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Treu S, Gonzalez-Rosa JJ, Soto-Leon V, Lozano-Soldevilla D, Oliviero A, Lopez-Sosa F, Reneses-Prieto B, Barcia JA, Strange BA. A ventromedial prefrontal dysrhythmia in obsessive-compulsive disorder is attenuated by nucleus accumbens deep brain stimulation. Brain Stimul 2021; 14:761-770. [PMID: 33984535 DOI: 10.1016/j.brs.2021.04.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/23/2021] [Accepted: 04/30/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has consistently been linked to abnormal frontostriatal activity. The electrophysiological disruption in this circuit, however, remains to be characterized. OBJECTIVE/HYPOTHESIS The primary goal of this study was to investigate the neuronal synchronization in OCD patients. We predicted aberrant oscillatory activity in frontal regions compared to healthy control subjects, which would be alleviated by deep brain stimulation (DBS) of the nucleus accumbens (NAc). METHODS We compared scalp EEG recordings from nine patients with OCD treated with NAc-DBS with recordings from healthy controls, matched for age and gender. Within the patient group, EEG activity was compared with DBS turned off vs. stimulation at typical clinical settings (3.5 V, frequency of stimulation 130 Hz, pulse width 60 μs). In addition, intracranial EEG was recorded directly from depth macroelectrodes in the NAc in four OCD patients. RESULTS Cross-frequency coupling between the phase of alpha/low beta oscillations and amplitude of high gamma was significantly increased over midline frontal and parietal electrodes in patients when stimulation was turned off, compared to controls. Critically, in patients, beta (16-25 Hz) -gamma (110-166 Hz) phase amplitude coupling source localized to the ventromedial prefrontal cortex, and was reduced when NAc-DBS was active. In contrast, intracranial EEG recordings showed no beta-gamma phase amplitude coupling. The contribution of non-sinusoidal beta waveforms to this coupling are reported. CONCLUSION We reveal an increased beta-gamma phase amplitude coupling in fronto-central scalp sensors in patients suffering from OCD, compared to healthy controls, which may derive from ventromedial prefrontal regions implicated in OCD and is normalized by DBS of the nucleus accumbens. This aberrant cross-frequency coupling could represent a biomarker of OCD, as well as a target for novel therapeutic approaches.
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Affiliation(s)
- Svenja Treu
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Spain.
| | - Javier J Gonzalez-Rosa
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Spain; University of Cadiz, Institute of Biomedical Research Cadiz (INiBICA), Cádiz, Spain
| | - Vanesa Soto-Leon
- Hospital Nacional de Parapléjicos, FENNSI Group, Hospital Nacional de Parapléjicos, Toledo, Spain
| | - Diego Lozano-Soldevilla
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Spain
| | - Antonio Oliviero
- Hospital Nacional de Parapléjicos, FENNSI Group, Hospital Nacional de Parapléjicos, Toledo, Spain
| | - Fernando Lopez-Sosa
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Spain; University of Cadiz, Institute of Biomedical Research Cadiz (INiBICA), Cádiz, Spain
| | - Blanca Reneses-Prieto
- Department of Psychiatry, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Spain
| | - Juan A Barcia
- Department of Neurosurgery, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Spain
| | - Bryan A Strange
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Spain
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Sarangi A, Payberah D, McMahon T. The Use of Clonidine in the Treatment of Debilitating Obsessive-Compulsive Behaviors Comorbid With Depression and Post-Traumatic Stress Disorder: A Case Report. Cureus 2021; 13:e14920. [PMID: 34123619 PMCID: PMC8186558 DOI: 10.7759/cureus.14920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Clonidine is an alpha-2 agonist traditionally used as an antihypertensive, and more recently in the treatment of psychiatric disorders such as attention-deficit hyperactive disorder (ADHD), tic disorders such as Tourette’s syndrome, and post-traumatic stress disorder (PTSD). However, there are scarce data in the literature about the use of clonidine in the treatment of obsessive-compulsive disorder (OCD). In this report, we present the case of a 16-year-old female suffering from OCD. The first-line treatment with sertraline was not very efficacious in improving her symptoms and even led to worsening of the same. However, subsequent treatment with clonidine resulted in rapid and significant improvement in her condition. We postulate that further research is required to gain more insight into the therapeutic potential of clonidine in OCD patients.
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Affiliation(s)
- Ashish Sarangi
- Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Daniel Payberah
- Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Terry McMahon
- Psychiatry, Texas Tech University Health Sciences Center, Lubbock, USA
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203
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The Role of Social Stress in the Development of Inhibitory Control Deficit: A Systematic Review in Preclinical Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094953. [PMID: 34066570 PMCID: PMC8124175 DOI: 10.3390/ijerph18094953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 11/29/2022]
Abstract
Inhibitory control deficit and impulsivity and compulsivity behaviours are present in different psychopathological disorders such as addiction, obsessive-compulsive disorders and schizophrenia, among others. Social relationships in humans and animals are governed by social organization rules, which modulate inhibitory control and coping strategies against stress. Social stress is associated with compulsive alcohol and drug use, pointing towards a determining factor in an increased vulnerability to inhibitory control deficit. The goal of the present review is to assess the implication of social stress and dominance on the vulnerability to develop impulsive and/or compulsive spectrum disorders, with the aid of the information provided by animal models. A systematic search strategy was carried out on the PubMed and Web of Science databases, and the most relevant information was structured in the text and tables. A total of 34 studies were recruited in the qualitative synthesis. The results show the role of social stress and dominance in increased drug and alcohol use, aggressive and impulsive behaviour. Moreover, the revised studies support the role of Dopaminergic (DA) activity and the alterations in the dopaminergic D1/D2 receptors as key factors in the development of inhibitory control deficit by social stress.
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204
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Price RB, Gillan CM, Hanlon C, Ferrarelli F, Kim T, Karim HT, Renard M, Kaskie R, Degutis M, Wears A, Vienneau EP, Peterchev AV, Brown V, Siegle GJ, Wallace MLL, Ahmari SE. Effect of Experimental Manipulation of the Orbitofrontal Cortex on Short-Term Markers of Compulsive Behavior: A Theta Burst Stimulation Study. Am J Psychiatry 2021; 178:459-468. [PMID: 33726523 PMCID: PMC8119344 DOI: 10.1176/appi.ajp.2020.20060821] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Compulsive behaviors are a core feature of obsessive-compulsive spectrum disorders but appear across a broad spectrum of psychological conditions. It is thought that compulsions reflect a failure to override habitual behaviors "stamped in" through repeated practice and short-term distress reduction. Animal models suggest a possible causal role of the orbitofrontal cortex (OFC) in compulsive behaviors, but human studies have largely been limited by correlational designs. The goal of this study was to establish the first experimental evidence in humans for a mechanistic model in order to inform further experimental work and the eventual development of novel mechanistic treatments involving synergistic biological-behavioral pairings. METHODS After a baseline assessment, 69 individuals with compulsive behavior disorders were randomly assigned, in a double-blind, between-subjects design, to receive a single session of one of two active stimulation conditions targeting the left OFC: intermittent theta burst stimulation (iTBS), expected to increase OFC activity, or continuous TBS (cTBS), expected to decrease activity (both conditions, 600 pulses at 110% of target resting motor threshold). In both conditions, brain modulation was paired with a subsequent computer task providing practice in overriding a clinically relevant habit (an overlearned shock avoidance behavior), delivered during the expected window of OFC increase or decrease. Pre- and post-TBS functional MRI assessments were conducted of target engagement and compulsive behaviors performed in response to an idiographically designed stressful laboratory probe. RESULTS cTBS and iTBS modulated OFC activation in the expected directions. cTBS, relative to iTBS, exhibited a beneficial impact on acute laboratory assessments of compulsive behaviors 90 minutes after TBS. These acute behavioral effects persisted 1 week after cTBS. CONCLUSIONS Experimental modulation of the OFC, within the behavioral context of habit override training, affected short-term markers of compulsive behavior vulnerability. The findings help delineate a causal translational model, serving as an initial precursor to mechanistic intervention development.
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205
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Jurng J, Park H, Kim T, Park I, Moon SY, Lho SK, Kim M, Kwon JS. Smaller volume of posterior thalamic nuclei in patients with obsessive-compulsive disorder. NEUROIMAGE-CLINICAL 2021; 30:102686. [PMID: 34215156 PMCID: PMC8102624 DOI: 10.1016/j.nicl.2021.102686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 12/25/2022]
Abstract
Thalamic subregional volumes were compared between medication-free OCD and HC groups. Left posterior thalamic nuclei volumes were smaller in OCD patients compared to HCs. The smaller thalamic subregional volumes were associated with later onset of OCD. Posterior thalamic nuclei volume may reflect OCD subtype related to the age of onset.
Aim Although the thalamus is a key structure in the pathophysiology of obsessive–compulsive disorder (OCD), reports regarding thalamic volume alterations in OCD patients have been inconsistent. Because the thalamus has a complex structure with distinct functions, we investigated subregional volume changes in the thalamus and their relationship with clinical attributes in a large sample of medication-free OCD patients. Methods We collected T1-weighted magnetic resonance imaging data from 177 OCD patients and 152 healthy controls (HCs). Using FreeSurfer, we segmented the thalamus into 12 nuclei groups; subregional volumes were compared between groups using an analysis of covariance. The relationships between altered thalamic volumes and OC symptom severity and OCD onset age were investigated. Results Compared to HCs, OCD patients showed a smaller volume of the left posterior thalamic nuclei. Other thalamic subregions did not show significant group differences. There was a significant negative correlation between the volume of the left posterior thalamic nuclei and the age of OCD onset but no significant correlation with OC symptom severity. Conclusions This is the first study to report reduced volume of the posterior thalamic nuclei in a large sample of medication-free OCD patients. Our results suggest that the volume of posterior thalamic nuclei may reflect different pathophysiological mechanisms of OCD subtypes related to the age of onset. Additional studies with pediatric samples are required to clarify the relationship between thalamic alterations and the onset age of OCD.
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Affiliation(s)
- Jinhyung Jurng
- Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyungyou Park
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Taekwan Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Inkyung Park
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Sun-Young Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Silvia Kyungjin Lho
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
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206
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Different Effects of Alcohol Exposure on Action and Outcome-Related Orbitofrontal Cortex Activity. eNeuro 2021; 8:ENEURO.0052-21.2021. [PMID: 33785522 PMCID: PMC8174034 DOI: 10.1523/eneuro.0052-21.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 11/21/2022] Open
Abstract
Alcohol dependence can result in long-lasting deficits to decision-making and action control. Neurobiological investigations have identified orbitofrontal cortex (OFC) as important for outcome-related contributions to goal-directed actions during decision-making. Prior work has shown that alcohol dependence induces long-lasting changes to OFC function that persist into protracted withdrawal and disrupts goal-directed control over actions. However, it is unclear whether these changes in function alter representation of action and outcome-related neural activity in OFC. Here, we used the well-validated chronic intermittent ethanol (CIE) exposure and withdrawal procedure to model alcohol dependence in mice and performed in vivo extracellular recordings during an instrumental task in which lever-press actions made for a food outcome. We found alcohol dependence disrupted goal-directed action control and increased OFC activity associated with lever-pressing but decreased OFC activity during outcome-related epochs. The ability to decode outcome-related information, but not action information, from OFC activity following CIE exposure was reduced. Hence, chronic alcohol exposure induced a long-lasting disruption to OFC function such that activity associated with actions was enhanced, but OFC activity contributions to outcome-related information was diminished. This has important implications for hypotheses regarding compulsive and habitual phenotypes observed in addiction.
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207
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Yalcinbas EA, Cazares C, Gremel CM. Call for a more balanced approach to understanding orbital frontal cortex function. Behav Neurosci 2021; 135:255-266. [PMID: 34060878 DOI: 10.1037/bne0000450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Orbital frontal cortex (OFC) research has historically emphasized the function of this associative cortical area within top-down theoretical frameworks. This approach has largely focused on mapping OFC activity onto human-defined psychological or cognitive constructs and has often led to OFC circuitry bearing the weight of entire theoretical frameworks. New techniques and tools developed in the last decade have made it possible to revisit long-standing basic science questions in neuroscience and answer them with increasing sophistication. We can now study and specify the genetic, molecular, cellular, and circuit architecture of a brain region in much greater detail, which allows us to piece together how they contribute to emergent circuit functions. For instance, adopting such systematic and unbiased bottom-up approaches to elucidating the function of the visual system has paved the way to building a greater understanding of the spectrum of its computational capabilities. In the same vein, we argue that OFC research would benefit from a more balanced approach that also places focus on novel bottom-up investigations into OFC's computational capabilities. Furthermore, we believe that the knowledge gained by employing a more bottom-up approach to investigating OFC function will ultimately allow us to look at OFC's dysfunction in disease through a more nuanced biological lens. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Ege A Yalcinbas
- The Neurosciences Graduate Program, University of California, San Diego
| | - Christian Cazares
- The Neurosciences Graduate Program, University of California, San Diego
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208
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Di Carlo F, Pettorruso M, Alessi MC, Picutti E, Collevecchio R, Migliara G, Baroni G, Gambi F, Cinosi E, Martinotti G, Grant JE, di Giannantonio M. Characterizing the building blocks of Problematic Use of the Internet (PUI): The role of obsessional impulses and impulsivity traits among Italian young adults. Compr Psychiatry 2021; 106:152225. [PMID: 33581451 DOI: 10.1016/j.comppsych.2021.152225] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Problematic Use of the Internet (PUI) is a considerable issue of the modern era, but its risk factors are still poorly understood. Impulsivity and obsessive-compulsive symptoms have been associated with PUI, but this relationship is still debated. In this article we focus on the relationships of PUI with obsessive-compulsive and impulsive symptoms in a cohort of Italian young adults, in order to identify possible vulnerability factors for PUI. METHODS A sample of 772 Italian individuals aged 18-30 (mean age 23.3 ± 3.3 years old; 38% males and 62% females) was assessed via online survey using the Internet Addiction Test (IAT), the Mini International Neuropsychiatric Interview (MINI) Screen, the Padua Inventory-Washington State University Revision (PI-WSUR) and the Barratt Impulsiveness Scale (BIS-11). RESULTS Ninety-seven subjects (12.6% of the sample) reported IAT scores at risk for PUI. PUI participants reported higher levels of impulsivity, obsessive-compulsive symptoms and a higher burden of co-occurrent psychiatric symptoms. In a logistic regression model, obsessional impulses to harm (OR = 1.108, p < 0.001), attentional impulsivity (OR = 1.155, p < 0.001) and depressive symptomatology (OR = 1.246, p = 0.012) had significant association with PUI. Finally, higher severity of PUI has been associated with manic/psychotic symptoms and with attentional impulsivity. CONCLUSIONS Our findings confirmed the role of impulsivity in PUI, while also underling the association of obsessional impulses with this pathological behavior. We could hypothesize a trigger role of obsessive impulses for the engagement in PUI, together with factors as negative affective states. Further research is needed with respect to more severe forms of PUI, also for establishing tailored interventions.
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Affiliation(s)
- Francesco Di Carlo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy.
| | - Maria Chiara Alessi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Elena Picutti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Rebecca Collevecchio
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Giuseppe Migliara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Gaia Baroni
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Francesco Gambi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
| | - Eduardo Cinosi
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire, UK
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy; Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, Herts, UK
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Massimo di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti - Pescara, Chieti, Italy
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Costanzi M, Cianfanelli B, Santirocchi A, Lasaponara S, Spataro P, Rossi-Arnaud C, Cestari V. Forgetting Unwanted Memories: Active Forgetting and Implications for the Development of Psychological Disorders. J Pers Med 2021; 11:jpm11040241. [PMID: 33810436 PMCID: PMC8066077 DOI: 10.3390/jpm11040241] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
Intrusive memories are a common feature of many psychopathologies, and suppression-induced forgetting of unwanted memories appears as a critical ability to preserve mental health. In recent years, biological and cognitive studies converged in revealing that forgetting is due to active processes. Recent neurobiological studies provide evidence on the active role of main neurotransmitter systems in forgetting, suggesting that the brain actively works to suppress retrieval of unwanted memories. On the cognitive side, there is evidence that voluntary and involuntary processes (here termed "intentional" and "incidental" forgetting, respectively) contribute to active forgetting. In intentional forgetting, an inhibitory control mechanism suppresses awareness of unwanted memories at encoding or retrieval. In incidental forgetting, retrieval practice of some memories involuntarily suppresses the retrieval of other related memories. In this review we describe recent findings on deficits in active forgetting observed in psychopathologies, like post-traumatic stress disorder, depression, schizophrenia, and obsessive-compulsive disorder. Moreover, we report studies in which the role of neurotransmitter systems, known to be involved in the pathogenesis of mental disorders, has been investigated in active forgetting paradigms. The possibility that biological and cognitive mechanisms of active forgetting could be considered as hallmarks of the early onset of psychopathologies is also discussed.
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Affiliation(s)
- Marco Costanzi
- Department of Human Sciences, Lumsa University, 00193 Rome, Italy; (B.C.); (S.L.)
- Correspondence:
| | - Beatrice Cianfanelli
- Department of Human Sciences, Lumsa University, 00193 Rome, Italy; (B.C.); (S.L.)
| | - Alessandro Santirocchi
- Department of Psychology, Sapienza University, 00185 Rome, Italy; (A.S.); (C.R.-A.); (V.C.)
| | - Stefano Lasaponara
- Department of Human Sciences, Lumsa University, 00193 Rome, Italy; (B.C.); (S.L.)
- Department of Psychology, Sapienza University, 00185 Rome, Italy; (A.S.); (C.R.-A.); (V.C.)
| | - Pietro Spataro
- Department of Economy, Universitas Mercatorum, 00100 Rome, Italy;
| | - Clelia Rossi-Arnaud
- Department of Psychology, Sapienza University, 00185 Rome, Italy; (A.S.); (C.R.-A.); (V.C.)
| | - Vincenzo Cestari
- Department of Psychology, Sapienza University, 00185 Rome, Italy; (A.S.); (C.R.-A.); (V.C.)
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Sulaimani MF, Bagadood NH. Implication of coronavirus pandemic on obsessive-compulsive-disorder symptoms. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:1-8. [PMID: 32866131 DOI: 10.1515/reveh-2020-0054] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
This review assesses various sources regarding obsessive-compulsive disorder (OCD) symptoms and the coronavirus pandemic via a study of literature related to OCD conditions in the United States, China, the United Kingdom, and India. Coronavirus's morbidity and its status as a global pandemic transmittable from one person to another has subsequently intensified the personal perception of distress. The projected shortage of vital medical equipment to fight coronavirus due to daily increases in COVID-19 cases creates social unrest. The world confronts perpetual news about high numbers of coronavirus cases, more people in quarantine, and more deaths; those not infected feel increasing fear about its proximity. Social media, print media, and electronic sources offer much advice on how to prevent coronavirus infection. Pandemics extend beyond pathophysiology and medical phenomena to associations with intense psychosocial impact. Studies have established that people with existing mental disorders are prone to relapses, the fear of faulty COVID-19 prevention measures, distress, and suicidal thoughts during pandemics. Precautionary measures aim to slow the spread of coronavirus, but these radical repetitive measures create great anxiety in the mental health of individuals suffering from OCD. Despite the nature of their conditions, these people must adhere to routine processes, such as washing hands, wearing masks and gloves, and sanitizing hands. Given the asymptomatic nature of people suffering from OCD, the routine measures for addressing COVID-19 have a hectic and adverse effect on their mental health and their state of relaxation. Through a systematic literature review, this paper provides insight into the coronavirus pandemic's implications for OCD symptoms.
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Affiliation(s)
- Mona F Sulaimani
- Department of Special Education, Faculty of Educational Graduate Studies, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nizar H Bagadood
- Department of Special Education, College of Education, Umm Al-Qura University, 21955, Makkah, Saudi Arabia
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211
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Kahn L, Sutton B, Winston HR, Abosch A, Thompson JA, Davis RA. Deep Brain Stimulation for Obsessive-Compulsive Disorder: Real World Experience Post-FDA-Humanitarian Use Device Approval. Front Psychiatry 2021; 12:568932. [PMID: 33868034 PMCID: PMC8044872 DOI: 10.3389/fpsyt.2021.568932] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: While case series have established the efficacy of deep brain stimulation (DBS) in treating obsessive-compulsive disorder (OCD), it has been our experience that few OCD patients present without comorbidities that affect outcomes associated with DBS treatment. Here we present our experience with DBS therapy for OCD in patients who all have comorbid disease, together with the results of our programming strategies. Methods: For this case series, we assessed five patients who underwent ventral capsule/ventral striatum (VC/VS) DBS for OCD between 2015 and 2019 at the University of Colorado Hospital. Every patient in this cohort exhibited comorbidities, including substance use disorders, eating disorder, tic disorder, and autism spectrum disorder. We conducted an IRB-approved, retrospective study of programming modifications and treatment response over the course of DBS therapy. Results: In addition to patients' subjective reports of improvement, we observed significant improvement in the Yale-Brown Obsessive-Compulsive Scale (44%), the Montgomery-Asberg Depression Rating Scale (53%), the Quality of Life Enjoyment and Satisfaction Questionnaire (27%), and the Hamilton Anxiety Rating scales (34.9%) following DBS. With respect to co-morbid disease, there was a significant improvement in a patient with tic disorder's Total Tic Severity Score (TTSS) (p = 0.005). Conclusions: DBS remains an efficacious tool for the treatment of OCD, even in patients with significant comorbidities in whom DBS has not previously been investigated. Efficacious treatment results not only from the accurate placement of the electrodes by the surgeon but also from programming by the psychiatrist.
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Affiliation(s)
- Lora Kahn
- Department of Neurosurgery, Ochsner Health, Tulane University-Ochsner Health Neurosurgery Program, New Orleans, LA, United States
| | - Brianne Sutton
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Helena R. Winston
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Aviva Abosch
- Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE, United States
| | - John A. Thompson
- Department of Neurosurgery, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
- Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Rachel A. Davis
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
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Asaoka N, Ibi M, Hatakama H, Nagaoka K, Iwata K, Matsumoto M, Katsuyama M, Kaneko S, Yabe-Nishimura C. NOX1/NADPH Oxidase Promotes Synaptic Facilitation Induced by Repeated D 2 Receptor Stimulation: Involvement in Behavioral Repetition. J Neurosci 2021; 41:2780-2794. [PMID: 33563722 PMCID: PMC8018731 DOI: 10.1523/jneurosci.2121-20.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 11/21/2022] Open
Abstract
Repetitive behavior is a widely observed neuropsychiatric symptom. Abnormal dopaminergic signaling in the striatum is one of the factors associated with behavioral repetition; however, the molecular mechanisms underlying the induction of repetitive behavior remain unclear. Here, we demonstrated that the NOX1 isoform of the superoxide-producing enzyme NADPH oxidase regulated repetitive behavior in mice by facilitating excitatory synaptic inputs in the central striatum (CS). In male C57Bl/6J mice, repeated stimulation of D2 receptors induced abnormal behavioral repetition and perseverative behavior. Nox1 deficiency or acute pharmacological inhibition of NOX1 significantly shortened repeated D2 receptor stimulation-induced repetitive behavior without affecting motor responses to a single D2 receptor stimulation. Among brain regions, Nox1 showed enriched expression in the striatum, and repeated dopamine D2 receptor stimulation further increased Nox1 expression levels in the CS, but not in the dorsal striatum. Electrophysiological analyses revealed that repeated D2 receptor stimulation facilitated excitatory inputs in the CS indirect pathway medium spiny neurons (iMSNs), and this effect was suppressed by the genetic deletion or pharmacological inhibition of NOX1. Nox1 deficiency potentiated protein tyrosine phosphatase activity and attenuated the accumulation of activated Src kinase, which is required for the synaptic potentiation in CS iMSNs. Inhibition of NOX1 or β-arrestin in the CS was sufficient to ameliorate repetitive behavior. Striatal-specific Nox1 knockdown also ameliorated repetitive and perseverative behavior. Collectively, these results indicate that NOX1 acts as an enhancer of synaptic facilitation in CS iMSNs and plays a key role in the molecular link between abnormal dopamine signaling and behavioral repetition and perseveration.SIGNIFICANCE STATEMENT Behavioral repetition is a form of compulsivity, which is one of the core symptoms of psychiatric disorders, such as obsessive-compulsive disorder. Perseveration is also a hallmark of such disorders. Both clinical and animal studies suggest important roles of abnormal dopaminergic signaling and striatal hyperactivity in compulsivity; however, the precise molecular link between them remains unclear. Here, we demonstrated the contribution of NOX1 to behavioral repetition induced by repeated stimulation of D2 receptors. Repeated stimulation of D2 receptors upregulated Nox1 mRNA in a striatal subregion-specific manner. The upregulated NOX1 promoted striatal synaptic facilitation in iMSNs by enhancing phosphorylation signaling. These results provide a novel mechanism for D2 receptor-mediated excitatory synaptic facilitation and indicate the therapeutic potential of NOX1 inhibition in compulsivity.
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Affiliation(s)
- Nozomi Asaoka
- Department of Pharmacology, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Masakazu Ibi
- Department of Pharmacology, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Hikari Hatakama
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, 606-8501, Japan
| | - Koki Nagaoka
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, 606-8501, Japan
| | - Kazumi Iwata
- Department of Pharmacology, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Misaki Matsumoto
- Department of Pharmacology, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Masato Katsuyama
- Radioisotope Center, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
| | - Shuji Kaneko
- Department of Molecular Pharmacology, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto, 606-8501, Japan
| | - Chihiro Yabe-Nishimura
- Department of Pharmacology, Kyoto Prefectural University of Medicine, Kyoto, 602-8566, Japan
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213
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Renteria R, Cazares C, Baltz ET, Schreiner DC, Yalcinbas EA, Steinkellner T, Hnasko TS, Gremel CM. Mechanism for differential recruitment of orbitostriatal transmission during actions and outcomes following chronic alcohol exposure. eLife 2021; 10:67065. [PMID: 33729155 PMCID: PMC8016477 DOI: 10.7554/elife.67065] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022] Open
Abstract
Psychiatric disease often produces symptoms that have divergent effects on neural activity. For example, in drug dependence, dysfunctional value-based decision-making and compulsive-like actions have been linked to hypo- and hyperactivity of orbital frontal cortex (OFC)-basal ganglia circuits, respectively; however, the underlying mechanisms are unknown. Here we show that alcohol-exposed mice have enhanced activity in OFC terminals in dorsal striatum (OFC-DS) associated with actions, but reduced activity of the same terminals during periods of outcome retrieval, corresponding with a loss of outcome control over decision-making. Disrupted OFC-DS terminal activity was due to a dysfunction of dopamine-type 1 receptors on spiny projection neurons (D1R SPNs) that resulted in increased retrograde endocannabinoid signaling at OFC-D1R SPN synapses reducing OFC-DS transmission. Blocking CB1 receptors restored OFC-DS activity in vivo and rescued outcome-based control over decision-making. These findings demonstrate a circuit-, synapse-, and computation-specific mechanism gating OFC activity in alcohol-exposed mice.
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Affiliation(s)
- Rafael Renteria
- Department of Psychology, University of California San Diego, San Diego, United States
| | - Christian Cazares
- The Neurosciences Graduate Program, University of California San Diego, San Diego, United States
| | - Emily T Baltz
- The Neurosciences Graduate Program, University of California San Diego, San Diego, United States
| | - Drew C Schreiner
- Department of Psychology, University of California San Diego, San Diego, United States
| | - Ege A Yalcinbas
- The Neurosciences Graduate Program, University of California San Diego, San Diego, United States
| | - Thomas Steinkellner
- Department of Neurosciences, University of California San Diego, San Diego, United States
| | - Thomas S Hnasko
- The Neurosciences Graduate Program, University of California San Diego, San Diego, United States.,Department of Neurosciences, University of California San Diego, San Diego, United States.,Research Service, VA San Diego Healthcare System, San Diego, United States
| | - Christina M Gremel
- Department of Psychology, University of California San Diego, San Diego, United States.,The Neurosciences Graduate Program, University of California San Diego, San Diego, United States
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214
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Peng Z, Xu C, Ma N, Yang Q, Ren P, Wen R, Jin L, Chen J, Wei Z, Verguts T, Chen Q. White Matter Alterations of the Goal-Directed System in Patients With Obsessive-Compulsive Disorder and Their Unaffected First-Degree Relatives. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:992-1001. [PMID: 33674244 DOI: 10.1016/j.bpsc.2020.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND It has been postulated that the neurobiological mechanism responsible for the onset of symptoms of obsessive-compulsive disorder (OCD), especially compulsive behavior, is related to alterations of the goal-directed and habitual learning systems. However, little is known about whether changes in these learning systems co-occur with changes in the white matter structure of patients with OCD and their unaffected first-degree relatives (UFDRs). METHODS Diffusion tensor imaging data were acquired from 32 patients with OCD (21 male), 32 UFDRs (16 male), and 32 healthy control subjects (16 male). White matter tracts in the goal-directed and habitual networks were reconstructed with seed-based probabilistic tractography. Partial least squares path modeling was used to measure the covariation between white matter connectivity, psychiatric symptoms, and cognitive flexibility. RESULTS Patients with OCD showed reduced connectivity in the fiber tracts within the goal-directed but not within the habitual network compared with healthy control subjects. Using partial least squares path modeling, patients' symptoms were negatively associated with connectivity within the goal-directed but not within the habitual network. Cognitive flexibility was correlated negatively with caudate-dorsolateral prefrontal cortex tracts in patients with OCD. UFDRs also exhibited reduced white matter connectivity in the goal-directed network. CONCLUSIONS These findings suggest that the balance of learning systems in OCD may be disrupted, mainly impairing white matter in the goal-directed network. Alterations of the goal-directed network could explain overt symptoms and impaired cognitive flexibility in patients with OCD. Similar alterations in the goal-directed network are present in UFDRs. The impaired goal-directed system may be an endophenotype of OCD.
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Affiliation(s)
- Ziwen Peng
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Beijing, China; School of Psychology, Center for Studies of Psychological Application, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
| | - Chuanyong Xu
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Beijing, China; School of Psychology, Center for Studies of Psychological Application, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Ning Ma
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Beijing, China; School of Psychology, Center for Studies of Psychological Application, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Qiong Yang
- Southern Medical University, Guangzhou, China; Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ping Ren
- Department of Geriatric Psychiatry, Shenzhen Kangning Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Rongzhen Wen
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Beijing, China; School of Psychology, Center for Studies of Psychological Application, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Lili Jin
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Beijing, China; School of Psychology, Center for Studies of Psychological Application, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Jierong Chen
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Zhen Wei
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Tom Verguts
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Qi Chen
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, Beijing, China; School of Psychology, Center for Studies of Psychological Application, Guangzhou, China; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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215
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van Westen M, Rietveld E, Bergfeld IO, de Koning P, Vullink N, Ooms P, Graat I, Liebrand L, van den Munckhof P, Schuurman R, Denys D. Optimizing Deep Brain Stimulation Parameters in Obsessive-Compulsive Disorder. Neuromodulation 2021; 24:307-315. [PMID: 33128489 PMCID: PMC7984355 DOI: 10.1111/ner.13243] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/22/2020] [Accepted: 06/16/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Deep brain stimulation (DBS) is an innovative and effective treatment for patients with therapy-refractory obsessive-compulsive disorder (OCD). DBS offers unique opportunities for personalized care, but no guidelines on how to choose effective and safe stimulation parameters in patients with OCD are available. Our group gained relevant practical knowledge on DBS optimization by treating more than 80 OCD patients since 2005, the world's largest cohort. The article's objective is to share this experience. MATERIALS AND METHODS We provide guiding principles for optimizing DBS stimulation parameters in OCD and discuss the neurobiological and clinical basis. RESULTS Adjustments in stimulation parameters are performed in a fixed order. First, electrode contact activation is determined by the position of the electrodes on postoperative imaging. Second, voltage and pulse width are increased stepwise, enlarging both the chance of symptom reduction and of inducing side effects. Clinical evaluation of adjustments in stimulation parameters needs to take into account: 1) the particular temporal sequence in which the various OCD symptoms and DBS side-effects change; 2) the lack of robust response predictors; 3) the limited sensitivity of the Yale-Brown Obsessive-Compulsive Scale to assess DBS-induced changes in OCD symptoms; and 4) a patient's fitness for additional cognitive-behavioral therapy (CBT). CONCLUSIONS Decision-making in stimulation parameter optimization needs to be sensitive to the particular time-courses on which various symptoms and side effects change.
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Affiliation(s)
- Maarten van Westen
- Department of PsychiatryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Erik Rietveld
- Department of PsychiatryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Isidoor O. Bergfeld
- Department of PsychiatryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Pelle de Koning
- Department of PsychiatryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Nienke Vullink
- Department of PsychiatryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Pieter Ooms
- Department of PsychiatryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Ilse Graat
- Department of PsychiatryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Luka Liebrand
- Department of PsychiatryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
- Department of Biomedical Engineering & PhysicsAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Pepijn van den Munckhof
- Department of NeurosurgeryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Rick Schuurman
- Department of NeurosurgeryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
| | - Damiaan Denys
- Department of PsychiatryAmsterdam UMC, University of AmsterdamMeibergdreef9AmsterdamThe Netherlands
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216
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Abstract
An instrumental action can be goal-directed after a moderate amount of practice and then convert to habit after more extensive practice. Recent evidence suggests, however, that habits can return to action status after different environmental manipulations. The present experiments therefore asked whether habit learning interferes with goal direction in a context-dependent manner like other types of retroactive interference (e.g., extinction, punishment, counterconditioning). In Experiment 1, rats were given a moderate amount of instrumental training to form an action in one context (Context A) and then more extended training of the same response to form a habit in another context (Context B). We then performed reinforcer devaluation with taste aversion conditioning in both contexts, and tested the response in both contexts. The response remained habitual in Context B, but was goal-directed in Context A, indicating renewal of goal direction after habit learning. Experiment 2 expanded on Experiment 1 by testing the response in a third context (Context C). It found that the habitual response also renewed as action in this context. Together, the results establish a parallel between habit and extinction learning: Conversion to habit does not destroy action knowledge, but interferes with it in a context-specific way. They are also consistent with other results suggesting that habit is specific to the context in which it is learned, whereas goal-direction can transfer between contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Mark E Bouton
- Department of Psychological Science, University of Vermont
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217
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High-frequency neuromodulation improves obsessive-compulsive behavior. Nat Med 2021; 27:232-238. [PMID: 33462447 PMCID: PMC9331184 DOI: 10.1038/s41591-020-01173-w] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/10/2020] [Indexed: 01/29/2023]
Abstract
Nearly one billion people worldwide suffer from obsessive-compulsive behaviors1,2, yet our mechanistic understanding of these behaviors is incomplete, and effective therapeutics are unavailable. An emerging perspective characterizes obsessive-compulsive behaviors as maladaptive habit learning3,4, which may be associated with abnormal beta-gamma neurophysiology of the orbitofrontal-striatal circuitry during reward processing5,6. We target the orbitofrontal cortex with alternating current, personalized to the intrinsic beta-gamma frequency of the reward network, and show rapid, reversible, frequency-specific modulation of reward- but not punishment-guided choice behavior and learning, driven by increased exploration in the setting of an actor-critic architecture. Next, we demonstrate that chronic application of the procedure over 5 days robustly attenuates obsessive-compulsive behavior in a non-clinical population for 3 months, with the largest benefits for individuals with more severe symptoms. Finally, we show that convergent mechanisms underlie modulation of reward learning and reduction of obsessive-compulsive symptoms. The results contribute to neurophysiological theories of reward, learning and obsessive-compulsive behavior, suggest a unifying functional role of rhythms in the beta-gamma range, and set the groundwork for the development of personalized circuit-based therapeutics for related disorders.
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218
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Cao X, Liu WP, Cheng LG, Li HJ, Wu H, Liu YH, Chen C, Xiao X, Li M, Wang GD, Zhang YP. Whole genome analyses reveal significant convergence in obsessive-compulsive disorder between humans and dogs. Sci Bull (Beijing) 2021; 66:187-196. [PMID: 36654227 DOI: 10.1016/j.scib.2020.09.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 08/20/2020] [Accepted: 08/31/2020] [Indexed: 01/20/2023]
Abstract
Obsessive-compulsive disorder (OCD) represents a heterogeneous collection of diseases with diverse levels of phenotypic, genetic, and etiologic variability, making it difficult to identify the underlying genetic and biological mechanisms in humans. Domestic dogs exhibit several OCD-like behaviors. Using continuous circling as a representative phenotype for OCD, we screened two independent dog breeds, the Belgian Malinois and Kunming Dog and subsequently sequenced ten circling dogs and ten unaffected dogs for each breed. Using population differentiation analyses, we identified 11 candidate genes in the extreme tail of the differentiated regions between cases and controls. These genes overlap significantly with genes identified in a genome wide association study (GWAS) of human OCD, indicating strong convergence between humans and dogs. Through gene expressional analysis and functional exploration, we found that two candidate OCD risk genes, PPP2R2B and ADAMTSL3, affected the density and morphology of dendritic spines. Therefore, changes in dendritic spine may underlie some common biological and physiological pathways shared between humans and dogs. Our study revealed an unprecedented level of convergence in OCD shared between humans and dogs, and highlighted the importance of using domestic dogs as a model species for many human diseases including OCD.
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Affiliation(s)
- Xue Cao
- State Key Laboratory of Genetic Resources and Evolution and Yunnan Laboratory of Molecular Biology of Domestic Animals, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; Department of Laboratory Animal Science, Kunming Medical University, Kunming 650500, China
| | - Wei-Peng Liu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming 650223, China
| | - Lu-Guang Cheng
- Kunming Police Dog Base, Ministry of Public Security, Kunming 650204, China
| | - Hui-Juan Li
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming 650223, China
| | - Hong Wu
- Laboratory for Conservation and Utilization of Bio-resource & Key Laboratory for Microbial Resources of the Ministry of Education, Yunnan University, Kunming 650091, China
| | - Yan-Hu Liu
- State Key Laboratory of Genetic Resources and Evolution and Yunnan Laboratory of Molecular Biology of Domestic Animals, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China
| | - Chao Chen
- Kunming Police Dog Base, Ministry of Public Security, Kunming 650204, China
| | - Xiao Xiao
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China
| | - Ming Li
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming 650223, China; Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China; KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China.
| | - Guo-Dong Wang
- State Key Laboratory of Genetic Resources and Evolution and Yunnan Laboratory of Molecular Biology of Domestic Animals, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming 650223, China.
| | - Ya-Ping Zhang
- State Key Laboratory of Genetic Resources and Evolution and Yunnan Laboratory of Molecular Biology of Domestic Animals, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China; Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming 650223, China.
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219
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Zhang C, Kim SG, Li J, Zhang Y, Lv Q, Zeljic K, Gong H, Wei H, Liu W, Sun B, Wang Z, Voon V. Anterior limb of the internal capsule tractography: relationship with capsulotomy outcomes in obsessive-compulsive disorder. J Neurol Neurosurg Psychiatry 2021; 92:jnnp-2020-323062. [PMID: 33461976 PMCID: PMC8142462 DOI: 10.1136/jnnp-2020-323062] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/18/2020] [Accepted: 12/22/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Surgical procedures targeting the anterior limb of the internal capsule (aLIC) can be effective in patients with selected treatment-refractory obsessive-compulsive disorder (OCD). The aLIC consists of white-matter tracts connecting cortical and subcortical structures and show a topographical organisation. Here we assess how aLIC streamlines are affected in OCD compared with healthy controls (HCs) and which streamlines are related with post-capsulotomy improvement. METHODS Diffusion-weighted MRI was used to compare white-matter microstructure via the aLIC between patients with OCD (n=100, 40 women, mean of age 31.8 years) and HCs (n=88, 39 women, mean of age 29.6 years). For each individual, the fractional anisotropy (FA) and streamline counts were calculated for each white-matter fibre bundle connecting a functionally defined prefrontal and subcortical region. Correlations between tractography measures and pre-capsulotomy and post-capsulotomy clinical outcomes (in obsessive-compulsive, anxiety and depression scores 6 months after surgery) were assessed in 41 patients with OCD. RESULTS Hierarchical clustering dendrograms show an aLIC organisation clustering lateral and dissociating ventral and dorsal prefrontal-thalamic streamlines, findings highly relevant to surgical targeting. Compared with HCs, patients with OCD had lower aLIC FA across multiple prefrontal cortical-subcortical regions (p<0.0073, false discovery rate-adjusted). Greater streamline counts of the dorsolateral prefrontal-thalamic tracts in patients with OCD predicted greater post-capsulotomy obsessive-compulsive improvement (p=0.016). In contrast, greater counts of the dorsal cingulate-thalamic streamlines predicted surgical outcomes mediated by depressive and anxiety improvements. CONCLUSIONS These findings shed light on the critical role of the aLIC in OCD and may potentially contribute towards precision targeting to optimise outcomes in OCD.
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Affiliation(s)
- Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Seung-Goo Kim
- Department of Psychiatry, Cambridge University, Cambridge, UK
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Jun Li
- Department of Neurosurgery, Center for Functional Neurosurgery, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Yingying Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Qiming Lv
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Shanghai, China
- University of the Chinese Academy of Sciences, Beijing, China
| | - Kristina Zeljic
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Shanghai, China
- University of the Chinese Academy of Sciences, Beijing, China
| | - Hengfen Gong
- Department of Psychiatry, Pudong District Mental Health Center, Shanghai, China
| | - Hongjiang Wei
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Wenjuan Liu
- Department of Psychiatry, Zhongshan Hospital Fudan University, Shanghai, China
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Zheng Wang
- University of the Chinese Academy of Sciences, Beijing, China
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, CAS Key Laboratory of Primate Neurobiology, Chinese Academy of Sciences, Shanghai, China
| | - Valerie Voon
- Department of Psychiatry, Cambridge University, Cambridge, UK
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220
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Sullivan CRP, Olsen S, Widge AS. Deep brain stimulation for psychiatric disorders: From focal brain targets to cognitive networks. Neuroimage 2021; 225:117515. [PMID: 33137473 PMCID: PMC7802517 DOI: 10.1016/j.neuroimage.2020.117515] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/19/2020] [Accepted: 10/24/2020] [Indexed: 01/16/2023] Open
Abstract
Deep brain stimulation (DBS) is a promising intervention for treatment-resistant psychiatric disorders, particularly major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). Up to 90% of patients who have not recovered with therapy or medication have reported benefit from DBS in open-label studies. Response rates in randomized controlled trials (RCTs), however, have been much lower. This has been argued to arise from surgical variability between sites, and recent psychiatric DBS research has focused on refining targeting through personalized imaging. Much less attention has been given to the fact that psychiatric disorders arise from dysfunction in distributed brain networks, and that DBS likely acts by altering communication within those networks. This is in part because psychiatric DBS research relies on subjective rating scales that make it difficult to identify network biomarkers. Here, we overview recent DBS RCT results in OCD and MDD, as well as the follow-on imaging studies. We present evidence for a new approach to studying DBS' mechanisms of action, focused on measuring objective cognitive/emotional deficits that underpin these and many other mental disorders. Further, we suggest that a focus on cognition could lead to reliable network biomarkers at an electrophysiologic level, especially those related to inter-regional synchrony of the local field potential (LFP). Developing the network neuroscience of DBS has the potential to finally unlock the potential of this highly specific therapy.
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Affiliation(s)
- Christi R P Sullivan
- University of Minnesota Medical School Department of Psychiatry and Behavioral Sciences, 2001 6th Street SE, Minneapolis, MN 55454, USA.
| | - Sarah Olsen
- University of Minnesota Medical School Department of Psychiatry and Behavioral Sciences, 2001 6th Street SE, Minneapolis, MN 55454, USA.
| | - Alik S Widge
- University of Minnesota Medical School Department of Psychiatry and Behavioral Sciences, 2001 6th Street SE, Minneapolis, MN 55454, USA.
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221
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Kashyap R, Eng GK, Bhattacharjee S, Gupta B, Ho R, Ho CSH, Zhang M, Mahendran R, Sim K, Chen SHA. Individual-fMRI-approaches reveal cerebellum and visual communities to be functionally connected in obsessive compulsive disorder. Sci Rep 2021; 11:1354. [PMID: 33446780 PMCID: PMC7809273 DOI: 10.1038/s41598-020-80346-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 12/11/2020] [Indexed: 01/29/2023] Open
Abstract
There is significant interest in understanding the pathophysiology of Obsessive-Compulsive Disorder (OCD) using resting-state fMRI (rsfMRI). Previous studies acknowledge abnormalities within and beyond the fronto-striato-limbic circuit in OCD that require further clarifications. However, limited information could be inferred from the conventional way of investigating the functional connectivity differences between OCD and healthy controls. Here, we identified altered brain organization in patients with OCD by applying individual-based approaches to maximize the identification of underlying network-based features specific to the OCD group. rsfMRI of 20 patients with OCD and 22 controls were preprocessed, and individual-fMRI-subspace was derived for each subject within each group. We evaluated group differences in functional connectivity using individual-fMRI-subspace and established its advantage over conventional-fMRI methodology. We applied prediction-based approaches to highlight the group differences by evaluating the differences in functional connections that predicted the clinical scores (namely, the Obsessive-Compulsive Inventory-Revised (OCI-R) and Hamilton Anxiety Rating Scale). Then, we explored the brain network organization of both groups by estimating the subject-specific communities within each group. Lastly, we evaluated associations between the inter-individual variation of nodes in the communities to clinical measures using linear regression. Functional connectivity analysis using individual-fMRI-subspace detected 83 connections that were different between OCD and control groups, compared to none found using conventional-fMRI methodology. Connectome-based prediction analysis did not show significant overlap between the two groups in the functional connections that predicted the clinical scores. This suggests that the functional architecture in patients with OCD may be different compared to controls. Seven communities were found in both groups. Interestingly, within the OCD group but not controls, we observed functional connectivity between cerebellar and visual regions, and lack of connectivity between striato-limbic and frontal areas. Inter-individual variations in the community-size of these two communities were also associated with the OCI-R score (p < .005). Due to our small sample size, we further validated our results by (i) accounting for head motion, (ii) applying global signal regression (GSR) in data processing, and (iii) using an alternate atlas for parcellation. While the main results were consistently observed with accounting for head motion and using another atlas, the key findings were not reproduced with GSR application. The study demonstrated the existence of disconnectedness in fronto-striato-limbic community and connectedness between cerebellar and visual areas in OCD patients, which was also related to the clinical symptomatology of OCD.
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Affiliation(s)
- Rajan Kashyap
- Centre for Research and Development in Learning (CRADLE), Nanyang Technological University, CRADLE, 61 Nanyang Drive, ABN-01b-10, Singapore, 637335, Singapore.
| | - Goi Khia Eng
- Department of Psychiatry, New York University School of Medicine, New York, USA
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, USA
- School of Social Sciences (SSS), Nanyang Technological University, 48 Nanyang Ave, SHHK-04-19, Singapore, 639818, Singapore
| | - Sagarika Bhattacharjee
- School of Social Sciences (SSS), Nanyang Technological University, 48 Nanyang Ave, SHHK-04-19, Singapore, 639818, Singapore
| | - Bhanu Gupta
- Community Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Roger Ho
- Psychological Medicine, National University Health Systems, Singapore, Singapore
| | - Cyrus S H Ho
- Psychological Medicine, National University Health Systems, Singapore, Singapore
| | - Melvyn Zhang
- Psychological Medicine, National University Health Systems, Singapore, Singapore
| | - Rathi Mahendran
- Psychological Medicine, National University Health Systems, Singapore, Singapore
- Academic Development Department, Duke-NUS Medical School, Singapore, Singapore
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
| | - S H Annabel Chen
- Centre for Research and Development in Learning (CRADLE), Nanyang Technological University, CRADLE, 61 Nanyang Drive, ABN-01b-10, Singapore, 637335, Singapore.
- School of Social Sciences (SSS), Nanyang Technological University, 48 Nanyang Ave, SHHK-04-19, Singapore, 639818, Singapore.
- Lee Kong Chian School of Medicine (LKC Medicine), Nanyang Technological University, Singapore, Singapore.
- Office of Educational Research, National Institute of Education, Nanyang Technological University, Singapore, Singapore.
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222
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Frota Lisbôa Pereira de Souza AM. Electroencephalographic Correlates of Obsessive-Compulsive Disorder. Curr Top Behav Neurosci 2021; 49:169-199. [PMID: 33590459 DOI: 10.1007/7854_2020_200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This chapter reviews EEG research in Obsessive-Compulsive Disorder (OCD), focusing on Event-Related Potentials (ERPs) such as the Contingent Negative Variation, N2, Error-Related Negativity, the feedback Error-Related Negativity and the Readiness Potential and their neural bases. The functional significance, utility and correlation of these ERPs with OCD symptoms will be discussed, alongside novel theories for integrating the research findings. I will consider hypotheses including goal-directed behaviour, overreliance on habits, dissociations between action and knowledge, and excessive intolerance of uncertainty in the context of EEG studies, thus providing a comprehensive framework of the electroencephalographic literature concerning OCD.
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223
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Abstract
In the last 20 years, functional magnetic resonance imaging (fMRI) has been extensively used to investigate system-level abnormalities in the brain of patients with obsessive-compulsive disorder (OCD). In this chapter, we start by reviewing the studies assessing regional brain differences between patients with OCD and healthy controls in task-based fMRI. Specifically, we review studies on executive functioning and emotional processing, protocols in which these patients have been described to show alterations at the behavioral level, as well as research using symptom provocation protocols. Next, we review studies on brain connectivity alterations, focusing on resting-state studies evaluating disruptions in fronto-subcortical functional connectivity and in cortical networks. Likewise, we also review research on effective connectivity, which, different from functional connectivity, allows for ascertaining the directionality of inter-regional connectivity alterations. We conclude by reviewing the most significant findings on a topic of translational impact, such as the use of different fMRI measurements to predict response across a variety of treatment approaches. Overall, results suggest that there exists a pattern of regions, involving, but not limited to, different nodes of the cortico-striatal-thalamo-cortical circuits, showing robust evidence of functional alteration across studies, although the nature of the alterations critically depends on the specific tasks and their particular demands. Moreover, such findings have been, to date, poorly translated into clinical practice. It is suggested that this may be partially accounted for by the difficulty to integrate into a common framework results obtained under a wide variety of analysis approaches.
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Affiliation(s)
- Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain. .,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain.
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224
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Biria M, Cantonas LM, Banca P. Magnetic Resonance Spectroscopy (MRS) and Positron Emission Tomography (PET) Imaging in Obsessive-Compulsive Disorder. Curr Top Behav Neurosci 2021; 49:231-268. [PMID: 33751502 DOI: 10.1007/7854_2020_201] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Obsessive-compulsive disorder (OCD) is characterised by structural and functional deficits in the cortico-striato-thalamic-cortical (CSTC) circuitry and abnormal neurochemical changes are thought to modulate these deficits. The hypothesis that an imbalanced concentration of the brain neurotransmitters, in particular glutamate (Glu) and gamma-amino-butyric acid (GABA), could impair the normal functioning of the CSTC, thus leading to OCD symptoms, has been tested in humans using magnetic resonance spectroscopy (MRS) and positron emission tomography (PET). This chapter summarises these neurochemical findings and represents an attempt to condense such scattered literature. We also discuss potential challenges in the field that may explain the inconsistent findings and suggest ways to overcome them. There is some convergent research from MRS pointing towards abnormalities in the brain concentration of neurometabolite markers of neuronal integrity, such as N-acetylaspartate (NAA) and choline (Cho). Lower NAA levels have been found in dorsal and rostral ACC of OCD patients (as compared to healthy volunteers), which increase after CBT and SSRI treatment, and higher Cho concentration has been reported in the thalamus of the OCD brain. However, findings for other neurometabolites are very inconsistent. Studies have reported abnormalities in the concentrations of creatine (Cr), GABA, glutamate (Glu), glutamine (Gln), Ins (myo-inositol), and serotonin (5-HT), but most of the results were not replicated. The question remains whether the NAA and Cho findings are genuinely the only neurochemical abnormalities in OCD or whether the lack of consistent findings for the other neurometabolites is caused by the lower magnetic field (1-3 Tesla (T)) used by the studies conducted so far, their small sample sizes or a lack of proper control for medication effects. To answer these questions and to further inform the biological underpinning of the symptoms and the cognitive problems at the basis of OCD we need better controlled studies using clear medicated vs unmedicated groups, larger sample sizes, stronger magnetic fields (e.g. at 7 T), and more consistency in the definition of the regions of interest.
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Affiliation(s)
- Marjan Biria
- Department of Psychology, University of Cambridge, Cambridge, UK.
| | | | - Paula Banca
- Department of Psychology, University of Cambridge, Cambridge, UK
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225
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Luo S, Guo Q, Yang L, Cheng Y, Long Y, Wang X, Liu L, Yang Z, Hu T, Du L, Chen M, Liao G. Characteristic and Early Discontinuation of Obsessive-Compulsive Disorder Trials Registered on ClinicalTrials.gov. Front Psychiatry 2021; 12:650057. [PMID: 34381385 PMCID: PMC8350037 DOI: 10.3389/fpsyt.2021.650057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/26/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: This study aimed to analyze the characteristics and reasons of early discontinuation of obsessive-compulsive disorder (OCD) trials registered on ClinicalTrials.gov. Methods: OCD trials and relevant publications were searched on ClinicalTrials.gov and PubMed, respectively. The characteristics and details regarding the timely publication of trials were recorded. Cox regression analysis was used to explore factors associated with the early discontinuation of OCD trials. Results: The analysis included 298 OCD therapy trials. Most investigations recruited <100 patients and were more likely to involve adults. Of all OCD studies identified, 67.8% were randomized and 61.4% were blind (single- or double-blind). Universities and hospitals were recorded as the two primary locations in the majority of trials. A total of 155 trials (52%) were completed; however, only 29% of those were published. Of the published trials, >70% were published at least 1 year after completion. Behavioral therapy trials were the most common type of major treatment-aimed OCD trials (39%), followed by drug trials (35.1%) and device/procedure trials (24.7%). The univariate Cox regression analysis indicated that drug trials [hazard ratio (HR) = 2.56, 95% confidence interval (CI): 1.21-5.43], absence of collaborators (HR = 3.87, 95% CI: 1.62-9.26), and sponsorship by industry (HR = 3.97, 95% CI: 1.49-10.53) were risk factors for early discontinuation of OCD trials. Further multivariate Cox regression showed that drug trials (HR = 3.93, 95% CI: 1.71-9.08) and absence of collaborators (HR = 5.17, 95% CI: 1.97-13.54) were independent risk factors for early trial discontinuation of OCD trials. The sensitivity analysis confirmed these results. Non-drug trials (OR = 3.32, 95% CI: 1.21-9.11), absence of collaborators (OR = 3.25, 95% CI: 1.10-9.60), and non-blinded trials (OR = 5.23, 95% CI: 1.05-26.2) were independent risk factors for unreported results in registry. Conclusion: The diagnosis and prevention of OCD are rarely investigated in trials. Underreporting and delayed reporting remain major problems. The type of intervention and participation of collaborators are associated with early discontinuation of OCD trials.
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Affiliation(s)
- Shanxia Luo
- Department of Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiong Guo
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Liu Yang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yifan Cheng
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Youlin Long
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.,Medical Device Regulatory Research and Evaluation Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Xinyi Wang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Liqin Liu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zixin Yang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Tengyue Hu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Liang Du
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China.,Medical Device Regulatory Research and Evaluation Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Min Chen
- Department of Traditional Chinese Medicine, The Third People's Hospital of Chengdu, Chengdu, China
| | - Ga Liao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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226
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Schiele MA, Thiel C, Weidner M, Endres D, Zaudig M, Berberich G, Domschke K. Serotonin transporter gene promoter hypomethylation in obsessive-compulsive disorder - Predictor of impaired response to exposure treatment? J Psychiatr Res 2021; 132:18-22. [PMID: 33035761 DOI: 10.1016/j.jpsychires.2020.09.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 12/16/2022]
Abstract
Treatment resistance is common in obsessive-compulsive disorder (OCD) and associated with a significant burden for the individual patient. Accordingly, the identification of biomarkers as early predictors of the clinical response has become a central goal in the search for more efficacious and personalized treatments. Epigenetic mechanisms such as DNA methylation of the serotonin transporter gene (SLC6A4) have been suggested to predict therapy outcome in mental disorders closely related to OCD, but have not yet been investigated as such in OCD. The present therapy-epigenetic study therefore sought to address the potential role of SLC6A4 promoter methylation in the prediction of treatment response for the first time in OCD. Overall, 112 patients with primary OCD were investigated over the course of 8-10-week OCD-specific, cognitive behavioral therapy (CBT) comprising exposure and response prevention/management (phase I) and in vivo exposure exercises ('flooding', phase II). OCD symptoms were measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) at baseline as well as before and after the in vivo exposure phase. SLC6A4 promoter methylation at baseline was analyzed via pyrosequencing of sodium bisulfite-treated DNA extracted from blood cells. Lower baseline SLC6A4 promoter methylation predicted impaired treatment response (defined as reduction in Y-BOCS scores) in phase II (but not phase I) of CBT (β = -0.359, p = .002). SLC6A4 methylation may thus constitute a potential early biomarker predicting biologically mediated clinical changes elicited specifically by exposure treatment. These results carry promise for clinical application and in the future could aid in early treatment modification and personalized treatment efforts.
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Affiliation(s)
- Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Christiane Thiel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Magdalena Weidner
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | | | | | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Germany.
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227
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Abstract
It becomes increasingly clear that (non-)invasive neurostimulation is an effective treatment for obsessive-compulsive disorder (OCD). In this chapter we review the available evidence on techniques and targets, clinical results including a meta-analysis, mechanisms of action, and animal research. We focus on deep brain stimulation (DBS), but also cover non-invasive neurostimulation including transcranial magnetic stimulation (TMS). Data shows that most DBS studies target the ventral capsule/ventral striatum (VC/VS), with an overall 76% response rate in treatment-refractory OCD. Also TMS holds clinical promise. Increased insight in the normalizing effects of neurostimulation on cortico-striatal-thalamic-cortical (CSTC) loops - through neuroimaging and animal research - provides novel opportunities to further optimize treatment strategies. Advancing clinical implementation of neurostimulation techniques is essential to ameliorate the lives of the many treatment-refractory OCD patients.
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228
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Zai G. Pharmacogenetics of Obsessive-Compulsive Disorder: An Evidence-Update. Curr Top Behav Neurosci 2021; 49:385-398. [PMID: 33550565 DOI: 10.1007/7854_2020_205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Pharmacogenetics has become increasingly important in the treatment of psychiatric disorders because approximately 50% of individuals who take psychotropic medications do not typically respond to them. Obsessive-compulsive disorder (OCD) is one such chronic and often debilitating mental illness with significant non-response to even the first-line medication, serotonin reuptake inhibitors. Precision medicine utilizing genetic testing panels has received significant attention based on the evidence that the variability of antidepressant response and adverse effects is partly due to the variability in an individual's genome. Thus, extensive research has investigated the role of genetic factors on antidepressant response in major depressive disorder (MDD) and their utility for guiding antidepressant treatment to significantly improving outcomes in individuals with MDD. However, limited progress remains in the pharmacogenetics of OCD. This chapter will provide an overview of the recent findings in the pharmacogenetics of OCD. Promising results with limited replications have been reported for the cytochrome P450 liver metabolism genes in addition to several serotonergic and glutamatergic system genes, which may play an important role in antidepressant response in the treatment of OCD.
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Affiliation(s)
- Gwyneth Zai
- Neurogenetics Section, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, and General Adult Psychiatry and Health Systems Division, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada. .,Institute of Medical Science, University of Toronto, Toronto, ON, Canada. .,Behavioural and Clinical Neuroscience Institute, Department of Psychiatry, University of Cambridge, Cambridge, UK.
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229
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Pöhlchen D, Priouret M, Kraft MS, Binder FP, Gürsel DA, Berberich G, Koch K, Spoormaker VI. Examining Differences in Fear Learning in Patients With Obsessive-Compulsive Disorder With Pupillometry, Startle Electromyography and Skin Conductance Responses. Front Psychiatry 2021; 12:730742. [PMID: 34658966 PMCID: PMC8517251 DOI: 10.3389/fpsyt.2021.730742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/02/2021] [Indexed: 11/13/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is characterized by recurrent, persistent thoughts and repetitive behaviors causing stress and anxiety. In the associative learning model of OCD, mechanisms of fear extinction are supposed to partly underlie symptom development, maintenance and treatment of OCD, proposing that OCD patients suffer from rigid memory associations and inhibitory learning deficits. To test these assumptions, previous studies have used skin conductance and subjective ratings as readouts in fear conditioning paradigms, finding impaired fear extinction learning, impaired fear extinction recall or no differences between individuals with OCD and healthy controls. Against this heterogeneous background, we tested fear acquisition and extinction in 37 OCD patients and 56 healthy controls, employing skin conductance as well as pupillometry and startle electromyography. Extinction recall was also included in a subsample. We did not observe differences between groups in any of the task phases, except a trend toward higher startle amplitudes during extinction for OCD. Overall, sensitive readouts such as pupillometry and startle responses did not provide evidence for moderate-to-large inhibitory learning deficits using classical fear conditioning, challenging the assumption of generically impaired extinction learning and memory in OCD.
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Affiliation(s)
- Dorothee Pöhlchen
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Marthe Priouret
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Miriam S Kraft
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Florian P Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Deniz A Gürsel
- Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Munich, Germany
| | - Götz Berberich
- Windach Institute and Hospital of Neurobehavioural Research and Therapy, Windach, Germany
| | | | - Kathrin Koch
- Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Munich, Germany
| | - Victor I Spoormaker
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
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230
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Walsh BR. A critical review of the evidence for the equivalence of canine and human compulsions. Appl Anim Behav Sci 2021. [DOI: 10.1016/j.applanim.2020.105166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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231
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Chamberlain SR, Solly JE, Hook RW, Vaghi MM, Robbins TW. Cognitive Inflexibility in OCD and Related Disorders. Curr Top Behav Neurosci 2021; 49:125-145. [PMID: 33547598 DOI: 10.1007/7854_2020_198] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cognitive inflexibility is suggested by the hallmark symptoms of obsessive-compulsive disorder (OCD), namely the occurrence of repetitive thoughts and/or behaviours that persist despite being functionally impairing and egodystonic to the individual. As well as being implied by the top-level symptoms, cognitive inflexibility in OCD, and some related conditions, has also been objectively quantified in case-control studies using computerised cognitive tasks. This chapter begins by considering the objective measurement of different aspects of cognitive flexibility using neuropsychological paradigms, with a focus on neural and neurochemical substrates. It moves on to conduct a systematic review and meta-analysis of findings from a widely deployed flexibility task: the Intra-Dimensional/Extra-Dimensional Set-Shift Task (IDED). By pooling data from 11 studies (335 OCD patients and 311 controls), we show that Extra-Dimensional (ED) shift deficits are a robust and reproducible finding (effect size medium-large) in OCD across the literature, and that this deficit is not attributable to group differences in age or IQ. The OCD ED deficit is then discussed in terms of dysfunction of fronto-striatal pathways (as exemplified, for example, by functional connectivity data), and the putative role of different neurotransmitters. We consider evidence that impaired ED shifting constitutes a candidate vulnerability marker (or 'endophenotype') for OCD. The available literature is then surveyed as to ED findings in other obsessive-compulsive (OC) related disorders (e.g. hoarding, body-dysmorphic disorder, and trichotillomania), as well as in non-OC disorders (schizophrenia and anxiety symptoms in general). Lastly, we consider more recent, emerging developments in the quantification of compulsivity using cognitive tasks and questionnaires, as well as key directions for future research, including the need to refine compulsivity and its composite cognitive processes.
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Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. .,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
| | - Jeremy E Solly
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Roxanne W Hook
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Matilde M Vaghi
- Max Planck University College London (UCL) Centre for Computational Psychiatry and Ageing Research, London, UK
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK
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232
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Sandia I, Baptista T. Ego-Dystonia: a Review in Search of Definitions. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 51:S0034-7450(20)30120-7. [PMID: 33735053 DOI: 10.1016/j.rcp.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/02/2020] [Indexed: 10/22/2022]
Abstract
The ego-dystonic experience refers to the negative assessment that the subject makes of some of their thoughts or emotions, in the context of a conserved state of consciousness, as well as other aspects of their social and intrapersonal life that are relatively intact. Ego-dystonia is a widely used construct, but one that has not been defined in reasonably operational terms. Perhaps this explains why it is no longer used in contemporary classifications of mental disorders such as the ICD-11 and DSM-5. It is related to the awareness of the mental illness, with feelings of guilt and shame, but intuitively we perceive relevant differences between all these experiences. Psychoanalytic theory conceives the ego-dystonic as an alteration in the early structuring of the ego. Cognitive psychology conceives it as a dysfunction of the corrective mechanisms that harmonise the cognitive and the metacognitive. Evolutionary theory has not addressed the issue directly, but through the analysis of guilt, to which it attributes a high adaptive value, since it limits aggression and promotes reparative behaviours. Given the importance of the concept of self-attunement, it is surprising how little theoretical and empirical research there is on the subject, the clarification of which could represent a considerable advance in the field of mental health.
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Affiliation(s)
- Ignacio Sandia
- Departamento de Medicina, Facultad de Medicina, Universidad de Los Andes, Mérida, Venezuela.
| | - Trino Baptista
- Departamento de Fisiología, Facultad de Medicina, Universidad de los Andes, Mérida, Venezuela
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233
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Zhou X, Meng Y, Schmitt HS, Montag C, Kendrick KM, Becker B. Cognitive flexibility mediates the association between early life stress and habitual behavior. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.110231] [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: 10/23/2022]
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234
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Cervin M, Pozza A, Barcaccia B, Dèttore D. Internalized psychopathology dimensions in middle childhood: Cross-sectional and temporal associations. J Anxiety Disord 2020; 76:102300. [PMID: 32942083 DOI: 10.1016/j.janxdis.2020.102300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 06/18/2020] [Accepted: 08/30/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Anxiety, depression, and obsessive-compulsive symptoms often onset during middle childhood and are major causes of disability in young individuals. A better understanding of how these symptoms are linked and unfold over time is important to develop valid etiological models and effective prevention and treatment. METHODS In the present study, 950 community children (8-14 years) reported on a broad range of internalised symptoms at three time points over the course of a year. First, factor analysis was used to examine the overarching dimensions of these symptoms. Second, network analysis was used to examine unique cross-sectional associations among these empirically supported symptom dimensions. Last, longitudinal structural equation models (SEMs) were used to examine temporal associations among the symptom dimensions. RESULTS Six broad symptom dimensions fitted the self-report data well at all time points. These dimensions were conceptualized as depression, general anxiety, situational fears, compulsivity, intrusive thoughts, and somatic anxiety. Network analysis showed that these dimensions formed a highly interconnected network with general anxiety and somatic anxiety being most central (i.e., most strongly associated with other dimensions) at all time points. Longitudinal SEMs supported the central role played by general anxiety in the temporal associations among these dimensions. CONCLUSIONS Overarching expressions of internalized psychopathology are highly interconnected in middle childhood with possible central roles played by general and somatic anxiety. Interventions aimed at a general proneness for anxiety may be warranted in preventing and treating internalizing symptoms in middle childhood.
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Affiliation(s)
- Matti Cervin
- Faculty of Medicine, Lund University, Lund, Sweden
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
| | - Barbara Barcaccia
- Department of Education, Roma Tre University, Rome, Italy; Associazione di Psicologia Cognitiva (APC) and Scuola di Psicoterapia Cognitiva srl (SPC), Rome, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
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235
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Vicente AM, Martins GJ, Costa RM. Cortico-basal ganglia circuits underlying dysfunctional control of motor behaviors in neuropsychiatric disorders. Curr Opin Genet Dev 2020; 65:151-159. [PMID: 32688249 PMCID: PMC7749078 DOI: 10.1016/j.gde.2020.05.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/31/2020] [Indexed: 11/26/2022]
Abstract
Neuropsychiatric disorders often manifest with abnormal control of motor behavior. Common symptoms include restricted and repetitive patterns of behavior (RRBs). Cortico-basal ganglia circuits have been implicated in the etiology of RBBs. However, there is a vast range of behaviors encompassed in RRBs, from simple explosive motor tics to rather complex ritualized compulsions. In this review, we highlight how recent findings about the function of specific basal ganglia circuits can begin to shed light into defined motor symptoms associated with neuropsychiatric disorders. We discuss recent studies using genetic animal models that advocate that different aspects of motor repetition in neurodevelopmental disorders, like obsessive-compulsive disorder and autism spectrum disorder, emerge from particular dysregulations in distinct cortico-basal ganglia circuits.
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Affiliation(s)
- Ana Mafalda Vicente
- Departments of Neuroscience and Neurology, Zuckerman Mind Brain Institute, Columbia University 3227 Broadway, New York, NY, 10027, United States
| | - Gabriela J Martins
- Departments of Neuroscience and Neurology, Zuckerman Mind Brain Institute, Columbia University 3227 Broadway, New York, NY, 10027, United States
| | - Rui M Costa
- Departments of Neuroscience and Neurology, Zuckerman Mind Brain Institute, Columbia University 3227 Broadway, New York, NY, 10027, United States.
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236
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Olsen ST, Basu I, Bilge MT, Kanabar A, Boggess MJ, Rockhill AP, Gosai AK, Hahn E, Peled N, Ennis M, Shiff I, Fairbank-Haynes K, Salvi JD, Cusin C, Deckersbach T, Williams Z, Baker JT, Dougherty DD, Widge AS. Case Report of Dual-Site Neurostimulation and Chronic Recording of Cortico-Striatal Circuitry in a Patient With Treatment Refractory Obsessive Compulsive Disorder. Front Hum Neurosci 2020; 14:569973. [PMID: 33192400 PMCID: PMC7645211 DOI: 10.3389/fnhum.2020.569973] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
Psychiatric disorders are increasingly understood as dysfunctions of hyper- or hypoconnectivity in distributed brain circuits. A prototypical example is obsessive compulsive disorder (OCD), which has been repeatedly linked to hyper-connectivity of cortico-striatal-thalamo-cortical (CSTC) loops. Deep brain stimulation (DBS) and lesions of CSTC structures have shown promise for treating both OCD and related disorders involving over-expression of automatic/habitual behaviors. Physiologically, we propose that this CSTC hyper-connectivity may be reflected in high synchrony of neural firing between loop structures, which could be measured as coherent oscillations in the local field potential (LFP). Here we report the results from the pilot patient in an Early Feasibility study (https://clinicaltrials.gov/ct2/show/NCT03184454) in which we use the Medtronic Activa PC+ S device to simultaneously record and stimulate in the supplementary motor area (SMA) and ventral capsule/ventral striatum (VC/VS). We hypothesized that frequency-mismatched stimulation should disrupt coherence and reduce compulsive symptoms. The patient reported subjective improvement in OCD symptoms and showed evidence of improved cognitive control with the addition of cortical stimulation, but these changes were not reflected in primary rating scales specific to OCD and depression, or during blinded cortical stimulation. This subjective improvement was correlated with increased SMA and VC/VS coherence in the alpha, beta, and gamma bands, signals which persisted after correcting for stimulation artifacts. We discuss the implications of this research, and propose future directions for research in network modulation in OCD and more broadly across psychiatric disorders.
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Affiliation(s)
- Sarah T. Olsen
- Department of Psychiatry, Medical School, University of Minnesota Twin Cities, Minneapolis, MN, United States
| | - Ishita Basu
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Mustafa Taha Bilge
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Anish Kanabar
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Matthew J. Boggess
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Alexander P. Rockhill
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Aishwarya K. Gosai
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Emily Hahn
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Noam Peled
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Michaela Ennis
- McLean Institute for Technology in Psychiatry and Harvard Medical School, Belmont, MA, United States
| | - Ilana Shiff
- McLean Institute for Technology in Psychiatry and Harvard Medical School, Belmont, MA, United States
| | - Katherine Fairbank-Haynes
- McLean Institute for Technology in Psychiatry and Harvard Medical School, Belmont, MA, United States
| | - Joshua D. Salvi
- McLean Institute for Technology in Psychiatry and Harvard Medical School, Belmont, MA, United States
| | - Cristina Cusin
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Thilo Deckersbach
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Ziv Williams
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States
| | - Justin T. Baker
- McLean Institute for Technology in Psychiatry and Harvard Medical School, Belmont, MA, United States
| | - Darin D. Dougherty
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Alik S. Widge
- Department of Psychiatry, Medical School, University of Minnesota Twin Cities, Minneapolis, MN, United States
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237
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Ye Q, Zhang Z, Fan Q, Li Y. Altered Intramodular Functional Connectivity in Drug Naïve Obsessive-Compulsive Disorder Patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:1734-1737. [PMID: 33018332 DOI: 10.1109/embc44109.2020.9175845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Modular functional alterations were shown in obsessive-compulsive disorder (OCD) patients from previous functional magnetic resonance imaging (fMRI) studies. However, most studies considered each module as a specific node and ignore the intramodular connectivity information. In this paper, we investigated the intramodular functional connectivity (FC) alterations in drug naïve OCD patients using a whole brain graph theoretical approach for functional modular parcellation. Seventy-three drug-naïve OCD patients and seventy-eight matched healthy controls were included in this study. We utilized infomap algorithm for modules detection. The functional connectivity strength (FCS) was calculated within each module to obtain the FC between a given voxel and all other voxels in the module. We found increased FCS in precentral and postcentral gyrus within sensor-motor network (SMN) and decreased FCS in insula within salience network (SN). Moreover, FC within SMN was negatively correlated with YBOCS- compulsions scores, while FC within SN was negatively correlated with YBOCS-total, compulsions and obsessions scores. Our findings brought useful insights in understanding the pathophysiology of OCD.
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238
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Vaghi MM, Moutoussis M, Váša F, Kievit RA, Hauser TU, Vértes PE, Shahar N, Romero-Garcia R, Kitzbichler MG, Bullmore ET, Dolan RJ. Compulsivity is linked to reduced adolescent development of goal-directed control and frontostriatal functional connectivity. Proc Natl Acad Sci U S A 2020; 117:25911-25922. [PMID: 32989168 PMCID: PMC7568330 DOI: 10.1073/pnas.1922273117] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A characteristic of adaptive behavior is its goal-directed nature. An ability to act in a goal-directed manner is progressively refined during development, but this refinement can be impacted by the emergence of psychiatric disorders. Disorders of compulsivity have been framed computationally as a deficit in model-based control, and have been linked also to abnormal frontostriatal connectivity. However, the developmental trajectory of model-based control, including an interplay between its maturation and an emergence of compulsivity, has not been characterized. Availing of a large sample of healthy adolescents (n = 569) aged 14 to 24 y, we show behaviorally that over the course of adolescence there is a within-person increase in model-based control, and this is more pronounced in younger participants. Using a bivariate latent change score model, we provide evidence that the presence of higher compulsivity traits is associated with an atypical profile of this developmental maturation in model-based control. Resting-state fMRI data from a subset of the behaviorally assessed subjects (n = 230) revealed that compulsivity is associated with a less pronounced change of within-subject developmental remodeling of functional connectivity, specifically between the striatum and a frontoparietal network. Thus, in an otherwise clinically healthy population sample, in early development, individual differences in compulsivity are linked to the developmental trajectory of model-based control and a remodeling of frontostriatal connectivity.
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Affiliation(s)
- Matilde M Vaghi
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, WC1 B5EH London, United Kingdom;
- Wellcome Centre for Human Neuroimaging, University College London, WC1N 3AR London, United Kingdom
| | - Michael Moutoussis
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, WC1 B5EH London, United Kingdom
- Wellcome Centre for Human Neuroimaging, University College London, WC1N 3AR London, United Kingdom
| | - František Váša
- Department of Psychiatry, University of Cambridge, CB2 2QQ Cambridge, United Kingdom
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, SE5 8AF London, United Kingdom
| | - Rogier A Kievit
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, WC1 B5EH London, United Kingdom
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, CB2 7EF Cambridge, United Kingdom
| | - Tobias U Hauser
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, WC1 B5EH London, United Kingdom
- Wellcome Centre for Human Neuroimaging, University College London, WC1N 3AR London, United Kingdom
| | - Petra E Vértes
- Department of Psychiatry, University of Cambridge, CB2 2QQ Cambridge, United Kingdom
- The Alan Turing Institute, NW1 2DB London, United Kingdom
- School of Mathematical Sciences, Queen Mary University of London, E1 4NS London, United Kingdom
| | - Nitzan Shahar
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, WC1 B5EH London, United Kingdom
- Wellcome Centre for Human Neuroimaging, University College London, WC1N 3AR London, United Kingdom
| | - Rafael Romero-Garcia
- Department of Psychiatry, University of Cambridge, CB2 2QQ Cambridge, United Kingdom
| | - Manfred G Kitzbichler
- Department of Psychiatry, University of Cambridge, CB2 2QQ Cambridge, United Kingdom
| | - Edward T Bullmore
- Department of Psychiatry, University of Cambridge, CB2 2QQ Cambridge, United Kingdom
| | - Raymond J Dolan
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, WC1 B5EH London, United Kingdom
- Wellcome Centre for Human Neuroimaging, University College London, WC1N 3AR London, United Kingdom
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239
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Li Q, Yan J, Liao J, Zhang X, Liu L, Fu X, Tan HY, Zhang D, Yan H. Distinct Effects of Social Stress on Working Memory in Obsessive-Compulsive Disorder. Neurosci Bull 2020; 37:81-93. [PMID: 33000423 PMCID: PMC7811969 DOI: 10.1007/s12264-020-00579-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/13/2020] [Indexed: 10/30/2022] Open
Abstract
Stress might exaggerate the compulsion and impair the working memory of patients with obsessive-compulsive disorder (OCD). This study evaluated the effect of stress on the cognitive neural processing of working memory in OCD and its clinical significance using a "number calculation working memory" task. Thirty-eight patients and 55 gender- and education-matched healthy controls were examined. Stress impaired the performance of the manipulation task in patients. Healthy controls showed less engagement of the medial prefrontal cortex and striatum during the task under stress versus less stress, which was absent in the patients with OCD. The diagnosis × stress interaction effect was significant in the right fusiform, supplementary motor area, precentral cortex and caudate. The failure of suppression of the medial prefrontal cortex and striatum and stress-related hyperactivation in the right fusiform, supplementary motor area, precentral cortex, and caudate might be an OCD-related psychopathological and neural response to stress.
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Affiliation(s)
- Qianqian Li
- Peking University Sixth Hospital, Beijing, 100191, China.,Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Jun Yan
- Peking University Sixth Hospital, Beijing, 100191, China.,Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Jinmin Liao
- Peking University Sixth Hospital, Beijing, 100191, China.,Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Xiao Zhang
- Peking University Sixth Hospital, Beijing, 100191, China.,Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Lijun Liu
- Peking University Sixth Hospital, Beijing, 100191, China.,Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Xiaoyu Fu
- Peking University Sixth Hospital, Beijing, 100191, China.,Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China
| | - Hao Yang Tan
- Lieber Institute for Brain Development, Baltimore, MD, 21205, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Dai Zhang
- Peking University Sixth Hospital, Beijing, 100191, China. .,Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China. .,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, 100871, China. .,PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China.
| | - Hao Yan
- Peking University Sixth Hospital, Beijing, 100191, China. .,Peking University Institute of Mental Health, National Health Commission Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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240
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Neural primacy of the dorsolateral prefrontal cortex in patients with obsessive-compulsive disorder. NEUROIMAGE-CLINICAL 2020; 28:102432. [PMID: 32987298 PMCID: PMC7522851 DOI: 10.1016/j.nicl.2020.102432] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 02/08/2023]
Abstract
The dorsolateral prefrontal cortex (DLPFC), a key structure in the executive system, has consistently emerged as a crucial element in the pathophysiology of obsessive-compulsive disorder (OCD). However, the neural primacy of the DLPFC remains elusive in this disorder. We investigated the causal interaction (measured by effective connectivity) between the DLPFC and the remaining brain areas using bivariate Granger causality analysis of resting-state fMRI collected from 88 medication-free OCD patients and 88 matched healthy controls. Additionally, we conducted seed-based functional connectivity (FC) analyses to identify network-level neural functional alterations using the bilateral DLPFC as seeds. OCD patients demonstrated reduced FC between the right DLPFC and right orbitofrontal cortex (OFC), and activity in the right OFC had an inhibitory effect on the right DLPFC. Additionally, we observed alterations in both feedforward and reciprocal influences between the inferior temporal gyrus (ITG) and the DLPFC in patients. Furthermore, activity in the cerebellum had an excitatory influence on the right DLPFC in OCD patients. These findings may help to elucidate the psychopathology of OCD by detailing the directional connectivity between the DLPFC and the rest of the brain, ultimately helping to identify regions that could serve as treatment targets in OCD.
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241
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5-Hydroxytryptophan as adjuvant therapy in treatment of moderate to severe obsessive-compulsive disorder: a double-blind randomized trial with placebo control. Int Clin Psychopharmacol 2020; 35:254-262. [PMID: 32541380 DOI: 10.1097/yic.0000000000000321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
On the basis of numerous previous studies, the serotonergic system plays a role in the pathogenesis of obsessive-compulsive disorder (OCD) and effective agents in this pathway, such as 5-hydroxytryptophan, can potentially contribute to treatment of patients with this disorder. Evaluating the efficacy of 5-hydroxytryptophan in treating OCD was the aim of the present randomized, double-blind, placebo-controlled 12-week trial. In a 12-week, randomized double-blind study, 60 patients with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of moderate to severe OCD and a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of >21 were randomly assigned to receive either fluoxetine plus placebo or fluoxetine plus 5-hydroxytryptophan (100 mg twice daily). All patients, regardless of their treatment group, received fluoxetine at 20 mg/day for the initial 4 weeks of the study followed by 60 mg/day of fluoxetine for the rest of the trial course. Symptoms were assessed using the Y-BOCS at baseline and weeks 4, 8 and 12. General linear model repeated measure showed significant effects for time × treatment interaction on total Y-BOCS (F = 12.07, df = 2.29, P-value <0.001), obsession (F = 8.25, df = 1.91, P-value = 0.001) and compulsion subscale scores (F = 6.64, df = 2.01, P-value = 0.002). 5-Hydroxytryptophan augmentation therapy demonstrated higher partial and complete treatment response rate (P = 0.032 and P = 0.001, respectively) according to the Y-BOCS total scores. The results of this study confirm that 5-hydroxytryptophan may be effective as an augmentative agent in treatment of moderate-to-severe OCD.
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242
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Emotions Modulate Subthalamic Nucleus Activity: New Evidence in Obsessive-Compulsive Disorder and Parkinson's Disease Patients. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:556-567. [PMID: 33060034 DOI: 10.1016/j.bpsc.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Subthalamic nucleus (STN) deep brain stimulation alleviates obsessive-compulsive disorder (OCD) symptoms, suggesting that this basal ganglia structure may play a key role in integrating limbic and motor information. We explored the modulation of STN neural activity by visual emotional information under different motor demands. METHODS We compared STN local field potentials acquired in 7 patients with OCD and 15 patients with Parkinson's disease off and on levodopa while patients categorized pictures as unpleasant, pleasant, or neutral and pressed a button for 1 of these 3 categories depending on the instruction. RESULTS During image presentation, theta power increased for unpleasant compared with neutral images in both patients with OCD and patients with Parkinson's disease. Only in patients with OCD was theta power also increased in pleasant compared with neutral trials. During the button press in patients with OCD, no modification of STN activity was seen on average, but theta power increased when the image triggering the motor response was unpleasant. Conversely, in patients with Parkinson's disease, a beta decrease was observed during the button press unrelated to the valence of the stimulus. Finally, in patients with OCD, a significant positive relationship was observed between the amplitude of the emotionally related theta response and symptom severity (measured using the Yale-Brown Obsessive Compulsive Scale). CONCLUSIONS We highlighted modulations of STN theta band activity related to emotions that were specific to OCD and correlated with OCD symptom severity. STN theta-induced activity might therefore underlie dysfunction of the limbic STN and its related network leading to OCD pathophysiology.
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243
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Martínez-Rivera FJ, Sánchez-Navarro MJ, Huertas-Pérez CI, Greenberg BD, Rasmussen SA, Quirk GJ. Prolonged avoidance training exacerbates OCD-like behaviors in a rodent model. Transl Psychiatry 2020; 10:212. [PMID: 32620740 PMCID: PMC7334221 DOI: 10.1038/s41398-020-00892-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 01/12/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is characterized by compulsive behaviors that often resemble avoidance of perceived danger. OCD can be treated with exposure-with-response prevention (ERP) therapy in which patients are exposed to triggers but are encouraged to refrain from compulsions, to extinguish compulsive responses. The compulsions of OCD are strengthened by many repeated exposures to triggers, but little is known about the effects of extended repetition of avoidance behaviors on extinction. Here we assessed the extent to which overtraining of active avoidance affects subsequent extinction-with-response prevention (Ext-RP) as a rodent model of ERP, in which rats are extinguished to triggers, while the avoidance option is prevented. Male rats conditioned for 8d or 20d produced similar avoidance behavior to a tone paired with a shock, however, the 20d group showed a severe impairment of extinction during Ext-RP, as well as heightened anxiety. Furthermore, the majority of overtrained (20d) rats (75%) exhibited persistent avoidance following Ext-RP. In the 8d group, only a minority of rats (37%) exhibited persistent avoidance, and this was associated with elevated activity (c-Fos) in the prelimbic cortex and nucleus accumbens. In the 20d group, the minority of non-persistent rats (25%) showed elevated activity in the insular-orbital cortex and paraventricular thalamus. Lastly, extending the duration of Ext-RP prevented the deleterious effects of overtraining on extinction and avoidance. These rodent findings suggest that repeated expression of compulsion-like behaviors biases individuals toward persistent avoidance and alters avoidance circuits, thereby reducing the effectiveness of current extinction-based therapies.
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Affiliation(s)
- Freddyson J Martínez-Rivera
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, 00936, USA.
- Nash family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
| | - Marcos J Sánchez-Navarro
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, 00936, USA
| | - Carlos I Huertas-Pérez
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, 00936, USA
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and Butler Hospital and the Providence VA Medical Center, Providence, RI, 02906, USA
| | - Steven A Rasmussen
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University and Butler Hospital and the Providence VA Medical Center, Providence, RI, 02906, USA
| | - Gregory J Quirk
- Departments of Psychiatry and Anatomy & Neurobiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, 00936, USA
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244
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Silveira VP, Frydman I, Fontenelle LF, Mattos P, de Oliveira-Souza R, Moll J, Hoexter MQ, Miguel EC, McLaughlin NC, Shephard E, Batistuzzo MC. Exploring response inhibition and error monitoring in obsessive-compulsive disorder. J Psychiatr Res 2020; 126:26-33. [PMID: 32413597 PMCID: PMC7313630 DOI: 10.1016/j.jpsychires.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 10/24/2022]
Abstract
Behavioral evidence of impaired response inhibition (RI) and hyperactive error monitoring (EM) in obsessive-compulsive disorder (OCD) is inconsistent. Recent neuroimaging work suggests that EM plays a role in RI impairments in OCD, but this has rarely been investigated using behavioral measures. The aims of this study were to (1) compare RI and EM performance between adults with OCD and non-psychiatric controls (NPC) while investigating possible moderators, and (2) assess whether excessive EM influences RI in OCD. We compared RI and EM performance on the Stop-Signal Task (SST) between 92 adults with OCD and 65 NPC from two Brazilian sites. We used linear regression to investigate which variables (group, age, medication use, clinical symptomatology) influenced performance, as well as to examine possible associations between RI and EM. OCD and NPC did not differ in RI and EM. However, age moderated RI performance in OCD with a medium effect size, reflecting differential effects of age on RI between groups: age was positively associated with RI in OCD but not NPC. Further, OCD severity predicted EM with a medium to large effect size, suggesting that more symptomatic patients showed greater monitoring of their mistakes. Finally, group moderated the relationship between RI and EM with a small effect size. Our findings suggest that demographic factors may influence RI, whereas clinical factors may influence EM. Further, we found preliminary behavioral evidence to indicate that impaired RI and excessive EM are related in OCD.
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Affiliation(s)
- Vitor Portella Silveira
- Departmento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR. R. Dr. Ovídio Pires de Campos, 785 - Cerqueira César, São Paulo, SP, 05403-903, Brazil.
| | - Ilana Frydman
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Av. Venceslau Brás, 71 - Botafogo, Rio de Janeiro - RJ, 22290-140, Brazil
| | - Leonardo F. Fontenelle
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Av. Venceslau Brás, 71 - Botafogo, Rio de Janeiro - RJ, 22290-140, Brazil,Turner Institute for Brain and Mental Health, Monash University, Wellington Rd, Clayton VIC 3800, Australia,D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. Rua Diniz Cordeiro, 30 - Botafogo, Rio de Janeiro - RJ, 22281-100, Brazil
| | - Paulo Mattos
- D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. Rua Diniz Cordeiro, 30 - Botafogo, Rio de Janeiro - RJ, 22281-100, Brazil
| | - Ricardo de Oliveira-Souza
- D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. Rua Diniz Cordeiro, 30 - Botafogo, Rio de Janeiro - RJ, 22281-100, Brazil
| | - Jorge Moll
- D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. Rua Diniz Cordeiro, 30 - Botafogo, Rio de Janeiro - RJ, 22281-100, Brazil
| | - Marcelo Queiroz Hoexter
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil. R. Dr. Ovídio Pires de Campos, 785 - Cerqueira César, São Paulo - SP, 05403-903, Brazil
| | - Eurípedes Constantino Miguel
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil. R. Dr. Ovídio Pires de Campos, 785 - Cerqueira César, São Paulo - SP, 05403-903, Brazil
| | - Nicole C.R. McLaughlin
- Butler Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA. 345 Blackstone Blvd, Providence, RI 02906, USA
| | - Elizabeth Shephard
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK. 16 De Crespigny Park, Camberwell, London SE5 8AF, UK
| | - Marcelo Camargo Batistuzzo
- Psychology Department, Health Sciences School, Pontifical Catholic University of São Paulo, São Paulo, SP, Brazil. Rua Monte Alegre 984 - Perdizes, São Paulo - SP, 05014-001, Brazil
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245
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Hervig ME, Piilgaard L, Božič T, Alsiö J, Robbins TW. Glutamatergic and Serotonergic Modulation of Rat Medial and Lateral Orbitofrontal Cortex in Visual Serial Reversal Learning. ACTA ACUST UNITED AC 2020; 13:438-458. [PMID: 33613854 PMCID: PMC7872199 DOI: 10.1037/pne0000221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 02/06/2023]
Abstract
Adapting behavior to a dynamic environment requires both steadiness when the environment is stable and behavioral flexibility in response to changes. Much evidence suggests that cognitive flexibility, which can be operationalized in reversal learning tasks, is mediated by cortico-striatal circuitries, with the orbitofrontal cortex (OFC) playing a prominent role. The OFC is a functionally heterogeneous region, and we have previously reported differential roles of lateral (lOFC) and medial (mOFC) regions in a touchscreen serial visual reversal learning task for rats using pharmacological inactivation. Here, we investigated the effects of pharmacological overactivation of these regions using a glutamate transporter 1 (GLT-1) inhibitor, dihydrokainate (DHK), which increases extracellular glutamate by blocking its reuptake. We also tested the impact of antagonism of the serotonin 2A receptor (5-HT2AR), which modulates glutamate action, in the mOFC and lOFC on the same task. Overactivation induced by DHK produced dissociable effects in the mOFC and lOFC, with more prominent effects in the mOFC, specifically improving performance in the early, perseveration phase. Intra-lOFC DHK increased the number of omitted responses without affecting errors. In contrast, blocking the 5-HT2AR in the lOFC impaired reversal learning overall, while mOFC 5-HT2AR blockade had no effect. These results further support dissociable roles of the rodent mOFC and lOFC in deterministic visual reversal learning and indicate that modulating glutamate transmission through blocking the GLT-1 and the 5-HT2AR have different roles in these two structures. This study further supports dissociable roles of specific orbitofrontal subregions, as well as glutamatergic and serotonergic transmission in these subregions, in cognitive flexibility. This knowledge will add to the understanding of specific neural mechanisms underlying inflexible behaviour across psychiatric disorders.
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Affiliation(s)
- Mona E Hervig
- Department of Psychology, University of Cambridge, and Department of Neuroscience, University of Copenhagen
| | - Louise Piilgaard
- Department of Psychology, University of Cambridge, and Behavioral and Clinical Neuroscience Institute, University of Cambridge
| | - Tadej Božič
- Department of Psychology, University of Cambridge, and Behavioral and Clinical Neuroscience Institute, University of Cambridge
| | - Johan Alsiö
- Department of Psychology, University of Cambridge, and Behavioral and Clinical Neuroscience Institute, University of Cambridge
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, and Behavioral and Clinical Neuroscience Institute, University of Cambridge
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246
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Lv Q, Lv Q, Yin D, Zhang C, Sun B, Voon V, Wang Z. Neuroanatomical Substrates and Predictors of Response to Capsulotomy in Intractable Obsessive-Compulsive Disorder. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:29-38. [PMID: 32653579 DOI: 10.1016/j.bpsc.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/27/2020] [Accepted: 05/12/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Anterior capsulotomy that surgically targets fiber tracts connecting prefrontal cortex and subcortical nuclei is a therapeutic option for a subgroup of patients with treatment-refractory obsessive-compulsive disorder. The goal of this study was to investigate neural correlates to anterior capsulotomy and find predictors of clinical improvement following this procedure. METHODS Structural and diffusion imaging data and clinical evaluation were acquired from 31 patients with refractory obsessive-compulsive disorder who underwent anterior capsulotomy. Of the 31 patients, 16 were clinical responders defined by a ≥35% reduction in the Yale-Brown Obsessive Compulsive Scale scores. Analysis of variance was applied on 2 levels (surgery and response) to examine alterations of gray matter volume and fiber tract integrity (measured by generalized fractional anisotropy). The correlation between preoperative data and clinical response was further investigated. RESULTS After surgery, generalized fractional anisotropy was significantly decreased in the bilateral anterior limb of the internal capsule and anterior thalamic radiation, accompanied by a decrease in gray matter volume in the prefrontal cortex, anterior cingulate cortex, striatum, thalamus, and cerebellum. Moreover, atrophy of the right caudate was greater in responders than in nonresponders, which correlated with alteration in Yale-Brown Obsessive Compulsive Scale score. In addition, preoperative gray matter volume in the right inferior frontal gyrus and generalized fractional anisotropy in the left superior longitudinal fasciculus and right cingulum predicted improved response. More anterior location of the lesion area predicted better clinical response. CONCLUSIONS These results demonstrate that reduced volume of the right caudate might be associated with therapeutic response of capsulotomy and might offer a potential predictor of treatment outcome and a guide for lesion site.
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Affiliation(s)
- Qian Lv
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Qiming Lv
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Dazhi Yin
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China
| | - Chencheng Zhang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bomin Sun
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
| | - Zheng Wang
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China; University of the Chinese Academy of Sciences, Beijing, China; Shanghai Center for Brain Science and Brain-Inspired Intelligence Technology, Shanghai, China.
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247
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A limbic circuitry involved in emotional stress-induced grooming. Nat Commun 2020; 11:2261. [PMID: 32385304 PMCID: PMC7210270 DOI: 10.1038/s41467-020-16203-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 04/16/2020] [Indexed: 01/08/2023] Open
Abstract
Prolonged exposure to negative stressors could be harmful if a subject cannot respond appropriately. Strategies evolved to respond to stress, including repetitive displacement behaviours, are important in maintaining behavioural homoeostasis. In rodents, self-grooming is a frequently observed repetitive behaviour believed to contribute to post-stress de-arousal with adaptive value. Here we identified a rat limbic di-synaptic circuit that regulates stress-induced self-grooming with positive affective valence. This circuit links hippocampal ventral subiculum to ventral lateral septum (LSv) and then lateral hypothalamus tuberal nucleus. Optogenetic activation of this circuit triggers delayed but robust excessive grooming with patterns closely resembling those evoked by emotional stress. Consistently, the neural activity of LSv reaches a peak before emotional stress-induced grooming while inhibition of this circuit significantly suppresses grooming triggered by emotional stress. Our results uncover a previously unknown limbic circuitry involved in regulating stress-induced self-grooming and pinpoint a critical role of LSv in this ethologically important behaviour. Self-grooming is a frequently observed repetitive behaviour in rodents that is believed to contribute to post-stress de-arousal. The authors identified a previously unknown limbic circuit that includes the ventral lateral septum in rats and is involved in regulating stress-induced self-grooming.
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248
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Dorantes-Nieto Á, Cortes C, Ugarte A, Trujillo Hernández A, Carrasco Á, Cepeda-Freyre HA, Eguibar JR. Yawning and Penile Erection Frequencies Are Resilient to Maternal Care Manipulation in the High-Yawning Subline of Sprague-Dawley Rats. Front Behav Neurosci 2020; 14:20. [PMID: 32226363 PMCID: PMC7080979 DOI: 10.3389/fnbeh.2020.00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/30/2020] [Indexed: 12/03/2022] Open
Abstract
Yawning is a stereotyped behavioral pattern characterized by wide opening of the mouth associated with deep inspiration followed by short expiration. All vertebrate species yawn, but with low frequencies. We obtained two sublines of Sprague–Dawley (SD) rats by a strict inbreeding process: one with a high-yawning frequency (HY) of 20 yawns/h, which is one order of magnitude higher with respect to the low-yawning frequency (LY) subline, with 2 yawns/h. Outbred SD rats had a yawning frequency of 1 yawn/h. HY dams had a different organization of maternal care with respect to that displayed by LY and SD dams because HY dams constructed lower quality nests and had more re-retrieving and atypical retrieving. The aim of this study was to analyze the changes in maternal care using in- and cross-fostering between the sublines and SD dams and to measure spontaneous and dopaminergic-induced yawning, penile erections, grooming and scratching bouts. We also measured the expression of dopamine D2 receptors in the striatum using Western blot analysis. Our results showed that HY male rats reared by SD or LY dams did not significantly differ in yawning frequencies with respect to HY male rats reared by mothers of their own phenotype. Maternal care did not differ between sublines and SD dams independent of the litter they reared. However, LY rats reared by HY dams showed a significant increase in the number of spontaneous penile erections. Importantly, in-fostered HY male rats had the highest number of yawns induced by systemic administration of (−)-quinpirole supporting that higher maternal care display can influence the frequency of dopaminergic-induced yawning. In fact HY male rats in all conditions yawned more than did LY and SD male rats independent of the dam that raised them supporting a strong influence of genetic background. However SD male rats raised by LY dams showed significantly increased the dopamine D2 receptor expression. In conclusion, maternal care and the environmental nest conditions during the lactation period did not change the phenotypic characteristics of the yawning sublines supporting that their genetic background is fundamental for the expression of spontaneous or dopaminergic-induced yawning.
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Affiliation(s)
| | - Carmen Cortes
- Institute of Physiology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Araceli Ugarte
- Institute of Physiology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | | | - Ángeles Carrasco
- Institute of Physiology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | | | - Jose R Eguibar
- Institute of Physiology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.,Research Office, Vice-rectory of Research and Postgraduate Studies, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
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249
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Haber SN, Tang W, Choi EY, Yendiki A, Liu H, Jbabdi S, Versace A, Phillips M. Circuits, Networks, and Neuropsychiatric Disease: Transitioning From Anatomy to Imaging. Biol Psychiatry 2020; 87:318-327. [PMID: 31870495 DOI: 10.1016/j.biopsych.2019.10.024] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 12/14/2022]
Abstract
Since the development of cellular and myelin stains, anatomy has formed the foundation for understanding circuitry in the human brain. However, recent functional and structural studies using magnetic resonance imaging have taken the lead in this endeavor. These innovative and noninvasive approaches have the advantage of studying connectivity patterns under different conditions directly in the human brain. They demonstrate dynamic and structural changes within and across networks linked to normal function and to a wide range of psychiatric illnesses. However, these indirect methods are unable to link networks to the hardwiring that underlies them. In contrast, anatomic invasive experimental studies can. Following a brief review of prefrontal cortical, anterior cingulate, and striatal connections and the different methodologies used, this article discusses how data from anatomic studies can help inform how hardwired connections are linked to the functional and structural networks identified in imaging studies.
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Affiliation(s)
- Suzanne N Haber
- Department of Pharmacology and Physiology, University of Rochester School of Medicine, Rochester, New York; Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts.
| | - Wei Tang
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Belmont, Massachusetts
| | - Eun Young Choi
- Department of Neuroscience, Stanford University, Palo Alto, California
| | - Anastasia Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard University & Massachusetts General Hospital, Boston, Massachusetts
| | - Hesheng Liu
- Department of Radiology, Medical University of South Carolina, Charleston, South Carolina
| | - Saad Jbabdi
- Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Amelia Versace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary Phillips
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
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Mirabella G, Upadhyay N, Mancini C, Giannì C, Panunzi S, Petsas N, Suppa A, Cardona F, Pantano P. Loss in grey matter in a small network of brain areas underpins poor reactive inhibition in Obsessive-Compulsive Disorder patients. Psychiatry Res Neuroimaging 2020; 297:111044. [PMID: 32078965 DOI: 10.1016/j.pscychresns.2020.111044] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/04/2020] [Accepted: 02/06/2020] [Indexed: 01/01/2023]
Abstract
Reactive inhibition correlates with the severity of symptoms in paediatric patients with Obsessive-Compulsive Disorder (OCD) though not in those with Tourette syndrome (TS). Here we assessed whether structural alterations in both grey (GM) and white matter (WM) volumes correlate with a measure of reactive inhibition, i.e. the stop-signal reaction time (SSRT), and with clinical scale scores. Nine OCD and 11 TS uncomplicated drug-naïve paediatric patients and 12 age-matched controls underwent 3T magnetic resonance imaging scanning. Between-group differences in GM and WM volumes across the whole brain were assessed. Outside the scanner, patients performed a reaching version of the stop-signal task. Both behavioural inhibitory control and neuroimaging measures were normal in TS patients. By contrast, OCD patients exhibited a significant loss in GM volume in five areas. The GM volume of the left inferior frontal gyrus was inversely correlated with the length of the SSRT, the left mid-cingulate gyrus and the right middle frontal gyrus were inversely correlated with the severity of OCD symptoms, and the left insula and the right medial orbitofrontal gyrus were inversely correlated with both. These results indicate that cortical areas showing GM loss in OCD patients are also involved in the network subserving reactive inhibition.
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Affiliation(s)
- Giovanni Mirabella
- Department of Anatomy, Histology, Forensic Medicine & Orthopedics, Sapienza University, Rome, Italy; IRCCS Neuromed, Pozzilli (IS), Italy.
| | - Neeraj Upadhyay
- Department of Human Neuroscience, Sapienza University, Rome, Italy; DZNE, German Centre for Neurodegenerative Diseases, Bonn, Germany
| | - Christian Mancini
- Department of Anatomy, Histology, Forensic Medicine & Orthopedics, Sapienza University, Rome, Italy
| | - Costanza Giannì
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Sara Panunzi
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Nikolaos Petsas
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Antonio Suppa
- IRCCS Neuromed, Pozzilli (IS), Italy; Department of Human Neuroscience, Sapienza University, Rome, Italy
| | | | - Patrizia Pantano
- IRCCS Neuromed, Pozzilli (IS), Italy; Department of Human Neuroscience, Sapienza University, Rome, Italy
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