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Xiao Q, Hou J, Xiao L, Zhou M, He Z, Dong H, Hu S. Lower synaptic density and its association with cognitive dysfunction in patients with obsessive-compulsive disorder. Gen Psychiatr 2024; 37:e101208. [PMID: 38894874 PMCID: PMC11184172 DOI: 10.1136/gpsych-2023-101208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Background Understanding synaptic alteration in obsessive-compulsive disorder (OCD) is crucial for elucidating its pathological mechanisms, but in vivo research on this topic remains limited. Aims This study aimed to identify the synaptic density indicators in OCD and explore the relationship between cognitive dysfunction and synaptic density changes in OCD. Methods This study enrolled 28 drug-naive adults with OCD aged 18-40 years and 16 healthy controls (HCs). Three-dimensional T1-weighted structural magnetic resonance imaging and 18F-SynVesT-1 positron emission tomography were conducted. Cognitive function was assessed using the Wisconsin Cart Sorting Test (WCST) in patients with OCD and HCs. Correlative analysis was performed to examine the association between synaptic density reduction and cognitive dysfunction. Results Compared with HCs, patients with OCD showed reduced synaptic density in regions of the cortico-striato-thalamo-cortical circuit such as the bilateral putamen, left caudate, left parahippocampal gyrus, left insula, left parahippocampal gyrus and left middle occipital lobe (voxel p<0.001, uncorrected, with cluster level above 50 contiguous voxels). The per cent conceptual-level responses of WCST were positively associated with the synaptic density reduction in the left middle occipital gyrus (R2=0.1690, p=0.030), left parahippocampal gyrus (R2=0.1464, p=0.045) and left putamen (R2=0.1967, p=0.018) in patients with OCD. Conclusions Adults with OCD demonstrated lower 18F-labelled difluoro analogue of 18F-SynVesT-1 compared with HCs, indicating potentially lower synaptic density. This is the first study to explore the synaptic density in patients with OCD and provides insights into potential biological targets for cognitive dysfunctions in OCD.
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Affiliation(s)
- Qian Xiao
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiale Hou
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ling Xiao
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ming Zhou
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhiyou He
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huixi Dong
- Mental Health Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shuo Hu
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Biological Nanotechnology, National Health Commission, Changsha, Hunan, China
- National Clinical Research Center, Geriatric Disorders (Xiangya), Changsha, Hunan, China
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Wang J, Huang C, Luo G, Xiao Y, Guo G, Quan D, Zheng H. Reduced sleep quality defines a subtype of obsessive-compulsive disorder with lower Glx levels in the resting thalamus and worse response inhibition. J Psychiatr Res 2024; 173:14-24. [PMID: 38461674 DOI: 10.1016/j.jpsychires.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND The aim of this study was to investigate the differences between resting and active thalamic neurometabolite levels and inhibitory function in obsessive compulsive disorder (OCD) patients with poor sleep quality (PSQ was defined as Pittsburgh Sleep Quality Index >5 and sleep efficiency ≤85%) compared to OCD patients with good sleep quality (GSQ) and healthy controls (HCs), as well as the relationship of these indices to obsessive compulsive symptoms. METHODS Functional magnetic resonance spectroscopy (fMRS) was used to measure resting and active thalamic neurometabolite levels in 72 subjects (20 HCs and 38 OCD patients included in study analysis). Response inhibition function was measured by the Go-Nogo task before and during MRS recording. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The symptoms of OCD, anxiety and depression were evaluated using relevant clinical scales. RESULTS OCD patients exhibited significantly reduced Glx/Cr levels in the resting thalamus. The levels of resting thalamic Glu/Cr and Glx/Cr in OCD patients with PSQ were significantly lowest. OCD patients had significantly lower correct rates on Go tasks, higher error rates on Nogo tasks, and longer error average response times (EART) to the Nogo task. OCD patients with PSQ demonstrated the highest Nogo task error rate and the longest EART to Nogo task. Furthermore, PSQI scores exhibited negative correlations with Glu/Cr and Glx/Cr in the resting thalamus. CONCLUSION OCD patients with PSQ demonstrated reduced levels of thalamic resting Glx and more pronounced response inhibitory function impairment. Aberrant neurometabolite levels in critical brain regions, coupled with heightened response inhibition function deficits, may be a neurobiological basis for the PSQ that OCD patients generally exhibit.
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Affiliation(s)
- Jian Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China; School of Medicine, South China University of Technology, Guangzhou, 510006, China
| | - Cigui Huang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China; The Second Clinical School of Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Guowei Luo
- Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518052, China
| | - Yuqing Xiao
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China; The Second Clinical School of Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Guangquan Guo
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China
| | - Dongming Quan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China
| | - Huirong Zheng
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China; School of Medicine, South China University of Technology, Guangzhou, 510006, China; The Second Clinical School of Medicine, Southern Medical University, Guangzhou, 510515, China.
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Biria M, Banca P, Keser E, Healy MP, Sawiak SJ, Frota Lisbôa Pereira de Souza AM, Marzuki AA, Sule A, Robbins TW. Excessive Checking in Obsessive-Compulsive Disorder: Neurochemical Correlates Revealed by 7T Magnetic Resonance Spectroscopy. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:363-373. [PMID: 38298778 PMCID: PMC10829650 DOI: 10.1016/j.bpsgos.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 02/02/2024] Open
Abstract
Background Compulsive checking, a common symptom of obsessive-compulsive disorder (OCD), has been difficult to capture experimentally. Therefore, determination of its neural basis remains challenging despite some evidence suggesting that it is linked to dysfunction of cingulostriatal systems. This study introduces a novel experimental paradigm to measure excessive checking and its neurochemical correlates. Methods Thirty-one patients with OCD and 29 healthy volunteers performed a decision-making task requiring them to decide whether 2 perceptually similar visual representations were the same or different under a high-uncertainty condition without feedback. Both groups underwent 7T magnetic resonance spectroscopy scans on the same day. Correlations between out-of-scanner experimental measures of checking and the glutamate/GABA (gamma-aminobutyric acid) ratio in the anterior cingulate cortex, supplementary motor area, and occipital cortex were assessed. Their relationship with subjective ratings of doubt, anxiety, and confidence was also investigated. Results Patients with OCD exhibited excessive and dysfunctional checking, which was significantly correlated with changes in the glutamate/GABA ratio within the anterior cingulate cortex. No behavioral/neurochemical relationships were evident for either the supplementary motor area or occipital cortex. The excessive checking observed in patients was negatively correlated with their confidence levels and positively related to doubt, anxiety, and compulsivity traits. Conclusions We conclude that experimental measures of excessive and dysfunctional checking in OCD, which have been linked to increased doubt, anxiety, and lack of confidence, are related to an imbalance between excitatory and inhibitory neural activity within the anterior cingulate cortex. This study adds to our understanding of the role of this region in OCD by providing a laboratory model of the possible development of compulsive checking.
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Affiliation(s)
- Marjan Biria
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Division of Psychiatry and Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Paula Banca
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Engin Keser
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Máiréad P. Healy
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Stephen J. Sawiak
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Ana Maria Frota Lisbôa Pereira de Souza
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Aleya A. Marzuki
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia
| | - Akeem Sule
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W. Robbins
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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Xu Y, Han S, Wei Y, Zheng R, Cheng J, Zhang Y. Abnormal resting-state effective connectivity in large-scale networks among obsessive-compulsive disorder. Psychol Med 2024; 54:350-358. [PMID: 37310178 DOI: 10.1017/s0033291723001228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a chronic mental illness characterized by abnormal functional connectivity among distributed brain regions. Previous studies have primarily focused on undirected functional connectivity and rarely reported from network perspective. METHODS To better understand between or within-network connectivities of OCD, effective connectivity (EC) of a large-scale network is assessed by spectral dynamic causal modeling with eight key regions of interests from default mode (DMN), salience (SN), frontoparietal (FPN) and cerebellum networks, based on large sample size including 100 OCD patients and 120 healthy controls (HCs). Parametric empirical Bayes (PEB) framework was used to identify the difference between the two groups. We further analyzed the relationship between connections and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). RESULTS OCD and HCs shared some similarities of inter- and intra-network patterns in the resting state. Relative to HCs, patients showed increased ECs from left anterior insula (LAI) to medial prefrontal cortex, right anterior insula (RAI) to left dorsolateral prefrontal cortex (L-DLPFC), right dorsolateral prefrontal cortex (R-DLPFC) to cerebellum anterior lobe (CA), CA to posterior cingulate cortex (PCC) and to anterior cingulate cortex (ACC). Moreover, weaker from LAI to L-DLPFC, RAI to ACC, and the self-connection of R-DLPFC. Connections from ACC to CA and from L-DLPFC to PCC were positively correlated with compulsion and obsession scores (r = 0.209, p = 0.037; r = 0.199, p = 0.047, uncorrected). CONCLUSIONS Our study revealed dysregulation among DMN, SN, FPN, and cerebellum in OCD, emphasizing the role of these four networks in achieving top-down control for goal-directed behavior. There existed a top-down disruption among these networks, constituting the pathophysiological and clinical basis.
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Affiliation(s)
- Yinhuan Xu
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruiping Zheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Kosová E, Pajuelo D, Fajnerová I, Greguš D, Brunovský M, Stopková P, Škoch A, Fürstová P, Španiel F, Horáček J. Spectroscopic abnormalities in the pregenual anterior cingulate cortex in obsessive-compulsive disorder using proton magnetic resonance spectroscopy: a controlled study. BMC Psychiatry 2023; 23:734. [PMID: 37817131 PMCID: PMC10565966 DOI: 10.1186/s12888-023-05228-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND The main aim of the present study is to determine the role of metabolites observed using proton magnetic resonance spectroscopy (1H-MRS) in obsessive-compulsive disorder (OCD). As the literature describing biochemical changes in OCD yields conflicting results, we focused on accurate metabolite quantification of total N-acetyl aspartate (tNAA), total creatine (tCr), total choline-containing compounds (tCh), and myo-inositol (mI) in the anterior cingulate cortex (ACC) to capture the small metabolic changes between OCD patients and controls and between OCD patients with and without medication. METHODS In total 46 patients with OCD and 46 healthy controls (HC) matched for age and sex were included in the study. The severity of symptoms in the OCD was evaluated on the day of magnetic resonance imaging (MRI) using the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Subjects underwent 1H-MRS from the pregenual ACC (pgACC) region to calculate concentrations of tNAA, tCr, tCho, and mI. Twenty-eight OCD and 28 HC subjects were included in the statistical analysis. We compared differences between groups for all selected metabolites and in OCD patients we analyzed the relationship between metabolite levels and symptom severity, medication status, age, and the duration of illness. RESULTS Significant decreases in tCr (U = 253.00, p = 0.022) and mI (U = 197.00, p = 0.001) in the pgACC were observed in the OCD group. No statistically significant differences were found in tNAA and tCho levels; however, tCho revealed a trend towards lower concentrations in OCD patients (U = 278.00, p = 0.062). Metabolic concentrations showed no significant correlations with the age and duration of illness. The correlation statistics found a significant negative correlation between tCr levels and YBOCS compulsions subscale (cor = -0.380, p = 0.046). tCho and YBOCS compulsions subscale showed a trend towards a negative correlation (cor = -0.351, p = 0.067). Analysis of subgroups with or without medication showed no differences. CONCLUSIONS Patients with OCD present metabolic disruption in the pgACC. The decrease in tCr shows an important relationship with OCD symptomatology. tCr as a marker of cerebral bioenergetics may also be considered as a biomarker of the severity of compulsions. The study failed to prove that metabolic changes correlate with the medication status or the duration of illness. It seems that a disruption in the balance between these metabolites and their transmission may play a role in the pathophysiology of OCD.
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Affiliation(s)
- Eliška Kosová
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Dita Pajuelo
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.
- MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
| | - Iveta Fajnerová
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - David Greguš
- National Institute of Mental Health, Klecany, Czech Republic
| | - Martin Brunovský
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavla Stopková
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Antonín Škoch
- National Institute of Mental Health, Klecany, Czech Republic
- MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petra Fürstová
- National Institute of Mental Health, Klecany, Czech Republic
| | - Filip Španiel
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Horáček
- National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
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6
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Kosová E, Pajuelo D, Greguš D, Brunovský M, Stopková P, Fajnerová I, Horáček J. Glutamatergic abnormalities in the pregenual anterior cingulate cortex in obsessive-compulsive disorder using magnetic resonance spectroscopy: A controlled study. Psychiatry Res Neuroimaging 2023; 335:111721. [PMID: 37832259 DOI: 10.1016/j.pscychresns.2023.111721] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023]
Abstract
In this study, we utilized proton magnetic resonance spectroscopy (MRS) to understand the role of glutamate (Glu), glutamine (Gln), and gamma-aminobutyric acid (GABA) of OCD patients in the pregenual anterior cingulate cortex (pgACC). In total, 54 patients with OCD and 54 healthy controls (HC) matched for age and sex were included in the study. They underwent MRS in the pgACC region to calculate the concentrations of Glu, Gln, GABA, and Glu + Gln (Glx). After quality control of the MRS data, 21 OCD and 21 HC were statistically analyzed. The severity of symptoms were evaluated using the Yale-Brown Obsessive-Compulsive Scale (YBOCS). In the statistical analysis, we compared differences between groups for the metabolites; in the OCD we analyzed the correlations with symptom severity, medication status, age, and duration of illness. A significant decrease in Glx, in Glu, and in Gln in the pgACC were observed in the OCD compared to HC. The correlation statistics showed a significant positive correlation between Glu levels and the YBOCS compulsions subscale. The results indicate that patients with OCD present a disturbance in glutamatergic metabolism in the pgACC. The results also demonstrate that these changes correlate with the severity of compulsions.
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Affiliation(s)
- Eliška Kosová
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Dita Pajuelo
- National Institute of Mental Health, Klecany, Czech Republic; MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - David Greguš
- National Institute of Mental Health, Klecany, Czech Republic
| | - Martin Brunovský
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavla Stopková
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Iveta Fajnerová
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Horáček
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Prague, Czech Republic
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7
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Biria M, Banca P, Healy MP, Keser E, Sawiak SJ, Rodgers CT, Rua C, de Souza AMFLP, Marzuki AA, Sule A, Ersche KD, Robbins TW. Cortical glutamate and GABA are related to compulsive behaviour in individuals with obsessive compulsive disorder and healthy controls. Nat Commun 2023; 14:3324. [PMID: 37369695 DOI: 10.1038/s41467-023-38695-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 05/09/2023] [Indexed: 06/29/2023] Open
Abstract
There has been little analysis of neurochemical correlates of compulsive behaviour to illuminate its underlying neural mechanisms. We use 7-Tesla proton magnetic resonance spectroscopy (1H-MRS) to assess the balance of excitatory and inhibitory neurotransmission by measuring glutamate and GABA levels in anterior cingulate cortex (ACC) and supplementary motor area (SMA) of healthy volunteers and participants with Obsessive-Compulsive Disorder (OCD). Within the SMA, trait and clinical measures of compulsive behaviour are related to glutamate levels, whereas a behavioural index of habitual control correlates with the glutamate:GABA ratio. Participants with OCD also show the latter relationship in the ACC while exhibiting elevated glutamate and lower GABA levels in that region. This study highlights SMA mechanisms of habitual control relevant to compulsive behaviour, common to the healthy sub-clinical and OCD populations. The results also demonstrate additional involvement of anterior cingulate in the balance between goal-directed and habitual responding in OCD.
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Affiliation(s)
- Marjan Biria
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.
| | - Paula Banca
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - Máiréad P Healy
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - Engin Keser
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
| | - Stephen J Sawiak
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, CB2 3EL, UK
| | - Christopher T Rodgers
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Catarina Rua
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Ana Maria Frota Lisbôa Pereira de Souza
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - Aleya A Marzuki
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
- Department of Psychology, School of Medical and Life Sciences, Sunway University, Petaling Jaya, Malaysia
| | - Akeem Sule
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Karen D Ersche
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, University of Heidelberg, Heidelberg, Germany
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK.
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.
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Luo G, Wang S, Yao S, Quan D, Guo G, Gao J, Zheng H. Direct changes of neurometabolic concentrations in the pregenual anterior cingulate cortex among obsessive-compulsive patients after repetitive transcranial magnetic stimulation treatment. J Affect Disord 2023; 333:79-85. [PMID: 37080494 DOI: 10.1016/j.jad.2023.04.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/01/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND AND AIM Although Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising new noninvasive brain stimulation therapy, its underlying mechanisms of action remain unknown. OCD patients exhibit impaired response control and attention shifting, which is linked to some brain areas such as anterior cingulate cortex and basal ganglia. OCD patients also display altered neurometabolic concentrations in cortical cortical-striatal-thalamic-cortical (CSTC). In this study, we aimed to elucidate efficacy of rTMS treatment in alleviating related symptoms and pregenual anterior cingulate cortex (pACC) neurometabolites. METHODS OCD patients were randomly divided into either drug (n = 23) or drug + rTMS (n = 29) groups, and those in the latter group subjected to 4-week rTMS treatment. All participants were visited twice, at baseline and follow-up after four weeks. During both visits, all patients were subjected to 1H-MRS, then Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Global Assessment Function (GAF) used to assess severity of obsessive-compulsive symptoms. We also evaluated synchronous anxiety and depression by Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Hamilton Anxiety Scale (HAM-A) and Hamilton Depression Scale (HAM-D). RESULTS After 4 weeks of treatment, patients in the Drug + rTMS group displayed significantly lower Y-BOCS (p = 0.038), BDI (p = 0.009), HAM-D (p = 0.013), HAM-A (p = 0.012) scores than their counterparts in the Drug group. Conversely, patients in the Drug + rTMS group had significantly higher tNAA concentrations (p = 0.030) than those in the Drug group. Notably, the Drug + rTMS group exhibited higher, but insignificant Glu (p = 0.055) and Glx (p = 0.068) concentrations compared to the Drug group. Partial correlation analysis revealed a significant negative correlation between post HAM-A scores and 4-week change of pACC glutamate levels in the Drug + rTMS group (r = -0.434, p = 0.02). CONCLUSION rTMS treatment is an efficacious treatment therapy for OCD, mainly by inducing changes in neurometabolites.
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Affiliation(s)
- Guowei Luo
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Shantou University Medical College, Shantou, China
| | - Shibin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Siyu Yao
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Dongming Quan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Guangquan Guo
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Junling Gao
- Department of Medicine, University of Hong Kong, Hong Kong, China
| | - Huirong Zheng
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China; South China University of Technology School of Medicine, Guangzhou, China; Shantou University Medical College, Shantou, China.
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Abstract
Obsessive-compulsive disorder (OCD) has a bidirectional relationship with metabolic disorders. The purposes of this review are to decipher the links between OCD and metabolic disorders and to explore the etiological mechanism of OCD in metabolism, which may aid in early identification of and tailored interventions for OCD and metabolic disorders.
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