analysis of variance with tDCS type (verum vs. sham) as between subjects factor showed that there was a significant tDCS-type X time-point interaction with significantly greater reduction of YBOCS total score [F (1,22) = 4.95,p = 0.04,partial-η2 = 0.18] in verum-tDCS group. CONCLUSIONS The results of this RCT suggest that tDCS may be effective in treating SSRI-resistant OCD. Future studies should examine the efficacy in larger samples of OCD and explore other potential target regions using randomized sham-controlled designs, in addition to examining the sustainability of the beneficial effects. TRIAL REGISTRATION Clinical Trials Registry India (http://ctri.nic.in/Clinicaltrials/login.php): Registration Number- CTRI/2016/04/006837).
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Affiliation(s)
- Shayanth M Gowda
- Obsessive Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India
| | - Janardhanan C Narayanaswamy
- Obsessive Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India; Translational Psychiatry Laboratory, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India.
| | - Nandita Hazari
- Obsessive Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India
| | - Anushree Bose
- Translational Psychiatry Laboratory, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India
| | - Harleen Chhabra
- Translational Psychiatry Laboratory, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India
| | - Srinivas Balachander
- Obsessive Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India
| | - Binukumar Bhaskarapillai
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India
| | - Venkataram Shivakumar
- Obsessive Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India; Translational Psychiatry Laboratory, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India
| | - Ganesan Venkatasubramanian
- Obsessive Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India; Translational Psychiatry Laboratory, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India
| | - Y C Janardhan Reddy
- Obsessive Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), 560029, India
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Wang YM, Zou LQ, Xie WL, Yang ZY, Zhu XZ, Cheung EFC, Sørensen TA, Møller A, Chan RCK. Altered Functional Connectivity of the Default Mode Network in Patients With Schizo-obsessive Comorbidity: A Comparison Between Schizophrenia and Obsessive-compulsive Disorder. Schizophr Bull 2019; 45:199-210. [PMID: 29365198 PMCID: PMC6293227 DOI: 10.1093/schbul/sbx194] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Clinical and neuroimaging data support the idea that schizo-obsessive comorbidity (SOC), similar to obsessive-compulsive disorder (OCD) and schizophrenia (SCZ), may be a distinct brain disorder. In this study, we examined the strength of resting-state functional connectivity (rsFC) between 19 subregions of the default mode network (DMN) and whole brain voxels in 22 patients with SOC features, 20 patients with SCZ alone, 22 patients with OCD, and 22 healthy controls (HC). The main results demonstrated that patients with SOC exhibited the highest rsFC strength within subregions of the DMN and the lowest rsFC strength between the DMN and subregions of the salience network (SN) compared with the other 3 groups. In addition, compared with HCs, all 3 patient groups exhibited increased rsFC between subregions of the DMN and the executive control network (ECN). The SOC and SCZ group both exhibited increased rsFC between subregions of the DMN and the middle temporal gyrus, but the OCD group exhibited decreased rsFC between them. These findings highlight a specific alteration in functional connectivity in the DMN in patients with SOC, and provide new insights into the dysfunctional brain organization of different mental disorders.
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Affiliation(s)
- Yong-ming Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, PR China,Sino-Danish College, University of Chinese Academy of Sciences, Beijing, PR China,Sino-Danish Center for Education and Research, Beijing, PR China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Lai-quan Zou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, PR China,Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Wen-lan Xie
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, PR China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhuo-ya Yang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, PR China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiong-zhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China,Medical Psychological Institute of Central South University, Changsha, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Thomas Alrik Sørensen
- Sino-Danish Center for Education and Research, Beijing, PR China,Centre for Cognitive Neuroscience, Institute of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Arne Møller
- Sino-Danish Center for Education and Research, Beijing, PR China,Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, PR China,Sino-Danish College, University of Chinese Academy of Sciences, Beijing, PR China,Sino-Danish Center for Education and Research, Beijing, PR China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,To whom correspondence should be addressed; Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing 100101, China; tel/fax: +86-10-64852558; e-mail:
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109
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Shivakumar V, Dinakaran D, Narayanaswamy JC, Venkatasubramanian G. Noninvasive brain stimulation in obsessive-compulsive disorder. Indian J Psychiatry 2019; 61:S66-S76. [PMID: 30745679 PMCID: PMC6343411 DOI: 10.4103/psychiatry.indianjpsychiatry_522_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a complex neuropsychiatric disorder with a chronic course, contributing to significant socio-occupational dysfunction. Forty percent of patients remain treatment refractive despite mainstream treatment options such as serotonin-reuptake inhibitors and cognitive behavior therapy. Noninvasive brain stimulation approaches such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have piqued interest as add-on treatment options in OCD. This review focuses on summarizing the TMS and tDCS studies in OCD with respect to their study design and stimulation parameters and key findings. We also briefly discuss the limitations and future directions noninvasive brain stimulation in OCD.
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Affiliation(s)
- Venkataram Shivakumar
- Department of Psychiatry, WISER Neuromodulation Program, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.,Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Damodharan Dinakaran
- Department of Psychiatry, WISER Neuromodulation Program, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Janardhanan C Narayanaswamy
- Department of Psychiatry, WISER Neuromodulation Program, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.,Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, WISER Neuromodulation Program, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Yang X, Luo J, Zhong Z, Yang X, Yao S, Wang P, Gao J, Liu R, Sun J, Li Z. Abnormal Regional Homogeneity in Patients With Obsessive-Compulsive Disorder and Their Unaffected Siblings: A Resting-State fMRI Study. Front Psychiatry 2019; 10:452. [PMID: 31316408 PMCID: PMC6609574 DOI: 10.3389/fpsyt.2019.00452] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/07/2019] [Indexed: 02/02/2023] Open
Abstract
Objective: Previous studies suggest that abnormal brain structure and function may be neuroimaging endophenotypes of obsessive-compulsive disorder (OCD). Comparing the intrinsic brain activity of OCD patients and their unaffected siblings will help to further understand the susceptibility to, and pathological mechanisms of, OCD. We used a case-control study design aiming to establish whether the abnormal regional homogeneity (ReHo) found in OCD patients also exists in their unaffected siblings. Method: Fifteen unmedicated OCD patients, 15 of their unaffected siblings, and 30 healthy controls (HCs) received resting-state functional magnetic resonance imaging (r-s fMRI) scanning and clinical evaluation. We used the ReHo method to analyze the inter-regional synchronized activity of all participants. One-way analysis of covariance with post hoc tests was used to compare the ReHo maps across groups. A Pearson correlation analysis was conducted to assess the correlations between clinical characteristics and abnormal ReHo in OCD patients. Results: Relative to HCs, OCD patients and their unaffected siblings showed overlapping higher ReHo values in the right dorsolateral prefrontal cortex (DLPFC). Patients with OCD showed increased ReHo in left middle frontal gyrus (MFG) relative to both their unaffected siblings and HCs. In addition to the right DLPFC and left MFG, OCD patients, compared with HCs, also showed abnormal ReHo in other regions, including higher ReHo in the right superior parietal cortex and lower ReHo in the left inferior parietal cortex, right parahippocampal region, left thalamus, and right inferior temporal cortex. Compared with HCs, the unaffected siblings of patients with OCD had significantly higher ReHo in the right inferior parietal cortex, right MFG, and right supplementary motor area. There was no association between clinical symptoms and abnormal ReHo values in OCD patients. Conclusions: This study found overlapping higher ReHo values in the right DLPFC of OCD patients and their unaffected siblings. Our results suggest that the higher ReHo in the right DLPFC may be a potential neuroimaging endophenotype, which may reflect an increased genetic risk of OCD.
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Affiliation(s)
- Xiangyun Yang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jia Luo
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaoxi Zhong
- Henan Key Lab of Biological Psychiatry, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xiaojie Yang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Shumin Yao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Pengchong Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jian Gao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Rui Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jing Sun
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
| | - Zhanjiang Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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111
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Lee DJ, Dallapiazza RF, De Vloo P, Elias GJB, Fomenko A, Boutet A, Giacobbe P, Lozano AM. Inferior thalamic peduncle deep brain stimulation for treatment-refractory obsessive-compulsive disorder: A phase 1 pilot trial. Brain Stimul 2018; 12:344-352. [PMID: 30514614 DOI: 10.1016/j.brs.2018.11.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/30/2018] [Accepted: 11/23/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Several different surgical procedures targeting the limbic circuit have been utilized for severe, treatment resistant obsessive-compulsive disorder; however, there has only been limited exploration of the inferior thalamic peduncle (ITP). The aim of this study was to determine the safety and initial efficacy of ITP deep brain stimulation (DBS) in patients with severe obsessive-compulsive disorder. METHODS Patients with severe, treatment-refractory obsessive-compulsive disorder were enrolled into this open-label phase 1 DBS pilot study. Bilateral ITP DBS devices were implanted between November 2010 and December 2015. The primary outcome was safety. The initial efficacy was determined by Yale-Brown Obsessive-Compulsive scale (YBOCs) scores. Component Y-BOCs scores, Hamilton Depression Severity Scale, Quality of Life Assessment (SF-36), Oxford Happiness Questionnaire, Warwick-Edinburgh Mental Well-Being Scale, and Sheehan Disability Scale were also analyzed for a minimum of 2 years after surgery. Additionally, preoperative and three-month postoperative FDG-PET studies were performed on two patients. RESULTS Five patients (2 males, 3 females; age range 25-48 years) received ITP DBS. All five patients were considered responders at one year (52% improvement in YBOCs scores compared to baseline (range 39-73%, p < 0.01) and last follow-up (54% improvement; range 38-85%; p < 0.01). At two years follow-up, there were three adverse events that occurred in two patients. One patient had his DBS system removed after one year due to the device becoming the object of his obsession. The other two adverse events were not related to the device. Post-operative FDG-PET imaging in two patients demonstrated decreased glucose uptake within the right caudate, right putamen, right supplementary motor area, and right cingulum and increased glucose uptake in bilateral motor areas, left temporal pole, and left orbitfrontal cortex. CONCLUSIONS ITP DBS has a favorable safety profile and is potentially an efficacious treatment for severe obsessive-compulsive disorder. Larger clinical trials are necessary to determine efficacy.
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Affiliation(s)
- Darrin J Lee
- Division of Neurosurgery, University of Toronto, Canada
| | | | | | | | - Anton Fomenko
- Division of Neurosurgery, University of Toronto, Canada
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112
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Yazdi-Ravandi S, Akhavanpour H, Shamsaei F, Matinnia N, Ahmadpanah M, Ghaleiha A, Khosrowabadi R. Differential pattern of brain functional connectome in obsessive-compulsive disorder versus healthy controls. EXCLI JOURNAL 2018; 17:1090-1100. [PMID: 30564085 PMCID: PMC6295628 DOI: 10.17179/excli2018-1757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 10/31/2018] [Indexed: 02/06/2023]
Abstract
Researchers believe that recognition of functional impairment in some of brain networks such as frontal-parietal, default mode network (DMN), anterior medial prefrontal cortex (MPFC) and striatal structures could be a beneficial biomarker for diagnosis of obsessive-compulsive disorder (OCD). Although it is well recognized brain functional connectome in OCD patients shows changes, debate still remains on characteristics of the changes. In this regard, little has been done so far to statistically assess the altered pattern using whole brain electroencephalography. In this study, resting state EEG data of 39 outpatients with OCD and 19 healthy controls (HC) were recorded. After, brain functional network was estimated from the cleaned EEG data using the weighted phase lag index algorithm. Output matrices of OCD group and HCs were then statistically compared to represent meaningful differences. Significant differences in functional connectivity pattern were demonstrated in several regions. As expected the most significant changes were observed in frontal cortex, more significant in frontal-temporal connections (between F3 and F7, and T5 regions). These results in OCD patients are consistent with previous studies and confirm the role of frontal and temporal brain regions in OCD.
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Affiliation(s)
- Saeid Yazdi-Ravandi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hassan Akhavanpour
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University GC, Tehran, Iran
| | - Farshid Shamsaei
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nasrin Matinnia
- Department of Nursing, College of Basic Science, Hamadan Branch, Islamic Azad University, Hamadan, Iran
| | - Mohammad Ahmadpanah
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Ghaleiha
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University GC, Tehran, Iran
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113
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Tripathi A, Avasthi A, Grover S, Sharma E, Lakdawala BM, Thirunavukarasu M, Dan A, Sinha V, Sareen H, Mishra KK, Rastogi P, Srivastava S, Dhingra I, Behere PB, Solanki RK, Sinha VK, Desai M, Reddy YCJ. Gender differences in obsessive-compulsive disorder: Findings from a multicentric study from India. Asian J Psychiatr 2018; 37:3-9. [PMID: 30086467 DOI: 10.1016/j.ajp.2018.07.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/31/2018] [Indexed: 11/28/2022]
Abstract
Obsessive-compulsive disorder (OCD) is phenotypically heterogeneous. Gender is an important factor mediating this heterogeneity. We examined gender differences in a large sample (n = 945) of OCD patients under a multi-centric study in India. Cross-sectional assessments were done on consecutive adult (>18 years) treatment-seeking patients with a DSM-5 diagnosis of OCD. Subjects were assessed on Structured Clinical Interview for DSM-5-Research Version for comorbid psychiatric illnesses, Yale Brown Obsessive Compulsive Scale for OCD phenomenology and symptom severity, Brown Assessment of Beliefs Scale for insight, Beck's Depression Inventory for severity of depressive symptoms, and the Obsessive Beliefs Questionnaire. On multivariate backward Wald logistic regression analysis, males (59.7%) had more years of education, had a higher rate of checking compulsions and comorbid substance use disorders. Women were more likely to be married, more commonly reported precipitating factors, had a higher rate of hoarding compulsions and comorbid agoraphobia. Findings from this large study validate gender as an important mediator of phenotypic heterogeneity in OCD. The mechanistic basis for these differences might involve complex interactions between biological, cultural and environmental factors.
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Affiliation(s)
| | - Ajit Avasthi
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Eesha Sharma
- National Institute of Mental Health and Neurosciences, Bangalore, India.
| | | | - M Thirunavukarasu
- SRM Medical College Hospital & Research Center, Kattankulathur, Kanchipuram District, 603203, India
| | | | | | | | | | - Pali Rastogi
- MGM Medical College & MYH Hospital, Indore, India
| | - Shruti Srivastava
- University College of Medical Sciences and GTBH, Dilshad Garden, Delhi, India
| | | | - Prakash B Behere
- Dr D.Y. Patil University Kasba Bawda, Kolhapur 416006, Maharashtra, India
| | | | - Vinod K Sinha
- Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Mahesh Desai
- Karnataka Institute of Medical Sciences (KIMS), Hubli, Karnataka India
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114
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Wang YM, Zou LQ, Xie WL, Yang ZY, Zhu XZ, Cheung EFC, Sørensen TA, Møller A, Chan RCK. Altered grey matter volume and cortical thickness in patients with schizo-obsessive comorbidity. Psychiatry Res Neuroimaging 2018; 276:65-72. [PMID: 29628272 DOI: 10.1016/j.pscychresns.2018.03.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 03/23/2018] [Accepted: 03/23/2018] [Indexed: 02/05/2023]
Abstract
Recent findings suggest that schizo-obsessive comorbidity (SOC) may be a unique diagnostic entity. We examined grey matter (GM) volume and cortical thickness in 22 patients with SOC, and compared them with 21 schizophrenia (SCZ) patients, 22 obsessive-compulsive disorder (OCD) patients and 22 healthy controls (HCs). We found that patients with SOC exhibited reduced GM volume in the left thalamus, the left inferior semi-lunar lobule of the cerebellum, the bilateral medial orbitofrontal cortex (medial oFC), the medial superior frontal gyrus (medial sFG), the rectus gyrus and the anterior cingulate cortex (aCC) compared with HCs. Patients with SOC also exhibited reduced cortical thickness in the right superior temporal gyrus (sTG), the right angular gyrus, the right supplementary motor area (SMA), the right middle cingulate cortex (mCC) and the right middle occipital gyrus (mOG) compared with HCs. Together with the differences in GM volume and cortical thickness between patients with SOC and patients with only SCZ or only OCD, these findings highlight the GM changes specific to patients with SOC.
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Affiliation(s)
- Yong-Ming Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, PR China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing 100190, PR China; Sino-Danish Center for Education and Research, Beijing 100190, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, PR China
| | - Lai-Quan Zou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, PR China; Department of Psychology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, Guangdong, PR China
| | - Wen-Lan Xie
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, PR China
| | - Zhuo-Ya Yang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, PR China
| | - Xiong-Zhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, PR China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, PR China
| | - Thomas Alrik Sørensen
- Sino-Danish Center for Education and Research, Beijing 100190, PR China; Centre for Cognitive Neuroscience, Institute of Communication and Psychology, Aalborg University, Denmark
| | - Arne Møller
- Sino-Danish Center for Education and Research, Beijing 100190, PR China; Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Denmark; Centre of Functionally Integrative Neuroscience, Aarhus University, Denmark
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, PR China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing 100190, PR China; Sino-Danish Center for Education and Research, Beijing 100190, PR China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, PR China.
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115
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Hirose M, Hirano Y, Nemoto K, Sutoh C, Asano K, Miyata H, Matsumoto J, Nakazato M, Matsumoto K, Masuda Y, Iyo M, Shimizu E, Nakagawa A. Relationship between symptom dimensions and brain morphology in obsessive-compulsive disorder. Brain Imaging Behav 2018; 11:1326-1333. [PMID: 27730476 DOI: 10.1007/s11682-016-9611-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Obsessive-compulsive disorder (OCD) is known as a clinically heterogeneous disorder characterized by symptom dimensions. Although substantial numbers of neuroimaging studies have demonstrated the presence of brain abnormalities in OCD, their results are controversial. The clinical heterogeneity of OCD could be one of the reasons for this. It has been hypothesized that certain brain regions contributed to the respective obsessive-compulsive dimensions. In this study, we investigated the relationship between symptom dimensions of OCD and brain morphology using voxel-based morphometry to discover the specific regions showing alterations in the respective dimensions of obsessive-compulsive symptoms. The severities of symptom dimensions in thirty-three patients with OCD were assessed using Obsessive-Compulsive Inventory-Revised (OCI-R). Along with numerous MRI studies pointing out brain abnormalities in autistic spectrum disorder (ASD) patients, a previous study reported a positive correlation between ASD traits and regional gray matter volume in the left dorsolateral prefrontal cortex and amygdala in OCD patients. We investigated the correlation between gray and white matter volumes at the whole brain level and each symptom dimension score, treating all remaining dimension scores, age, gender, and ASD traits as confounding covariates. Our results revealed a significant negative correlation between washing symptom dimension score and gray matter volume in the right thalamus and a significant negative correlation between hoarding symptom dimension score and white matter volume in the left angular gyrus. Although our result was preliminary, our findings indicated that there were specific brain regions in gray and white matter that contributed to symptom dimensions in OCD patients.
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Affiliation(s)
- Motohisa Hirose
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan. .,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan.
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Chihiro Sutoh
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kenichi Asano
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan
| | - Haruko Miyata
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Junko Matsumoto
- Department of Regional Disaster Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Michiko Nakazato
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan
| | - Koji Matsumoto
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan.,Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Osaka, Japan
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Li P, Yang X, Greenshaw AJ, Li S, Luo J, Han H, Liu J, Zhong Z, Guo Z, Xiong H, Yao S, Chen Y, Sun J, Li Z. The effects of cognitive behavioral therapy on resting-state functional brain network in drug-naive patients with obsessive-compulsive disorder. Brain Behav 2018; 8:e00963. [PMID: 29761016 PMCID: PMC5943755 DOI: 10.1002/brb3.963] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/08/2018] [Accepted: 02/25/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Although cognitive behavioral therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD), the treatment mechanisms remain poorly understood. This study aimed to investigate the effects of CBT on changes in the intrinsic whole-brain functional network of OCD patients. MATERIALS AND METHODS Twenty drug-naive and noncomorbid OCD patients were recruited, and resting-state functional magnetic resonance imaging was performed before and after 12 weeks of CBT. Moreover, 20 healthy controls were scanned twice with a 12-week interval. A graph-theory degree centrality (DC) approach and functional connectivity method were used to analyze the whole-brain functional network hub and connectivity changes in OCD patients before and after CBT treatment. RESULTS A significant group × time interaction on DC was found in the left dorsolateral prefrontal cortex (DLPFC); the DC in the left DLPFC was significantly reduced after CBT treatment. Resting-state functional connectivity (RSFC) between the left DLPFC and right orbitofrontal cortex was increased in the OCD patients at baseline, and normalized after CBT treatment. RSFC changes between the left DLPFC and default mode network (DMN) positively correlated with changes in clinical symptoms in OCD patients. CONCLUSIONS These findings suggest that CBT can modulate changes in intrinsic functional network hubs in the cortico-striato-thalamo-cortical circuit in OCD patients. Cognitive control network and DMN connectivity may be a potential imaging biomarker for evaluating CBT treatment for OCD.
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Affiliation(s)
- Ping Li
- Department of Psychiatry Qiqihar Medical University Qiqihar Heilongjiang China
| | - Xiangyun Yang
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China
| | | | - Sufang Li
- Department of Psychiatry & Behavioral Sciences Johns Hopkins University School of Medicine Baltimore MD USA
| | - Jia Luo
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China
| | - Haiying Han
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China
| | - Jing Liu
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China
| | - Zhaoxi Zhong
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China
| | - Zhihua Guo
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China
| | - Hongfang Xiong
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China
| | - Shumin Yao
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China
| | - Yunhui Chen
- Department of Psychiatry Qiqihar Medical University Qiqihar Heilongjiang China
| | - Jing Sun
- Menzies Health Institute Queensland and School of Medicine Griffith University Nathan Qld Australia
| | - Zhanjiang Li
- The China Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital Capital Medical University Beijing China
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Cauda F, Nani A, Costa T, Palermo S, Tatu K, Manuello J, Duca S, Fox PT, Keller R. The morphometric co-atrophy networking of schizophrenia, autistic and obsessive spectrum disorders. Hum Brain Mapp 2018; 39:1898-1928. [PMID: 29349864 PMCID: PMC5895505 DOI: 10.1002/hbm.23952] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 12/19/2017] [Accepted: 12/28/2017] [Indexed: 12/13/2022] Open
Abstract
By means of a novel methodology that can statistically derive patterns of co-alterations distribution from voxel-based morphological data, this study analyzes the patterns of brain alterations of three important psychiatric spectra-that is, schizophrenia spectrum disorder (SCZD), autistic spectrum disorder (ASD), and obsessive-compulsive spectrum disorder (OCSD). Our analysis provides five important results. First, in SCZD, ASD, and OCSD brain alterations do not distribute randomly but, rather, follow network-like patterns of co-alteration. Second, the clusters of co-altered areas form a net of alterations that can be defined as morphometric co-alteration network or co-atrophy network (in the case of gray matter decreases). Third, within this network certain cerebral areas can be identified as pathoconnectivity hubs, the alteration of which is supposed to enhance the development of neuronal abnormalities. Fourth, within the morphometric co-atrophy network of SCZD, ASD, and OCSD, a subnetwork composed of eleven highly connected nodes can be distinguished. This subnetwork encompasses the anterior insulae, inferior frontal areas, left superior temporal areas, left parahippocampal regions, left thalamus and right precentral gyri. Fifth, the co-altered areas also exhibit a normal structural covariance pattern which overlaps, for some of these areas (like the insulae), the co-alteration pattern. These findings reveal that, similarly to neurodegenerative diseases, psychiatric disorders are characterized by anatomical alterations that distribute according to connectivity constraints so as to form identifiable morphometric co-atrophy patterns.
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Affiliation(s)
- Franco Cauda
- GCS‐FMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Focus Lab, Department of PsychologyUniversity of TurinTurinItaly
| | - Andrea Nani
- GCS‐FMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Focus Lab, Department of PsychologyUniversity of TurinTurinItaly
- Michael Trimble Neuropsychiatry Research Group, University of Birmingham and BSMHFTBirminghamUK
| | - Tommaso Costa
- GCS‐FMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Focus Lab, Department of PsychologyUniversity of TurinTurinItaly
| | - Sara Palermo
- Department of NeuroscienceUniversity of TurinTurinItaly
| | - Karina Tatu
- GCS‐FMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Focus Lab, Department of PsychologyUniversity of TurinTurinItaly
| | - Jordi Manuello
- GCS‐FMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
- Focus Lab, Department of PsychologyUniversity of TurinTurinItaly
| | - Sergio Duca
- GCS‐FMRI, Koelliker Hospital and Department of PsychologyUniversity of TurinTurinItaly
| | - Peter T. Fox
- Research Imaging Institute, University of Texas Health Science Center At San AntonioSan AntonioTexas
- South Texas Veterans Health Care SystemSan AntonioTexas
| | - Roberto Keller
- Adult Autism Center, DSM Local Health Unit ASL Citta’ Di TorinoTurinItaly
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Fontenelle LF, Frydman I, Hoefle S, Oliveira-Souza R, Vigne P, Bortolini TS, Suo C, Yücel M, Mattos P, Moll J. Decoding moral emotions in obsessive-compulsive disorder. Neuroimage Clin 2018; 19:82-89. [PMID: 30035005 PMCID: PMC6051311 DOI: 10.1016/j.nicl.2018.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/07/2018] [Accepted: 04/01/2018] [Indexed: 11/20/2022]
Abstract
Background Patients with obsessive-compulsive disorder (OCD) exhibit abnormal neural responses when they experience particular emotions or when they evaluate stimuli with emotional value. Whether these brain responses are sufficiently distinctive to discriminate between OCD patients and healthy controls is unknown. The present study is the first to investigate the discriminative power of multivariate pattern analysis of regional fMRI responses to moral and non-moral emotions. Method To accomplish this goal, we performed a searchlight-based multivariate pattern analysis to unveil brain regions that could discriminate 18 OCD patients from 18 matched healthy controls during provoked guilt, disgust, compassion, and anger. We also investigated the existence of distinctive neural patterns while combining those four emotions (herein termed multiemotion analysis). Results We found that different frontostriatal regions discriminated OCD patients from controls based on individual emotional experiences. Most notably, the left nucleus accumbens (NAcc) discriminated OCD patients from controls during both disgust and the multiemotion analysis. Among other regions, the angular gyrus responses to anger and the lingual and the middle temporal gyri in the multi-emotion analysis were highly discriminant between samples. Additional BOLD analyses supported the directionality of these findings. Conclusions In line with previous studies, differential activity in regions beyond the frontostriatal circuitry differentiates OCD from healthy volunteers. The finding that the response of the left NAcc to different basic and moral emotions is highly discriminative for a diagnosis of OCD confirms current pathophysiological models and points to new venues of research.
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Affiliation(s)
- Leonardo F Fontenelle
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil.
| | - Ilana Frydman
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Sebastian Hoefle
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | - Paula Vigne
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Tiago S Bortolini
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Chao Suo
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Paulo Mattos
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Jorge Moll
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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Gillett CB, Bilek EL, Hanna GL, Fitzgerald KD. Intolerance of uncertainty in youth with obsessive-compulsive disorder and generalized anxiety disorder: A transdiagnostic construct with implications for phenomenology and treatment. Clin Psychol Rev 2018; 60:100-108. [DOI: 10.1016/j.cpr.2018.01.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/12/2017] [Accepted: 01/31/2018] [Indexed: 12/15/2022]
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120
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Winter C, Greene DM, Mavrogiorgou P, Schaper H, Sohr R, Bult-Ito A, Juckel G. Altered serotonergic and GABAergic neurotransmission in a mice model of obsessive-compulsive disorder. Behav Brain Res 2018; 337:240-245. [DOI: 10.1016/j.bbr.2017.09.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/07/2017] [Accepted: 09/07/2017] [Indexed: 01/04/2023]
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121
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Clinical and electrophysiological outcomes of deep TMS over the medial prefrontal and anterior cingulate cortices in OCD patients. Brain Stimul 2018; 11:158-165. [DOI: 10.1016/j.brs.2017.09.004] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 07/03/2017] [Accepted: 09/04/2017] [Indexed: 01/07/2023] Open
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122
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A critical review of PANDAS research in the context of obsessive compulsive disorder. HEALTH PSYCHOLOGY REPORT 2018. [DOI: 10.5114/hpr.2018.70356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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123
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Kamaradova D, Brunovsky M, Prasko J, Horacek J, Hajda M, Grambal A, Latalova K. EEG correlates of induced anxiety in obsessive-compulsive patients: comparison of autobiographical and general anxiety scenarios. Neuropsychiatr Dis Treat 2018; 14:2165-2174. [PMID: 30214206 PMCID: PMC6120576 DOI: 10.2147/ndt.s169172] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The underlying symptomatology of obsessive-compulsive disorder (OCD) can be viewed as an impairment in both cognitive and behavioral inhibition, regarding difficult inhibition of obsessions and behavioral compulsions. Converging results from neuroimaging and electroencephalographic (EEG) studies have identified changes in activities throughout the medial frontal and orbital cortex and subcortical structures supporting the cortico-striato-thalamo-cortical circuit model of OCD. This study aimed to elucidate the electrophysiological changes induced by autobiographical and general anxiety scenarios in patients with OCD. METHODS Resting-state eyes-closed EEG data were recorded in 19 OCD patients and 15 healthy controls. Cortical EEG sources were estimated by standardized low-resolution electromagnetic tomography (sLORETA). The changes in the emotional state were induced by two different scenarios: the autobiographical script related to patient's OCD symptoms and the script triggering general anxiety. RESULTS During the resting state, we proved increased delta activity in the frontal, limbic and temporal lobe and the sub-lobar area in OCD patients. In a comparison of neural activities during general anxiety in OCD patients and the control group, we proved an increase in delta (parietal, temporal, occipital, frontal and limbic lobes, and sub-lobal area), theta (temporal, parietal and occipital lobes) and alpha-1 activities (parietal lobe). Finally, we explored the neural activity of OCD patients during exposure to the autobiographic scenario. We proved an increase in beta-3 activity (left frontal lobe). CONCLUSION Our study proved differences in neural activation in OCD patients and healthy controls during imagination of general anxiety. Exposure to the autobiographic OCD scenario leads to activation of left frontal brain areas. The results show the possibility of using specific scenarios in OCD therapy.
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Affiliation(s)
- Dana Kamaradova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
| | | | - Jan Prasko
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
| | - Jiri Horacek
- National Institute of Mental Health, Klecany, Czech Republic
| | - Miroslav Hajda
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
| | - Ales Grambal
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
| | - Klara Latalova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
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Hatchondo L, Jaafari N, Langbour N, Maillochaud S, Herpe G, Guillevin R, Guillevin C. 1H magnetic resonance spectroscopy suggests neural membrane alteration in specific regions involved in obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2017; 269:48-53. [PMID: 28938221 DOI: 10.1016/j.pscychresns.2017.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 11/23/2022]
Affiliation(s)
- Laura Hatchondo
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
| | - Nematollah Jaafari
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Nicolas Langbour
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Sylvie Maillochaud
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Guillaume Herpe
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Department of Medical Imaging - University Hospital of Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
| | - Rémy Guillevin
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Department of Medical Imaging - University Hospital of Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
| | - Carole Guillevin
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Department of Medical Imaging - University Hospital of Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
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125
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Carlisi CO, Norman L, Murphy CM, Christakou A, Chantiluke K, Giampietro V, Simmons A, Brammer M, Murphy DG, Mataix-Cols D, Rubia K. Disorder-Specific and Shared Brain Abnormalities During Vigilance in Autism and Obsessive-Compulsive Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:644-654. [PMID: 29167833 PMCID: PMC5685008 DOI: 10.1016/j.bpsc.2016.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 11/17/2016] [Accepted: 12/27/2016] [Indexed: 11/02/2022]
Abstract
BACKGROUND Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) are often comorbid and share similarities across some cognitive phenotypes, including certain aspects of attention. However, no functional magnetic resonance imaging studies have compared the underlying neural mechanisms contributing to these shared phenotypes. METHODS Age- and IQ-matched boys (11-17 years old) with ASD (n = 20), boys with OCD (n = 20), and healthy control boys (n = 20) performed a parametrically modulated psychomotor vigilance functional magnetic resonance imaging task. Brain activation and performance were compared among adolescents with OCD, adolescents with ASD, and control adolescents. RESULTS Whereas boys with ASD and OCD were not impaired on task performance, there was a significant group by attention load interaction in several brain regions. With increasing attention load, left inferior frontal cortex/insula and left inferior parietal lobe/pre/post-central gyrus were progressively less activated in boys with OCD relative to the other two groups. In addition, boys with OCD showed progressively increased activation with increasing attention load in rostromedial prefrontal/anterior cingulate cortex relative to boys with ASD and control boys. Shared neurofunctional abnormalities between boys with ASD and boys with OCD included increased activation with increasing attention load in cerebellum and occipital regions, possibly reflecting increased default mode network activation. CONCLUSIONS This first functional magnetic resonance imaging study to compare boys with ASD and OCD showed shared abnormalities in posterior cerebellar-occipital brain regions. However, boys with OCD showed a disorder-specific pattern of reduced activation in left inferior frontal and temporo-parietal regions but increased activation of medial frontal regions, which may potentially be related to neurobiological mechanisms underlying cognitive and clinical phenotypes of OCD.
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Affiliation(s)
- Christina O. Carlisi
- Department of Child and Adolescent Psychiatry, Sackler Institute for Translational Neurodevelopmental Sciences, London
| | - Luke Norman
- Department of Child and Adolescent Psychiatry, Sackler Institute for Translational Neurodevelopmental Sciences, London
| | - Clodagh M. Murphy
- Department of Child and Adolescent Psychiatry, Sackler Institute for Translational Neurodevelopmental Sciences, London
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopmental Sciences, Psychology and Neuroscience, King’s College, London
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London
| | - Anastasia Christakou
- Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Kaylita Chantiluke
- Department of Child and Adolescent Psychiatry, Sackler Institute for Translational Neurodevelopmental Sciences, London
| | - Vincent Giampietro
- Department of Neuroimaging, Psychology and Neuroscience, King’s College, London
| | - Andrew Simmons
- Department of Neuroimaging, Psychology and Neuroscience, King’s College, London
- National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King’s College, London
- Department of Neurobiology, Care Sciences and Society (AS), Center for Alzheimer Research, Division of Clinical Geriatrics, Stockholm, Sweden
| | - Michael Brammer
- Department of Neuroimaging, Psychology and Neuroscience, King’s College, London
| | - Declan G. Murphy
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopmental Sciences, Psychology and Neuroscience, King’s College, London
- Behavioural Genetics Clinic, Adult Autism Service, Behavioural and Developmental Psychiatry Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London
| | | | - David Mataix-Cols
- Department of Clinical Neuroscience(DM-C), Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Sackler Institute for Translational Neurodevelopmental Sciences, London
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126
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Zhang C, Chen Y, Tian S, Wang T, Xie Y, Jin H, Lin G, Gong H, Zeljic K, Sun B, Yang T, Zhan S. Effects of Anterior Capsulotomy on Decision Making in Patients with Refractory Obsessive-Compulsive Disorder. Front Psychol 2017; 8:1814. [PMID: 29089909 PMCID: PMC5651033 DOI: 10.3389/fpsyg.2017.01814] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 09/29/2017] [Indexed: 12/05/2022] Open
Abstract
Despite various lines of evidence implicating impaired decision-making ability in individuals with obsessive–compulsive disorder (OCD), neuropsychological investigation has generated inconsistent findings. Although the cortico-striato-thalamo-cortical (CSTC) circuitry has been suggested, the involvement of the cortex has not yet been fully demonstrated. Moreover, it is unknown whether surgical intervention on the CSTC circuitry results in a predicted improvement of decision-making ability of OCD. Here we present a study of decision making based on the Iowa Gambling Task (IGT) to investigate decision making in a large sample of individuals with treatment-resistant OCD with and without anterior capsulotomy (AC). Task performance was evaluated in healthy subjects, individuals with OCD that had not undergone surgery, and postsurgical OCD patients with AC. The latter group was further divided into a short-term postsurgical group and a long-term postsurgical group. We found that the OCD patients without surgery performed significantly worse than the healthy controls on the IGT. There were no significant differences in decision-making between the presurgical OCD patients and those at the short-term postsurgical follow-up. Decision-making ability of the long-term postsurgical OCD patients was improved to the level comparable to that of healthy controls. All clinical symptoms (OCD, depression, and anxiety) assessed by psychiatric rating scales were significantly alleviated post-surgically, but exhibited no correlation with their IGT task performance. Our findings provide strong evidence that OCD is linked to impairments in decision-making ability; that impaired CSTC circuitry function is directly involved in the manifestation of OCD; and that AC related improvements in cognitive functions are caused by long-term plasticity in the brain circuitry.
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Affiliation(s)
- Chencheng Zhang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yilin Chen
- Institute of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Shuaiwei Tian
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Wang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yile Xie
- Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Jin
- Department of Psychiatry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guozhen Lin
- Department of Psychiatry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hengfen Gong
- Department of Psychiatry, Pudong District Mental Health Center, Shanghai, China
| | - Kristina Zeljic
- Institute of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Bomin Sun
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianming Yang
- Institute of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Shikun Zhan
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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127
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Martínez-Pernía D, Núñez-Huasaf J, Del Blanco Á, Ruiz-Tagle A, Velásquez J, Gomez M, Robert Blesius C, Ibañez A, Fernández-Manjón B, Slachevsky A. Using game authoring platforms to develop screen-based simulated functional assessments in persons with executive dysfunction following traumatic brain injury. J Biomed Inform 2017; 74:71-84. [PMID: 28842292 DOI: 10.1016/j.jbi.2017.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 08/11/2017] [Accepted: 08/20/2017] [Indexed: 11/15/2022]
Abstract
The assessment of functional status is a critical component of clinical neuropsychological evaluations used for both diagnostic and therapeutic purposes in patients with cognitive brain disorders. There are, however, no widely adopted neuropsychological tests that are both ecologically valid and easily administered in daily clinical practice. This discrepancy is a roadblock to the widespread adoption of functional assessments. In this paper, we propose a novel approach using a serious game authoring platform (eAdventure) for creating screen-based simulated functional assessments. We created a naturalistic functional task that consisted of preparing a cup of tea (SBS-COT) and applied the assessment in a convenience sample of eight dyads of therapists/patients with mild executive dysfunction after traumatic brain injury. We had three main aims. First, we performed a comprehensive review of executive function assessment in activities of daily living. Second, we were interested in measuring the feasibility of this technology with respect to staffing, economic and technical requirements. Third, a serious game was administered to patients to study the feasibility of this technology in the clinical context (pre-screening test). In addition, quantitative (Technology Acceptance Model (TAM) questionnaires) and qualitative (semistructured interviews) evaluations were applied to obtain user input. Our results suggest that the staffing, economic and technical requirements of the SBS-COT are feasible. The outcomes of the pre-screening test provide evidence that this technology is useful in the functional assessment of patients with executive dysfunction. In relation to subjective data, the TAM questionnaire showed good user acceptability from a professional perspective. Interview analyses with professionals and patients showed positive experiences related to the use of the SBS-COT. Our work indicates that the use of these types of authoring platforms could have positive long-term implications for neuropsychological research, opening the door to more reproducible, cooperative and efficient research by allowing the facilitated production, reuse and sharing of neuropsychological assessment tools.
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Affiliation(s)
- David Martínez-Pernía
- Center for Advanced Research in Education (CIAE), University of Chile, 8330014, Santiago, Chile; Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibañez, Santiago, Chile; Experiential Neurorehabilitation Research Department, Fundación Polibea, Spain
| | - Javier Núñez-Huasaf
- Los Muermos Primary Care Center and Reloncaví Health Service (SSDR), Los Muermos, Chile
| | - Ángel Del Blanco
- Departamento de Ingeniería del Software e Inteligencia Artificial, Facultad de Informática, Universidad Complutense de Madrid
| | - Amparo Ruiz-Tagle
- Center for Advanced Research in Education (CIAE), University of Chile, 8330014, Santiago, Chile
| | - Juan Velásquez
- Departamento de Ingeniería Industrial, Facultad de Ciencias Físicas y Matemáticas, Universidad de Chile, Santiago, Chile
| | - Mariela Gomez
- Center for Advanced Research in Education (CIAE), University of Chile, 8330014, Santiago, Chile
| | - Carl Robert Blesius
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School
| | - Agustin Ibañez
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibañez, Santiago, Chile; Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad Autónoma del Caribe, Barranquilla, Colombia; Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Sydney, Australia
| | - Baltasar Fernández-Manjón
- Departamento de Ingeniería del Software e Inteligencia Artificial, Facultad de Informática, Universidad Complutense de Madrid
| | - Andrea Slachevsky
- Center for Advanced Research in Education (CIAE), University of Chile, 8330014, Santiago, Chile; Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile; Physiopathology Department, ICBM, Department of Neuroscience and East Neuroscience Department, Faculty of Medicine, University of Chile, Avenida Salvador 486, Providencia, Santiago, Chile; Cognitive Neurology and Dementia, Neurology Department, Hospital del Salvador, Av. Salvador 386, Providencia, Santiago, Chile; Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.
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128
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Moreira PS, Marques P, Soriano-Mas C, Magalhães R, Sousa N, Soares JM, Morgado P. The neural correlates of obsessive-compulsive disorder: a multimodal perspective. Transl Psychiatry 2017; 7:e1224. [PMID: 28850108 PMCID: PMC5611752 DOI: 10.1038/tp.2017.189] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/20/2017] [Accepted: 06/23/2017] [Indexed: 01/14/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is one of the most debilitating psychiatric conditions. An extensive body of the literature has described some of the neurobiological mechanisms underlying the core manifestations of the disorder. Nevertheless, most reports have focused on individual modalities of structural/functional brain alterations, mainly through targeted approaches, thus possibly precluding the power of unbiased exploratory approaches. Eighty subjects (40 OCD and 40 healthy controls) participated in a multimodal magnetic resonance imaging (MRI) investigation, integrating structural and functional data. Voxel-based morphometry analysis was conducted to compare between-group volumetric differences. The whole-brain functional connectome, derived from resting-state functional connectivity (FC), was analyzed with the network-based statistic methodology. Results from structural and functional analysis were integrated in mediation models. OCD patients revealed volumetric reductions in the right superior temporal sulcus. Patients had significantly decreased FC in two distinct subnetworks: the first, involving the orbitofrontal cortex, temporal poles and the subgenual anterior cingulate cortex; the second, comprising the lingual and postcentral gyri. On the opposite, a network formed by connections between thalamic and occipital regions had significantly increased FC in patients. Integrative models revealed direct and indirect associations between volumetric alterations and FC networks. This study suggests that OCD patients display alterations in brain structure and FC, involving complex networks of brain regions. Furthermore, we provided evidence for direct and indirect associations between structural and functional alterations representing complex patterns of interactions between separate brain regions, which may be of upmost relevance for explaining the pathophysiology of the disorder.
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Affiliation(s)
- P S Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal,ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal,Clinical Academic Center–Braga, Braga, Portugal
| | - P Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal,ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal,Clinical Academic Center–Braga, Braga, Portugal
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) and CIBERSAM, Carlos III Health Institute, Barcelona, Spain,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal,ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal,Clinical Academic Center–Braga, Braga, Portugal
| | - N Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal,ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal,Clinical Academic Center–Braga, Braga, Portugal
| | - J M Soares
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal,ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal,Clinical Academic Center–Braga, Braga, Portugal
| | - P Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal,ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal,Clinical Academic Center–Braga, Braga, Portugal,Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus Gualtar, Braga 4710-057 Portugal. E-mail:
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129
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Holbert RC, Witter DP. Positive clinical response to treatment of obsessive-compulsive disorder using dual-site transcranial magnetic stimulation. Aust N Z J Psychiatry 2017; 51:642-643. [PMID: 27920060 DOI: 10.1177/0004867416682600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Richard C Holbert
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Daniel P Witter
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, USA
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130
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Saremi AA, Shariat SV, Nazari MA, Dolatshahi B. Neuropsychological Functioning in Obsessive-Compulsive Washers: Drug-Naive Without Depressive Symptoms. Basic Clin Neurosci 2017; 8:233-248. [PMID: 28781731 PMCID: PMC5535329 DOI: 10.18869/nirp.bcn.8.3.233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 11/25/2016] [Accepted: 12/19/2016] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Obsessive-Compulsive Disorder (OCD) is a complex and heterogeneous neuropsychiatric syndrome. Contamination obsessions and washing/cleaning compulsions are the most frequent clinical OCD subtypes. The current study aimed at examining the neuropsychological impairments in drug-naive obsessive-compulsive (OC) washers without depressive symptoms and their association with the severity of symptoms. METHODS In the current causal-comparative study, 35 patients with diagnostic and statistical mental disorders class (DSM)-IV diagnosed with washing-subtype OCD and 35 healthy subjects were selected by the convenience sampling method and evaluated by computerized neuropsychology battery and clinical tests as Stroop Color-Word Test (SCWT), Wisconsin Card Sorting Test (WCST), Go/No-Go Test, Digits Forward (DF), Digits Backward (DB), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and General Health Questionnaire (GHQ)-28. The patients were matched to the comparison group with regard to age, gender, intelligence quotient (IQ), education, and handedness. All the tests were standardized in Iran. SPSS version 20.00 was used for descriptive and analytical data analysis. RESULTS There was no statistically significant different between the OCD washing and the control groups regarding socio-demographic variables or IQ. There were significant differences between the OC washer and the healthy control groups on the neuropsychological functioning. The obtained results suggested that OC washers performed significantly worse on neuropsychological measures than the controls. There was no significant association between the severity of OC symptoms and the neuropsychological functions in the OCD washing group. CONCLUSION It was concluded that executive function impairment, which is a core feature in OC washers was trait-like in nature.
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Affiliation(s)
- Ali Akbar Saremi
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Seyed Vahid Shariat
- Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioural Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Nazari
- Department of Psychology, Faculty of Education & Psychology, University of Tabriz, Tabriz, Iran
| | - Behrooz Dolatshahi
- Department of Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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131
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Shayganfard M, Jahangard L, Nazaribadie M, Haghighi M, Ahmadpanah M, Sadeghi Bahmani D, Bajoghli H, Holsboer-Trachsler E, Brand S. Repetitive Transcranial Magnetic Stimulation Improved Symptoms of Obsessive-Compulsive Disorders but Not Executive Functions: Results from a Randomized Clinical Trial with Crossover Design and Sham Condition. Neuropsychobiology 2017; 74:115-124. [PMID: 28334708 DOI: 10.1159/000457128] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 01/18/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Whereas there is growing evidence that repetitive transcranial magnetic stimulation (rTMS) favorably impacts on symptoms of obsessive-compulsive disorders (OCD), less is known regarding the influence of rTMS on cognitive performance of patients with OCD. Here, we tested the hypothesis that rTMS has a positive impact both on symptom severity and executive functions in such patients. METHODS We assessed 10 patients diagnosed with OCD (mean age: 33.5 years) and treated with a standard medication; they were randomly assigned either to a treatment-first or to a sham-first condition. Symptom severity (experts' ratings) and executive functions (Wisconsin Card Sorting Test) were assessed by independent raters unaware of the patients' group assignments at baseline, after 2 and 4 weeks. After 2 weeks, treatment switched to sham condition, and sham condition switched to treatment condition. RESULTS Under treatment but not under sham conditions, symptom severity decreased. Performance on the executive function test increased continuously with every new assessment and was unrelated to rTMS treatment. CONCLUSION Whereas the present study confirmed previous research suggesting that rTMS improved symptoms of OCD, rTMS did not improve executive functions to a greater degree than sham treatment. More research is needed to investigate the effect of rTMS on executive functions in patients with OCD.
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Affiliation(s)
- Mehran Shayganfard
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
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132
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Fettes P, Schulze L, Downar J. Cortico-Striatal-Thalamic Loop Circuits of the Orbitofrontal Cortex: Promising Therapeutic Targets in Psychiatric Illness. Front Syst Neurosci 2017; 11:25. [PMID: 28496402 PMCID: PMC5406748 DOI: 10.3389/fnsys.2017.00025] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 04/07/2017] [Indexed: 12/18/2022] Open
Abstract
Corticostriatal circuits through the orbitofrontal cortex (OFC) play key roles in complex human behaviors such as evaluation, affect regulation and reward-based decision-making. Importantly, the medial and lateral OFC (mOFC and lOFC) circuits have functionally and anatomically distinct connectivity profiles which differentially contribute to the various aspects of goal-directed behavior. OFC corticostriatal circuits have been consistently implicated across a wide range of psychiatric disorders, including major depressive disorder (MDD), obsessive compulsive disorder (OCD), and substance use disorders (SUDs). Furthermore, psychiatric disorders related to OFC corticostriatal dysfunction can be addressed via conventional and novel neurostimulatory techniques, including deep brain stimulation (DBS), electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS). Such techniques elicit changes in OFC corticostriatal activity, resulting in changes in clinical symptomatology. Here we review the available literature regarding how disturbances in mOFC and lOFC corticostriatal functioning may lead to psychiatric symptomatology in the aforementioned disorders, and how psychiatric treatments may exert their therapeutic effect by rectifying abnormal OFC corticostriatal activity. First, we review the role of OFC corticostriatal circuits in reward-guided learning, decision-making, affect regulation and reappraisal. Second, we discuss the role of OFC corticostriatal circuit dysfunction across a wide range of psychiatric disorders. Third, we review available evidence that the therapeutic mechanisms of various neuromodulation techniques may directly involve rectifying abnormal activity in mOFC and lOFC corticostriatal circuits. Finally, we examine the potential of future applications of therapeutic brain stimulation targeted at OFC circuitry; specifically, the role of OFC brain stimulation in the growing field of individually-tailored therapies and personalized medicine in psychiatry.
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Affiliation(s)
- Peter Fettes
- Institute of Medical Science, University of TorontoToronto, ON, Canada
| | - Laura Schulze
- Institute of Medical Science, University of TorontoToronto, ON, Canada
| | - Jonathan Downar
- Institute of Medical Science, University of TorontoToronto, ON, Canada.,Krembil Research Institute, University Health NetworkToronto, ON, Canada.,Department of Psychiatry, University of TorontoToronto, ON, Canada.,MRI-Guided rTMS Clinic, University Health NetworkToronto, ON, Canada
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133
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Mulders AEP, Plantinga BR, Schruers K, Duits A, Janssen MLF, Ackermans L, Leentjens AFG, Jahanshahi A, Temel Y. Deep brain stimulation of the subthalamic nucleus in obsessive-compulsive disorder: Neuroanatomical and pathophysiological considerations. Eur Neuropsychopharmacol 2016; 26:1909-1919. [PMID: 27838106 DOI: 10.1016/j.euroneuro.2016.10.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/04/2016] [Accepted: 10/29/2016] [Indexed: 11/17/2022]
Abstract
Obsessive-compulsive disorder (OCD) is among the most disabling chronic psychiatric disorders and has a significant negative impact on multiple domains of quality of life. For patients suffering from severe refractory OCD, deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been applied. Reviewing the literature of the last years we believe that through its central position within the cortico-basal ganglia-thalamocortical circuits, the STN has a coordinating role in decision-making and action-selection mechanisms. Dysfunctional information-processing at the level of the STN is responsible for some of the core symptoms of OCD. Research confirms an electrophysiological dysfunction in the associative and limbic (non-motor) parts of the STN. Compared to Parkinson׳s disease patients, STN neurons in OCD exhibit a lower firing rate, less frequent but longer bursts, increased burst activity in the anterior ventromedial area, an asymmetrical left-sided burst distribution, and a predominant oscillatory activity in the δ-band. Moreover, there is direct evidence for the involvement of the STN in both checking behavior and OCD symptoms, which are both related to changes in electrophysiological activity in the non-motor STN. Through a combination of mechanisms, DBS of the STN seems to interrupt the disturbed information-processing, leading to a normalization of connectivity within the cortico-basal ganglia-thalamocortical circuits and consequently to a reduction in symptoms. In conclusion, based on the STN׳s strategic position within cortico-basal ganglia-thalamocortical circuits and its involvement in action-selection mechanisms that are responsible for some of the core symptoms of OCD, the STN is a mechanism-based target for DBS in OCD.
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Affiliation(s)
- A E P Mulders
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - B R Plantinga
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Biomedical Image Analysis, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - K Schruers
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Duits
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M L F Janssen
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - L Ackermans
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A F G Leentjens
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Jahanshahi
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Y Temel
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
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134
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Frydman I, de Salles Andrade JB, Vigne P, Fontenelle LF. Can Neuroimaging Provide Reliable Biomarkers for Obsessive-Compulsive Disorder? A Narrative Review. Curr Psychiatry Rep 2016; 18:90. [PMID: 27549605 DOI: 10.1007/s11920-016-0729-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In this integrative review, we discuss findings supporting the use neuroimaging biomarkers in the diagnosis and treatment of obsessive-compulsive disorder (OCD). To do so, we have selected the most recent studies that attempted to identify the underlying pathogenic process associated with OCD and whether they provide useful information to predict clinical features, natural history or treatment responses. Studies using functional magnetic resonance (fMRI), voxel-based morphometry (VBM), diffusion tensor imaging (DTI) and proton magnetic resonance spectroscopy (1H MRS) in OCD patients are generally supportive of an expanded version of the earlier cortico-striatal-thalamus-cortical (CSTC) model of OCD. Although it is still unclear whether this information will be incorporated into the daily clinical practice (due to current conceptual approaches to mental illness), statistical techniques, such as pattern recognition methods, appear promising in identifying OCD patients and predicting their outcomes.
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Affiliation(s)
- Ilana Frydman
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Juliana B de Salles Andrade
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paula Vigne
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia.
- , Rua Visconde de Pirajá, 547, 617, Ipanema, Rio de Janeiro, RJ, 22410-003, Brazil.
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135
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Leung A, Bleakley C, Loh A, Saran K, Stewart SE. Pediatric Obsessive-Compulsive Disorder Exacerbation and Obstructive Hydrocephalus: A Case Report. Pediatrics 2016; 138:peds.2016-0558. [PMID: 27609824 DOI: 10.1542/peds.2016-0558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2016] [Indexed: 11/24/2022] Open
Abstract
We present the case of an 11 year-old boy with a previous history of obsessive-compulsive disorder (OCD), who experienced a dramatic and acute worsening of OCD symptoms in temporal association with obstructive hydrocephalus secondary to a tectal low-grade glioma. Management and resolution of the hydrocephalus was temporally associated with an improvement in his OCD compulsion symptoms. The present case does not establish proof of cause and effect, but highlights potential multifactorial influences on OCD onset and clinical course. Cortico-striatal-thalamic-cortical pathways, physically distorted by hydrocephalus in this case, have long been implicated in OCD etiology. Clinical implications include the importance of conducting an appropriate neurologic work-up to rule out biological causes for acute and dramatic OCD exacerbations with neurologic signs, even in the context of preexisting OCD. Given that neurologic lesions may exist in the absence of typical signs and symptoms, that they may further disrupt OCD circuitry, and that treatment may lead to resolution of associated psychiatric symptoms, it is important to remain cognizant of these differential diagnoses.
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Affiliation(s)
- Aldrich Leung
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Clare Bleakley
- Division of Psychiatry, British Columbia Children's Hospital, Vancouver, British Columbia, Canada; and
| | - Adrian Loh
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Division of Psychiatry, British Columbia Children's Hospital, Vancouver, British Columbia, Canada; and
| | - Kelly Saran
- Division of Psychiatry, British Columbia Children's Hospital, Vancouver, British Columbia, Canada; and
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; .,Division of Psychiatry, British Columbia Children's Hospital, Vancouver, British Columbia, Canada; and.,Harvard Medical School, Boston, Massachusetts
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136
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Brooks SJ, Stein DJ. A systematic review of the neural bases of psychotherapy for anxiety and related disorders. DIALOGUES IN CLINICAL NEUROSCIENCE 2016. [PMID: 26487807 PMCID: PMC4610611 DOI: 10.31887/dcns.2015.17.3/sbrooks] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Brain imaging studies over two decades have delineated the neural circuitry of anxiety and related disorders, particularly regions involved in fear processing and in obsessive-compulsive symptoms. The neural circuitry of fear processing involves the amygdala, anterior cingulate, and insular cortex, while cortico-striatal-thalamic circuitry plays a key role in obsessive-compulsive disorder. More recently, neuroimaging studies have examined how psychotherapy for anxiety and related disorders impacts on these neural circuits. Here we conduct a systematic review of the findings of such work, which yielded 19 functional magnetic resonance imaging studies examining the neural bases of cognitive-behavioral therapy (CBT) in 509 patients with anxiety and related disorders. We conclude that, although each of these related disorders is mediated by somewhat different neural circuitry, CBT may act in a similar way to increase prefrontal control of subcortical structures. These findings are consistent with an emphasis in cognitive-affective neuroscience on the potential therapeutic value of enhancing emotional regulation in various psychiatric conditions.
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Affiliation(s)
- Samantha J Brooks
- UCT Department of Psychiatry and Mental Health, Grotte Schuur Hospital, Observatory, Cape Town, South Africa
| | - Dan J Stein
- UCT Department of Psychiatry and Mental Health, Grotte Schuur Hospital, Observatory, Cape Town, South Africa; MRC Unit on Anxiety & Stress Disorders, Cape Town, South Africa
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137
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Schirmbeck F, Swets M, Meijer CJ, Zink M, de Haan L. Longitudinal association between cognitive performance and obsessive-compulsive symptoms in patients with psychosis and unaffected siblings. Acta Psychiatr Scand 2016; 133:399-409. [PMID: 26861535 DOI: 10.1111/acps.12558] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Obsessive-compulsive symptoms (OCS) frequently occur in psychotic disorders. Cross-sectional associations between OCS and cognitive impairment have led to different causal explanations. Whereas one assumes that higher cognitive impairment reflects a risk factor for psychotic patients to develop OCS, another suggests that deficits reflect a consequence of OCS. This study investigated the longitudinal interrelation between OCS and cognitive functioning. METHOD Baseline and follow-up data from 622 patients and 670 un-affected siblings from the 'Genetic Risk and Outcome in Psychosis' study were analyzed. Participants were allocated to groups according to the presence or absence of OCS at assessments and compared on several cognitive domains. RESULTS Cross-sectional comparisons revealed no group differences in cognitive performance. Longitudinal analyses comparing the groups with changes in OCS revealed one significant group effect with more problems in set-shifting abilities in patient who reported OCS development at follow-up. Significant time and interaction effects were mainly due to improvement in immediate verbal recall and digit-symbol coding in patients and siblings who reported remission of OCS. CONCLUSION Although insight into causality needs further exploration, our results do not confirm the hypothesis of pre-existing cognitive risk constellations. Findings suggest that remission of comorbid OCS results in improved immediate verbal recall and processing speed.
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Affiliation(s)
- F Schirmbeck
- Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands.,Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - M Swets
- Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - C J Meijer
- Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - M Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - L de Haan
- Academic Medical Centre, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands.,Arkin Institute for Mental Health, Amsterdam, the Netherlands
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138
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Klimke A, Nitsche MA, Maurer K, Voss U. Case Report: Successful Treatment of Therapy-Resistant OCD With Application of Transcranial Alternating Current Stimulation (tACS). Brain Stimul 2016; 9:463-465. [DOI: 10.1016/j.brs.2016.03.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 02/27/2016] [Accepted: 03/05/2016] [Indexed: 10/22/2022] Open
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139
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Aznar S, Hervig MES. The 5-HT2A serotonin receptor in executive function: Implications for neuropsychiatric and neurodegenerative diseases. Neurosci Biobehav Rev 2016; 64:63-82. [DOI: 10.1016/j.neubiorev.2016.02.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 11/05/2015] [Accepted: 02/08/2016] [Indexed: 02/07/2023]
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140
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Mas S, Gassó P, Morer A, Calvo A, Bargalló N, Lafuente A, Lázaro L. Integrating Genetic, Neuropsychological and Neuroimaging Data to Model Early-Onset Obsessive Compulsive Disorder Severity. PLoS One 2016; 11:e0153846. [PMID: 27093171 PMCID: PMC4836736 DOI: 10.1371/journal.pone.0153846] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/05/2016] [Indexed: 01/03/2023] Open
Abstract
We propose an integrative approach that combines structural magnetic resonance imaging data (MRI), diffusion tensor imaging data (DTI), neuropsychological data, and genetic data to predict early-onset obsessive compulsive disorder (OCD) severity. From a cohort of 87 patients, 56 with complete information were used in the present analysis. First, we performed a multivariate genetic association analysis of OCD severity with 266 genetic polymorphisms. This association analysis was used to select and prioritize the SNPs that would be included in the model. Second, we split the sample into a training set (N = 38) and a validation set (N = 18). Third, entropy-based measures of information gain were used for feature selection with the training subset. Fourth, the selected features were fed into two supervised methods of class prediction based on machine learning, using the leave-one-out procedure with the training set. Finally, the resulting model was validated with the validation set. Nine variables were used for the creation of the OCD severity predictor, including six genetic polymorphisms and three variables from the neuropsychological data. The developed model classified child and adolescent patients with OCD by disease severity with an accuracy of 0.90 in the testing set and 0.70 in the validation sample. Above its clinical applicability, the combination of particular neuropsychological, neuroimaging, and genetic characteristics could enhance our understanding of the neurobiological basis of the disorder.
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Affiliation(s)
- Sergi Mas
- Dept. Anatomic Pathology, Pharmacology and Microbiology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- * E-mail:
| | - Patricia Gassó
- Dept. Anatomic Pathology, Pharmacology and Microbiology, University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Anna Calvo
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Nuria Bargalló
- Department of Radiology, Centre de Diagnostic per la Imatge, Hospital Clínic, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Amalia Lafuente
- Dept. Anatomic Pathology, Pharmacology and Microbiology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Luisa Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic de Barcelona, Barcelona, Spain
- Dept. Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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141
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Magioncalda P, Martino M, Ely BA, Inglese M, Stern ER. Microstructural white-matter abnormalities and their relationship with cognitive dysfunction in obsessive-compulsive disorder. Brain Behav 2016; 6:e00442. [PMID: 27099803 PMCID: PMC4831422 DOI: 10.1002/brb3.442] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/29/2015] [Accepted: 12/30/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In recent years, diffusion tensor imaging (DTI) studies have detected subtle microstructural abnormalities of white matter (WM) in obsessive-compulsive disorder (OCD). However, findings have been inconsistent, and it is unclear whether WM abnormalities are related to cognitive processes. The aim of this study was to explore the relationship of WM alterations with cognitive variables in OCD in order to investigate the structural correlates of behaviorally relevant features of the disorder. METHODS We compared DTI-derived fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) measures between OCD patients (n = 16) and healthy controls (n = 18) using a whole-brain tract-based spatial statistics (TBSS) approach. We also explored the correlations of WM alterations with clinical and cognitive variables. RESULTS Patients with OCD demonstrated increases in MD in the bilateral posterior corona radiata; left anterior corona radiata; bilateral superior longitudinal fasciculus; genu, body, and splenium of the corpus callosum; and left posterior limb of the internal capsule. An increase in RD values was also found in some of the same tracts (right posterior corona radiata, right superior longitudinal fasciculus, left anterior corona radiata, and corpus callosum). Furthermore, increased MD value in the internal capsule was correlated with the percentage of errors made during a target detection task, which was greater in the OCD group overall. CONCLUSIONS These findings indicate that OCD patients show greater diffusivity in several white-matter regions. The correlation between cognitive performance and diffusivity in the internal capsule suggests that microstructural WM alternations may have functional consequences for the disorder.
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Affiliation(s)
- Paola Magioncalda
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health Section of Psychiatry University of Genoa Genoa Italy
| | - Matteo Martino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health Section of Psychiatry University of Genoa Genoa Italy
| | - Benjamin A Ely
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York City New York
| | - Matilde Inglese
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York City New York; Department of Neurology Icahn School of Medicine at Mount Sinai New York City New York
| | - Emily R Stern
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York City New York; Department of Psychiatry Icahn School of Medicine at Mount Sinai New York City New York
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142
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Bation R, Poulet E, Haesebaert F, Saoud M, Brunelin J. Transcranial direct current stimulation in treatment-resistant obsessive-compulsive disorder: An open-label pilot study. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:153-7. [PMID: 26439873 DOI: 10.1016/j.pnpbp.2015.10.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/17/2015] [Accepted: 10/02/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a severe mental illness. OCD symptoms are often resistant to available treatments. Abnormalities within the orbitofronto-striato-pallido-thalamic circuitry, especially orbitofrontal cortex (OFC) hyperactivity and cerebellar hypoactivity have been observed in patients. Non-invasive brain stimulation studies have indicated that transcranial direct current stimulation (tDCS) may be a useful alternative to alleviate treatment-resistant symptoms in various neuropsychiatric conditions. METHODS In an open-label pilot study, 8 patients with treatment-resistant OCD received 10 sessions (twice a day) of 2mA tDCS applied with the cathode over the left OFC and the anode over the right cerebellum. OCD (Y-BOCS and OCD-VAS) as well as depressive (MADRS) symptoms were measured 4 times: one time before tDCS and 3 times after (immediately after, 1 and 3months after the 10th tDCS session). RESULTS We reported a significant 26.4% (±15.8) decrease of Y-BOCS score (p=0.002). The beneficial effect lasted during the 3month follow-up. No effect of tDCS was observed on depressive symptoms. At end point, 5 out of 8 patients had a decrease of ≥25%; and 3 out of 8 patients had a decrease of ≥35% in Y-BOCS score. tDCS was well tolerated. CONCLUSION tDCS with the cathode placed over the left OFC combined with the anode placed over the right cerebellum is a suitable and safe approach to decrease OCD symptoms in patients with treatment-resistant OCD. Large scale randomized controlled studies are needed to confirm this promising result.
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Affiliation(s)
- Remy Bation
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France.
| | - Emmanuel Poulet
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France; CHU de Lyon - Groupement Hospitalier Edouard Herriot - Service de Psychiatrie des Urgences, France
| | - Frederic Haesebaert
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France
| | - Mohamed Saoud
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France; CHU de Lyon - Groupement Hospitalier Est - Hôpital Pierre Wertheimer - Psychiatrie adultes - Consultations/Liaison, France
| | - Jerome Brunelin
- Université de Lyon, F-69003, Université Claude Bernard Lyon I, EA 4615, Centre Hospitalier le Vinatier, Bron, France
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Kamaradova D, Hajda M, Prasko J, Taborsky J, Grambal A, Latalova K, Ociskova M, Brunovsky M, Hlustik P. Cognitive deficits in patients with obsessive-compulsive disorder - electroencephalography correlates. Neuropsychiatr Dis Treat 2016; 12:1119-25. [PMID: 27226716 PMCID: PMC4866747 DOI: 10.2147/ndt.s93040] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is associated with cognitive dysfunction. Although there are several studies focused on the neurobiology of OCD, little is known about the biological correlates of the cognitive deficit linked to this disorder. The aim of our study was to examine the association between cognitive impairment and current source density markers in patients with OCD. METHODS Resting-state eyes-closed electroencephalography (EEG) data were recorded in 20 patients with OCD and 15 healthy controls who were involved in the study. Cortical EEG sources were estimated by standardized low-resolution electromagnetic tomography in seven frequency bands: delta (1.5-6 Hz), theta (6.5-8 Hz), alpha-1 (8.5-10 Hz), alpha-2 (10.5-12 Hz), beta-1 (12.5-18 Hz), beta-2 (18.5-21 Hz), and beta-3 (21.5-30 Hz). Cognitive performance was measured by the Trail-Making Test (versions A and B), Stroop CW Test, and D2 Test. RESULTS Frontal delta and theta EEG sources showed significantly higher activity in the whole group of patients with OCD (N=20) than in control subjects (N=15). Subsequent analysis revealed that this excess of low-frequency activity was present only in the subgroup of eleven patients with cognitive impairment (based on the performance in the Trail-Making Test - A). The subgroup of patients with normal cognitive functions (N=9) did not differ in cortical EEG sources from healthy controls. CONCLUSION The present results suggest that frontal low-frequency cortical sources of resting-state EEG rhythms can distinguish groups of cognitively impaired and cognitively intact patients with OCD. Based on our results, future studies should consider whether the present methodological approach provides clinically useful information for the revelation of cognitive impairment in patients with OCD.
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Affiliation(s)
- Dana Kamaradova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic; Department of Psychiatry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Miroslav Hajda
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic; Department of Psychiatry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Jan Prasko
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic; Department of Psychiatry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Jiri Taborsky
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic; Department of Psychiatry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Ales Grambal
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic; Department of Psychiatry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Klara Latalova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic; Department of Psychiatry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Marie Ociskova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic; Department of Psychiatry, Palacky University Olomouc, Olomouc, Czech Republic
| | | | - Petr Hlustik
- Department of Neurology, University Hospital Olomouc, Olomouc, Czech Republic; Department of Neurology, Palacky University, Olomouc, Czech Republic
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Yang XY, Sun J, Luo J, Zhong ZX, Li P, Yao SM, Xiong HF, Huang FF, Li ZJ. Regional homogeneity of spontaneous brain activity in adult patients with obsessive-compulsive disorder before and after cognitive behavioural therapy. J Affect Disord 2015; 188:243-51. [PMID: 26378734 DOI: 10.1016/j.jad.2015.07.048] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 07/16/2015] [Accepted: 07/30/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD). Several neuroimaging studies have explored alterations of brain function in OCD patients as they performed tasks after CBT. However, the effects of CBT on the neural activityin OCD during rest remain unknown. Therefore, we investigated changes in regional homogeneity (ReHo) in OCD patients before and after CBT. METHODS Twenty-two OCD patients and 22 well-matched healthy controls participated in the resting-state functional magnetic resonance imaging scans. We compared differences in ReHo between the OCD and control groups before treatment and investigated the changes of ReHo in 17 OCD patients who responded to CBT. RESULTS Compared to healthy controls, OCD patients exhibited higher ReHo in the right orbitofrontal cortex (OFC), bilateral middle frontal cortex, right precuneus, left cerebellum, and vermis, as well as lower ReHo in the bilateral caudate, right calcarine, right posterior cingulate cortex, and right middle temporal cortex. Along with the clinical improvement in OCD patients after CBT, we found decreased ReHo in the right OFC, bilateral middle frontal cortex, left cerebellum and vermis, and increased ReHo in the left caudate. Improvement of OCD symptoms was significantly correlated with the changed ReHo in the right OFC and left cerebellum. CONCLUSIONS Although these findings are preliminary and need to be replicated in larger samples, they indicate the presence of abnormal spontaneous brain activity of the prefrontal-striatal-cerebellar circuit in OCD patients, and provide evidence that CBT can selectively modulate the spontaneous brain activity of this circuit in OCD patients.
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Affiliation(s)
- Xiang-Yun Yang
- Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
| | - Jing Sun
- Menzies Health Institute Queensland and School of Medicine, Griffith University, Australia.
| | - Jia Luo
- Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
| | - Zhao-Xi Zhong
- Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
| | - Ping Li
- Department of Psychiatry, Qiqihaer Medical University, Qiqihaer, Heilongjiang, China.
| | - Shu-Min Yao
- Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China
| | - Hong-Fang Xiong
- Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
| | - Fang-Fang Huang
- Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
| | - Zhan-Jiang Li
- Department of Clinical Psychology, Beijing Key Lab of Mental Disorders, Beijing Anding Hospital, Capital Medical University, and Center of Schizophrenia, Beijing Institute for Brain Disorders, Beijing, People's Republic of China.
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Fitzgerald PB, Segrave RA. Deep brain stimulation in mental health: Review of evidence for clinical efficacy. Aust N Z J Psychiatry 2015; 49:979-93. [PMID: 26246408 DOI: 10.1177/0004867415598011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE There is increasing interest in the use of deep brain stimulation as a treatment for psychiatric disorders. In this review, we consider the evidence for the effectiveness of deep brain stimulation for psychiatric indications, with a primary focus on obsessive compulsive disorder and major depressive disorder. METHODS Case reports, case series and clinical trials where deep brain stimulation was primarily utilised in the treatment of a psychiatric disorder, including obsessive compulsive disorder, major depressive disorder, anorexia nervosa or an addictive disorder were identified. The evidence for the effectiveness of deep brain stimulation in the treatment of obsessive compulsive disorder and major depressive disorder was reviewed with studies clustered by the site of implantation. RESULTS The majority of identified manuscripts report small case series or single cases. A limited number of studies have reported some form of randomised or blinded stimulation comparison. All of these comparative reports have included small samples of subjects (less than 20 per study in total) compromising the feasibility of making statistical comparison between outcomes in the comparison phases. The two exceptions to this have been industry-sponsored studies conducted in the treatment of major depressive disorder. However, both were stopped prematurely due to concerns about poor efficacy. CONCLUSIONS There is insufficient evidence at this point in time to support the use of deep brain stimulation as a clinical treatment for any psychiatric disorder outside of research and programmes where formal outcome data are being systematically collated. While some promising initial data exist to support its potential efficacy for a number of psychiatric conditions, further research is required to establish optimal implantation targets, patient characteristics associated with positive therapeutic outcomes and optimal deep brain stimulation parameters and parameter-programming methods.
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Affiliation(s)
- Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Alfred Psychiatry Research Centre, Monash University Central Clinical School and Alfred Health, Melbourne, VIC, Australia
| | - Rebecca A Segrave
- Monash Alfred Psychiatry Research Centre, Alfred Psychiatry Research Centre, Monash University Central Clinical School and Alfred Health, Melbourne, VIC, Australia
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Yamasue H. Using endophenotypes to examine molecules related to candidate genes as novel therapeutics: The “endophenotype-associated surrogate endpoint (EASE)” concept. Neurosci Res 2015; 99:1-7. [DOI: 10.1016/j.neures.2015.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/25/2015] [Accepted: 05/25/2015] [Indexed: 01/16/2023]
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147
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Repetitive Transcranial Magnetic Stimulation (rTMS) improves symptoms and reduces clinical illness in patients suffering from OCD--Results from a single-blind, randomized clinical trial with sham cross-over condition. J Psychiatr Res 2015; 68:238-44. [PMID: 26228425 DOI: 10.1016/j.jpsychires.2015.06.020] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/05/2015] [Accepted: 06/29/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Both psychotherapeutic and psychopharmacological methods are used in the treatment of patients suffering from obsessive-compulsive disorders (OCD), and both with encouraging but also mixed results. Here, we tested the hypothesis that repetitive Transcranial Magnetic Stimulation (rTMS) improves symptoms and reduces illness severity in patients suffering from treatment-resistant OCD. METHODS A total of 21 patients (57% females; mean age: M = 35.8 years) suffering from treatment-resistant OCD were randomly assigned either to an rTMS-first-sham-second, or a sham-first-rTMS-second condition. Treatment sessions lasted for 4 weeks with five sessions per week, each of about 50 min duration. Symptoms were assessed via both self- and expert-ratings. RESULTS Both self- and expert-reported symptom severity reduced in the rTMS condition as compared to the sham condition. Full- and partial responses were observed in the rTMS-condition, but not in the sham-condition. CONCLUSIONS The pattern of results from this single-blind, sham- and cross-over design suggests that rTMS is a successful intervention for patients suffering from treatment-resistant OCD.
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148
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Sinha S, McGovern RA, Mikell CB, Banks GP, Sheth SA. Ablative Limbic System Surgery: Review and Future Directions. Curr Behav Neurosci Rep 2015; 2:49-59. [PMID: 31745448 PMCID: PMC6863509 DOI: 10.1007/s40473-015-0038-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The limbic system is a network of interconnected brain regions regulating emotion, memory, and behavior. Pathology of the limbic system can manifest as psychiatric disease, including obsessive-compulsive disorder and major depressive disorder. For patients with these disorders who have not responded to standard pharmacological and cognitive behavioral therapy, ablative surgery is a neurosurgical treatment option. The major ablative limbic system procedures currently used are anterior capsulotomy, dorsal anterior cingulotomy, subcaudate tractotomy, and limbic leucotomy. In this review, we include a brief history of ablative limbic system surgery leading up to its current form. Mechanistic justification for these procedures is considered in a discussion of the pathophysiology of psychiatric disease. We then discuss therapeutic efficacy as demonstrated by recent trials. Finally, we consider future directions, including the search for predictors of treatment response, the development of more precise targeting methods, and the use of advances in neuroimaging to track treatment response.
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Affiliation(s)
- Saurabh Sinha
- Division of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Robert A. McGovern
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY
| | - Charles B. Mikell
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY
| | - Garrett P. Banks
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY
| | - Sameer A. Sheth
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY
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