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Patel C, Patel R, Kesharwani A, Rao L, Jain NS. Central cholinergic transmission modulates endocannabinoid-induced marble-burying behavior in mice. Behav Brain Res 2024; 476:115252. [PMID: 39278464 DOI: 10.1016/j.bbr.2024.115252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 08/30/2024] [Accepted: 09/12/2024] [Indexed: 09/18/2024]
Abstract
Central cholinergic system and endocannabinoid, anandamide exhibits anti-compulsive-like behavior in mice. However, the role of the central cholinergic system in the anandamide-induced anti-compulsive-like behavior is still unexplored. Therefore, the present study assessed the role of central cholinergic transmission in the anandamide-induced anti-compulsive activity using a marble-burying behavior (MBB) model in mice. The modulation in the anandamide-induced effect on MBB was evaluated using mice with altered central cholinergic transmission achieved by pretreatment (i.c.v.) with various cholinergic agents like acetylcholine (ACh), acetylcholinesterase inhibitor (AChEI), neostigmine, nicotine, mAChR antagonist, atropine, and nAChR antagonist, mecamylamine. The influence of anandamide treatment on the brain AChE activity was also evaluated. The results revealed that i.c.v. injection of anandamide (10, 20 µg/mouse, i.c.v.) dose-dependently reduced MBB in mice. Moreover, anandamide in all the tested doses inhibited the brain AChE activity indicating the role of an enhanced central cholinergic transmission in its anti-compulsive-like effect . Furthermore, the anti-compulsive-like effect of anandamide (20 µg/mouse, i.c.v.) was found to be enhanced in mice centrally pre-treated with, ACh (0.1 µg/mouse, i.c.v.) or AChEI, neostigmine (0.3 µg/mouse, i.c.v.). In addition, the anandamide-induced anti-compulsive-like effect was significantly increased in mice pre-treated with a low dose of nicotine (0.1 µg/mouse, i.c.v.) while, it was attenuated by the higher dose of nicotine (2 µg/mouse, i.c.v.). On the other hand, the anandamide (20 µg/mouse, i.c.v.) induced anti-compulsive-like effect was found to be diminished in mice pre-treated with mAChR antagonist, atropine (0.1, 0.5 µg/mouse, i.c.v.) and pre-injection of nAChR antagonist, mecamylamine (0.1, 0.5 µg/mouse, i.c.v.) potentiated the anandamide induced anti-compulsive-like response in mice. Thus, the present investigation delineates the modulatory role of an enhanced central cholinergic transmission in the anandamide-induced anti-compulsive-like behavior in mice by inhibition of brain AChE or via muscarinic and nicotinic receptors mediated mechanism.
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Affiliation(s)
- Chhatrapal Patel
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India
| | - Richa Patel
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India
| | - Anuradha Kesharwani
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India
| | - Laxmi Rao
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India
| | - Nishant Sudhir Jain
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India.
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2
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He J, Li X, Li K, Yang H, Wang X. Abnormal functional connectivity of the putamen in obsessive-compulsive disorder. J Psychiatr Res 2024; 177:338-345. [PMID: 39068778 DOI: 10.1016/j.jpsychires.2024.07.031] [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: 08/15/2023] [Revised: 06/28/2024] [Accepted: 07/22/2024] [Indexed: 07/30/2024]
Abstract
The putamen has been proposed to play a critical role in the development of obsessive-compulsive disorder (OCD). The primary objective of this study was to examine the resting-state regional activity and functional connectivity patterns of the putamen in individuals diagnosed with OCD. To achieve this, we employed resting-state functional magnetic resonance imaging (rs-fMRI) to collect data from a sample of 45 OCD patients and 53 healthy control participants. We aimed to use the regional amplitude of low-frequency fluctuation (ALFF) analysis to generate the ROI masks of the putamen and then conduct the whole brain functional connectivity of the putamen in individuals with OCD. Compared to controls, the OCD group demonstrated decreased ALFF in bilateral putamen. The right putamen also displayed decreased FC with the left putamen extending to the inferior frontal gyrus (IFG), bilateral precuneus extending to calcarine, the right middle occipital cortex extending to the right middle temporal cortex, and the left middle occipital gyrus. The decreased connectivity between the right putamen and the left IFG was negatively correlated with Yale-Brown Obsessive Compulsive scale (Y-BOCS) Obsession Scores. This study aimed to reveal the putamen changes in resting-state activity and connectivity in OCD patients, highlighting the significance of aberrant ALFF/FC of the putamen is a key characteristic of OCD.
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Affiliation(s)
- Jie He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xun Li
- Department of Clinical Psychology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, 421002, Hunan, China
| | - Kangning Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Huan Yang
- Department of Psychiatry and Clinical Psychology, The Seventh Affiliated Hospital, Sun Yat-sen University, China.
| | - Xiaoping Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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3
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Perera MPN, Gotsis ES, Bailey NW, Fitzgibbon BM, Fitzgerald PB. Exploring functional connectivity in large-scale brain networks in obsessive-compulsive disorder: a systematic review of EEG and fMRI studies. Cereb Cortex 2024; 34:bhae327. [PMID: 39152672 PMCID: PMC11329673 DOI: 10.1093/cercor/bhae327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/16/2024] [Accepted: 07/25/2024] [Indexed: 08/19/2024] Open
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition that is difficult to treat due to our limited understanding of its pathophysiology. Functional connectivity in brain networks, as evaluated through neuroimaging studies, plays a pivotal role in understanding OCD. While both electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) have been extensively employed in OCD research, few have fully synthesized their findings. To bridge this gap, we reviewed 166 studies (10 EEG, 156 fMRI) published up to December 2023. In EEG studies, OCD exhibited lower connectivity in delta and alpha bands, with inconsistent findings in other frequency bands. Resting-state fMRI studies reported conflicting connectivity patterns within the default mode network (DMN) and sensorimotor cortico-striato-thalamo-cortical (CSTC) circuitry. Many studies observed decreased resting-state connectivity between the DMN and salience network (SN), implicating the 'triple network model' in OCD. Task-related hyperconnectivity within the DMN-SN and hypoconnectivity between the SN and frontoparietal network suggest OCD-related cognitive inflexibility, potentially due to triple network dysfunction. In conclusion, our review highlights diverse connectivity differences in OCD, revealing complex brain network interplay that contributes to symptom manifestation. However, the presence of conflicting findings underscores the necessity for targeted research to achieve a comprehensive understanding of the pathophysiology of OCD.
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Affiliation(s)
- M Prabhavi N Perera
- College of Health and Medicine, Australian National University, Building 4, The Canberra Hospital, Hospital Rd, Garran ACT 2605, Australia
- Monarch Research Institute, Monarch Mental Health Group, Level 4, 131 York Street Sydney NSW 2000, Australia
| | - Efstathia S Gotsis
- College of Health and Medicine, Australian National University, Building 4, The Canberra Hospital, Hospital Rd, Garran ACT 2605, Australia
- Monarch Research Institute, Monarch Mental Health Group, Level 4, 131 York Street Sydney NSW 2000, Australia
| | - Neil W Bailey
- College of Health and Medicine, Australian National University, Building 4, The Canberra Hospital, Hospital Rd, Garran ACT 2605, Australia
- Monarch Research Institute, Monarch Mental Health Group, Level 4, 131 York Street Sydney NSW 2000, Australia
| | - Bernadette M Fitzgibbon
- College of Health and Medicine, Australian National University, Building 4, The Canberra Hospital, Hospital Rd, Garran ACT 2605, Australia
- Monarch Research Institute, Monarch Mental Health Group, Level 4, 131 York Street Sydney NSW 2000, Australia
| | - Paul B Fitzgerald
- College of Health and Medicine, Australian National University, Building 4, The Canberra Hospital, Hospital Rd, Garran ACT 2605, Australia
- Monarch Research Institute, Monarch Mental Health Group, Level 4, 131 York Street Sydney NSW 2000, Australia
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4
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Ghane M, Trambaiolli L, Bertocci MA, Martinez-Rivera FJ, Chase HW, Brady T, Skeba A, Graur S, Bonar L, Iyengar S, Quirk GJ, Rasmussen SA, Haber SN, Phillips ML. Specific Patterns of Endogenous Functional Connectivity Are Associated With Harm Avoidance in Obsessive-Compulsive Disorder. Biol Psychiatry 2024; 96:137-146. [PMID: 38336216 DOI: 10.1016/j.biopsych.2023.12.027] [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: 07/07/2023] [Revised: 11/11/2023] [Accepted: 12/06/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND Individuals with obsessive-compulsive disorder (OCD) show persistent avoidance behaviors, often in the absence of actual threat. Quality-of-life costs and heterogeneity support the need for novel brain-behavior intervention targets. Informed by mechanistic and anatomical studies of persistent avoidance in rodents and nonhuman primates, our goal was to test whether connections within a hypothesized persistent avoidance-related network predicted OCD-related harm avoidance (HA), a trait measure of persistent avoidance. We hypothesized that 1) HA, not an OCD diagnosis, would be associated with altered endogenous connectivity in at least one connection in the network; 2) HA-specific findings would be robust to comorbid symptoms; and 3) reliable findings would replicate in a holdout testing subsample. METHODS Using resting-state functional connectivity magnetic resonance imaging, cross-validated elastic net for feature selection, and Poisson generalized linear models, we tested which connections significantly predicted HA in our training subsample (n = 73; 71.8% female; healthy control group n = 36, OCD group n = 37); robustness to comorbidities; and replicability in a testing subsample (n = 30; 56.7% female; healthy control group n = 15, OCD group n = 15). RESULTS Stronger inverse connectivity between the right dorsal anterior cingulate cortex and right basolateral amygdala and stronger positive connectivity between the right ventral anterior insula and left ventral striatum were associated with greater HA across groups. Network connections did not discriminate OCD diagnostic status or predict HA-correlated traits, suggesting sensitivity to trait HA. The dorsal anterior cingulate cortex-basolateral amygdala relationship was robust to controlling for comorbidities and medication in individuals with OCD and was also predictive of HA in our testing subsample. CONCLUSIONS Stronger inverse dorsal anterior cingulate cortex-basolateral amygdala connectivity was robustly and reliably associated with HA across groups and in OCD. Results support the relevance of a cross-species persistent avoidance-related network to OCD, with implications for precision-based approaches and treatment.
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Affiliation(s)
- Merage Ghane
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Lucas Trambaiolli
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michele A Bertocci
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tyler Brady
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Alex Skeba
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Simona Graur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Lisa Bonar
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Satish Iyengar
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gregory J Quirk
- School of Medicine, University of Puerto Rico, San Juan, Puerto Rico
| | - Steven A Rasmussen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Suzanne N Haber
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, Massachusetts; School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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5
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Spiroiu FI, Minuzzi L, Duarte D, McCabe RE, Soreni N. Neurocognitive effects of transcranial direct current stimulation in obsessive-compulsive disorder: a systematic review. Int J Neurosci 2024:1-14. [PMID: 38913323 DOI: 10.1080/00207454.2024.2371303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 06/15/2024] [Indexed: 06/25/2024]
Abstract
Transcranial direct current stimulation (tDCS) has been used with increasing frequency as a therapeutic tool to alleviate clinical symptoms of obsessive compulsive-disorder (OCD). However, little is known about the effects of tDCS on neurocognitive functioning among OCD patients. The aim of this review was to provide a comprehensive overview of the literature examining the effects of tDCS on specific neurocognitive functions in OCD. A literature search following PRISMA guidelines was conducted on the following databases: PubMed, PsycINFO, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. The search yielded 4 results: one randomized, sham-controlled study (20 patients), one randomized, controlled, partial crossover trial (12 patients), one open-label study (5 patients), and one randomized, double-blind, sham-controlled, parallel-group trial (37 patients). A total of 51 patients received active tDCS with some diversity in electrode montages targeting the dorsolateral prefrontal cortex, the pre-supplementary motor area, or the orbitofrontal cortex. tDCS was associated with improved decision-making in study 1, enhanced attentional monitoring and response inhibition in study 2, improved executive and inhibitory control in study 3, and reduced attentional bias and improved response inhibition and working memory in study 4. Limitations of this review include its small sample, the absence of a sham group in half of the studies, and the heterogeneity in tDCS parameters. These preliminary results highlight the need for future testing in randomized, sham-controlled trials to examine whether and how tDCS induces relevant cognitive benefits in OCD.
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Affiliation(s)
- Flavia I Spiroiu
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Luciano Minuzzi
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Dante Duarte
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Randi E McCabe
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Noam Soreni
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Pediatric OCD Consultation Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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6
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Patel C, Patel R, Maturkar V, Jain NS. Central cholinergic transmission affects the compulsive-like behavior of mice in marble-burying test. Brain Res 2024; 1825:148713. [PMID: 38097126 DOI: 10.1016/j.brainres.2023.148713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/02/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
The presence of the cholinergic system in the brain areas implicated in the precipitation of obsessive-compulsive behavior (OCB) has been reported but the exact role of the central cholinergic system therein is still unexplored. Therefore, the current study assessed the effect of cholinergic analogs on central administration on the marble-burying behavior (MBB) of mice, a behavior correlated with OCB. The result reveals that the enhancement of central cholinergic transmission in mice achieved by intracerebroventricular (i.c.v.) injection of acetylcholine (0.01 µg) (Subeffective: 0.1 and 0.5 µg), cholinesterase inhibitor, neostigmine (0.1, 0.3, 0.5 µg/mouse) and neuronal nicotinic acetylcholine receptor agonist, nicotine (0.1, 2 µg/mouse) significantly attenuated the number of marbles buried by mice in MBB test without affecting basal locomotor activity. Similarly, central injection of mAChR antagonist, atropine (0.1, 0.5, 5 µg/mouse), nAChR antagonist, mecamylamine (0.1, 0.5, 3 µg/mouse) per se also reduced the MBB in mice, indicative of anti-OCB like effect of all the tested cholinergic mAChR or nAChR agonist and antagonist. Surprisingly, i.c.v. injection of acetylcholine (0.01 µg), and neostigmine (0.1 µg) failed to elicit an anti-OCB-like effect in mice pre-treated (i.c.v.) with atropine (0.1 µg), or mecamylamine (0.1 µg). Thus, the findings of the present investigationdelineate the role of central cholinergic transmission in the compulsive-like behavior of mice probably via mAChR or nAChR stimulation.
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Affiliation(s)
- Chhatrapal Patel
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India
| | - Richa Patel
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India
| | - Vaibhav Maturkar
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India
| | - Nishant Sudhir Jain
- Department of Pharmacy, Guru Ghasidas Vishwavidyalaya, Koni, Bilaspur, Chhattisgarh, India.
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7
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Bracco L, Dusi N, Moltrasio C, Brambilla P, Delvecchio G. Structural and functional brain imaging after treatment with selective-serotonin reuptake-inhibitors in obsessive-compulsive disorder: A mini review. J Affect Disord 2024; 345:141-148. [PMID: 37820957 DOI: 10.1016/j.jad.2023.10.034] [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: 05/25/2023] [Revised: 10/02/2023] [Accepted: 10/08/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a psychiatric disorder whose etiopathogenesis, according to various neuroimaging studies, seems to be linked to selective dysfunctions in regions within the cortico-striatal-thalamo-cortical circuit. Selective Serotonin Reuptake Inhibitors (SSRIs) are the first-line therapy for OCD but their neurobiological effects on the brain is only partially understood. Therefore, the aim of this review is to highlight structural and functional brain imaging modifications induced by SSRIs treatment. METHODS A literature search on PubMed, Psych-Info and Embase database was performed. Studies including patients with OCD that analyzed the effect of SSRIs through structural and functional Magnetic Resonance Imaging were selected. Seven relevant studies were considered eligible for the present review. RESULTS Overall, the results of the reviewed studies showed that SSRIs treatment seems to normalize structural, in terms of the white matter and gray matter volumes, and functional activity alterations observed in OCD patients, especially in regions within the prefrontal cortex and striatum. LIMITATIONS The poor design of the studies, the small and heterogeneous samples, differences in age, gender, illness course, comorbidities, treatment protocols and the different magnetic fields used make it difficult to generalize the results. CONCLUSIONS From the available evidence it emerged that SSRIs treatment has proven to be effective in normalizing brain structural and functional alterations observed in OCD patients. However, future neuroimaging investigations should focus on long-term effects of drugs on brain structure and function in OCD patients through longitudinal approaches in order to identify more effective treatments for these patients.
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Affiliation(s)
- L Bracco
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - N Dusi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - C Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - P Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - G Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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8
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Li R, Tang J, Wang Y, Wang Y, Yang H, Wei H. Metabolomics and transcriptomics analysis of prefrontal cortex in the Pax2 neuron-specific deletion mice. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110858. [PMID: 37660748 DOI: 10.1016/j.pnpbp.2023.110858] [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: 04/20/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/05/2023]
Abstract
Restricted and repetitive behaviors (RRBs) are one of the characteristics of various neuropsychiatric disorders with complex and diverse molecular mechanisms. Repetitive self-grooming behavior is one of the manifestations of RRBs in humans and rodents. Research on the neural mechanism of repetitive self-grooming behavior is expected to reveal the underlying logic of the occurrence of RRBs. Pax2 is an important member of the paired-box transcription factor family. It is expressed in different regions of the developing central nervous system. Our previous study showed that Pax2 heterozygous gene knockout mice (Pax2+/- KO mice) exhibit significantly increased self-grooming, which suggests that the Pax2 gene is involved in the control of self-grooming behavior, but the molecular mechanism is still unclear. In this study, we further constructed the Pax2 neuron-specific deletion mice (Nestin-Pax2 mice). Targeted metabolomics and transcriptomics techniques was used to analyze. The results showed that there is an excitatory/inhibitory imbalance of the neurotransmitter system and the Arc gene was significantly up-regulated in the prefrontal cortex (PFC) of Nestin-Pax2 mice. This study suggests that the potential regulatory mechanism of the increased repetitive self-grooming behavior in Pax2 gene deletion mice is that the deletion of the Pax2 gene affects the expression of Arc in the PFC, leading to impaired synaptic plasticity and excitatory/inhibitory imbalance, and participating in the occurrence of repetitive self-grooming behavior.
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Affiliation(s)
- Rui Li
- Department of Neurology, Shanxi Provincial People's Hospital, the Fifth Clinical Medical College of Shanxi Medical University, Taiyuan 030012, China; Shanxi Key Laboratory of Brain Disease Control, Shanxi Provincial People's Hospital, Taiyuan 030012, China
| | - Jiaming Tang
- School of the Third Clinic, Shanxi University of Chinese Medicine, Taiyuan 030024, China
| | - Yizhuo Wang
- Department of Neurology, Shanxi Provincial People's Hospital, the Fifth Clinical Medical College of Shanxi Medical University, Taiyuan 030012, China
| | - Ying Wang
- Department of Neurology, Shanxi Provincial People's Hospital, the Fifth Clinical Medical College of Shanxi Medical University, Taiyuan 030012, China
| | - Hua Yang
- Department of Neurology, Shanxi Provincial People's Hospital, the Fifth Clinical Medical College of Shanxi Medical University, Taiyuan 030012, China; Shanxi Key Laboratory of Brain Disease Control, Shanxi Provincial People's Hospital, Taiyuan 030012, China.
| | - Hongen Wei
- Department of Neurology, Shanxi Provincial People's Hospital, the Fifth Clinical Medical College of Shanxi Medical University, Taiyuan 030012, China; Shanxi Key Laboratory of Brain Disease Control, Shanxi Provincial People's Hospital, Taiyuan 030012, China.
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9
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Lee IB, Lee E, Han NE, Slavuj M, Hwang JW, Lee A, Sun T, Jeong Y, Baik JH, Park JY, Choi SY, Kwag J, Yoon BJ. Persistent enhancement of basolateral amygdala-dorsomedial striatum synapses causes compulsive-like behaviors in mice. Nat Commun 2024; 15:219. [PMID: 38191518 PMCID: PMC10774417 DOI: 10.1038/s41467-023-44322-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/08/2023] [Indexed: 01/10/2024] Open
Abstract
Compulsive behaviors are observed in a range of psychiatric disorders, however the neural substrates underlying the behaviors are not clearly defined. Here we show that the basolateral amygdala-dorsomedial striatum (BLA-DMS) circuit activation leads to the manifestation of compulsive-like behaviors. We revealed that the BLA neurons projecting to the DMS, mainly onto dopamine D1 receptor-expressing neurons, largely overlap with the neuronal population that responds to aversive predator stress, a widely used anxiogenic stressor. Specific optogenetic activation of the BLA-DMS circuit induced a strong anxiety response followed by compulsive grooming. Furthermore, we developed a mouse model for compulsivity displaying a wide spectrum of compulsive-like behaviors by chronically activating the BLA-DMS circuit. In these mice, persistent molecular changes at the BLA-DMS synapses observed were causally related to the compulsive-like phenotypes. Together, our study demonstrates the involvement of the BLA-DMS circuit in the emergence of enduring compulsive-like behaviors via its persistent synaptic changes.
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Affiliation(s)
- In Bum Lee
- Department of Life Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Eugene Lee
- Department of Brain and Cognitive Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Na-Eun Han
- Department of Life Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Marko Slavuj
- Department of Life Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Jeong Wook Hwang
- Department of Life Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Ahrim Lee
- Department of Life Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Taeyoung Sun
- Department of Life Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Yehwan Jeong
- Department of Life Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Ja-Hyun Baik
- Department of Life Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Jae-Yong Park
- School of Biosystems and Biomedical Sciences, College of Health Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Se-Young Choi
- Department of Physiology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, 03080, Republic of Korea
| | - Jeehyun Kwag
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, 08826, Republic of Korea
| | - Bong-June Yoon
- Department of Life Sciences, Korea University, Seoul, 02841, Republic of Korea.
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10
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Becker HC, Beltz AM, Himle JA, Abelson JL, Block SR, Taylor SF, Fitzgerald KD. Changes in Brain Network Connections After Exposure and Response Prevention Therapy for Obsessive-Compulsive Disorder in Adolescents and Adults. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:70-79. [PMID: 37820789 PMCID: PMC10842137 DOI: 10.1016/j.bpsc.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Functional alterations of tripartite neural networks during cognitive control (i.e., frontoparietal network [FPN], cingulo-opercular network, and default mode network) occur in patients with obsessive-compulsive disorder (OCD) and may contribute to illness expression. However, the degree to which changes in these networks are elicited by gold standard treatment (e.g., exposure and response prevention [EX/RP]) remains unknown. Understanding how EX/RP modulates network connectivity in adolescent versus adult patients with OCD may aid the identification of developmentally sensitive treatment targets that enhance cognitive control. METHODS Data from a total of 169 adolescents (13-17 years) and adults (25-40 years; 57% female) were analyzed, including healthy control participants (n = 58) and patients with OCD (n = 111) who were randomized to either EX/RP or an active control therapy (stress management training). Participants performed a flanker task during functional magnetic resonance imaging pre- and posttreatment. To retain sensitivity to individual differences in connectivity, group iterative multiple model estimation was used to assess functional connectivity (i.e., density) within and between brain networks. RESULTS Significant increases in FPN density and decreases in FPN-default mode network density were observed from pre- to posttreatment in patients who received EX/RP. The opposite patterns of change occurred in patients who received stress management training. These treatment-related changes in network density did not differ across age group. CONCLUSIONS Results suggest EX/RP-specific changes in task-based connectivity in patients with OCD. Given baseline differences between healthy control participants and patients by age group, these treatment-related changes may indicate restoration of healthy FPN and default mode network development across patients, providing targets for improving response to EX/RP.
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Affiliation(s)
- Hannah C Becker
- Department of Psychology, University of Michigan, Ann Arbor, Michigan; Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
| | - Adriene M Beltz
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - Joseph A Himle
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; School of Social Work, University of Michigan, Ann Arbor, Michigan
| | - James L Abelson
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | | | - Stephan F Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Kate D Fitzgerald
- Columbia University and New York State Psychiatric Institute, New York, New York
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11
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Becker HC, Norman LJ, Yang H, Monk CS, Phan KL, Taylor SF, Liu Y, Mannella K, Fitzgerald KD. Disorder-specific cingulo-opercular network hyperconnectivity in pediatric OCD relative to pediatric anxiety. Psychol Med 2023; 53:1468-1478. [PMID: 37010220 PMCID: PMC10009399 DOI: 10.1017/s0033291721003044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/17/2021] [Accepted: 07/13/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Prior investigation of adult patients with obsessive compulsive disorder (OCD) has found greater functional connectivity within orbitofrontal-striatal-thalamic (OST) circuitry, as well as altered connectivity within and between large-scale brain networks such as the cingulo-opercular network (CON) and default mode network (DMN), relative to controls. However, as adult OCD patients often have high rates of co-morbid anxiety and long durations of illness, little is known about the functional connectivity of these networks in relation to OCD specifically, or in young patients near illness onset. METHODS In this study, unmedicated female patients with OCD (ages 8-21 years, n = 23) were compared to age-matched female patients with anxiety disorders (n = 26), and healthy female youth (n = 44). Resting-state functional connectivity was used to determine the strength of functional connectivity within and between OST, CON, and DMN. RESULTS Functional connectivity within the CON was significantly greater in the OCD group as compared to the anxiety and healthy control groups. Additionally, the OCD group displayed greater functional connectivity between OST and CON compared to the other two groups, which did not differ significantly from each other. CONCLUSIONS Our findings indicate that previously noted network connectivity differences in pediatric patients with OCD were likely not attributable to co-morbid anxiety disorders. Moreover, these results suggest that specific patterns of hyperconnectivity within CON and between CON and OST circuitry may characterize OCD relative to non-OCD anxiety disorders in youth. This study improves understanding of network dysfunction underlying pediatric OCD as compared to pediatric anxiety.
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Affiliation(s)
- Hannah C. Becker
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Luke J. Norman
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- National Human Genome Research Institute, Bethesda, MD, USA
| | - Huan Yang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- The Second Xiangya Hospital, Central South University, Changsha, China
| | - Christopher S. Monk
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - K. Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Stephan F. Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Yanni Liu
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Kristin Mannella
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Kate D. Fitzgerald
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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12
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Masharipov R, Korotkov A, Knyazeva I, Cherednichenko D, Kireev M. Impaired Non-Selective Response Inhibition in Obsessive-Compulsive Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1171. [PMID: 36673927 PMCID: PMC9859350 DOI: 10.3390/ijerph20021171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/17/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Two prominent features of obsessive-compulsive disorder (OCD) are the inability to inhibit intrusive thoughts and behaviors and pathological doubt or intolerance of uncertainty. Previous study showed that uncertain context modeled by equiprobable presentation of excitatory (Go) and inhibitory (NoGo) stimuli requires non-selective response inhibition in healthy subjects. In other words, it requires transient global inhibition triggered not only by excitatory stimuli but also by inhibitory stimuli. Meanwhile, it is unknown whether OCD patients show abnormal brain activity of the non-selective response inhibition system. In order to test this assumption, we performed an fMRI study with an equiprobable Go/NoGo task involving fourteen patients with OCD and compared them with 34 healthy controls. Patients with OCD showed pathological slowness in the Go/NoGo task. The non-selective response inhibition system in OCD included all brain areas seen in healthy controls and, in addition, involved the right anterior cingulate cortex (ACC) and the anterior insula/frontal operculum (AIFO). Moreover, a between-group comparison revealed hypoactivation of brain regions within cingulo-opercular and cortico-striato-thalamo-cortical (CSTC) circuits in OCD. Among hypoactivated areas, the right ACC and the right dorsolateral prefrontal cortex (DLPFC) were associated with non-selective inhibition. Furthermore, regression analysis showed that OCD slowness was associated with decreased activation in cingulate regions and two brain areas related to non-selective inhibition: the right DLPFC and the right inferior parietal lobule (IPL). These results suggest that non-selective response inhibition is impaired in OCD, which could be a potential explanation for a relationship between inhibitory deficits and the other remarkable characteristic of OCD known as intolerance of uncertainty.
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Affiliation(s)
- Ruslan Masharipov
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
| | - Alexander Korotkov
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
| | - Irina Knyazeva
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
| | - Denis Cherednichenko
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
| | - Maxim Kireev
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
- Institute for Cognitive Studies, Saint Petersburg State University, Saint Petersburg 197376, Russia
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13
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Russman Block S, Norman LJ, Zhang X, Mannella KA, Yang H, Angstadt M, Abelson JL, Himle JA, Taylor SF, Fitzgerald KD. Resting-State Connectivity and Response to Psychotherapy Treatment in Adolescents and Adults With OCD: A Randomized Clinical Trial. Am J Psychiatry 2023; 180:89-99. [PMID: 36475374 PMCID: PMC10956516 DOI: 10.1176/appi.ajp.21111173] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Cortical-subcortical hyperconnectivity related to affective-behavioral integration and cortical network hypoconnectivity related to cognitive control have been demonstrated in obsessive-compulsive disorder (OCD); the study objective was to examine whether these connectivity patterns predict treatment response. METHODS Adolescents (ages 12-17) and adults (ages 24-45) were randomly assigned to 12 sessions of exposure and response prevention (ERP) or stress management therapy (SMT), an active control. Before treatment, resting-state connectivity of ventromedial prefrontal cortical (vmPFC), cingulo-opercular, frontoparietal, and subcortical regions was assessed with functional MRI. OCD severity was assessed with the Yale-Brown Obsessive Compulsive Scale before, during, and after treatment. Usable fMRI and longitudinal symptom data were obtained from 116 patients (68 female; 54 adolescents; 60 medicated). RESULTS ERP produced greater decreases in symptom scores than SMT. ERP was selectively associated with less vmPFC-subcortical (caudate and thalamus) connectivity in both age groups and primarily in unmedicated participants. Greater symptom improvement with both ERP and SMT was associated with greater cognitive-control (cingulo-opercular and frontoparietal) and subcortical (putamen) connectivity across age groups. Developmental specificity was observed across ERP and SMT treatments, such that greater improvements with ERP than SMT were associated with greater frontoparietal-subcortical (nucleus accumbens) connectivity in adolescents but greater connectivity between frontoparietal regions in adults. Comparison of response-predictive connections revealed no significant differences compared with a matched healthy control group. CONCLUSIONS The results suggest that less vmPFC-subcortical connectivity related to affect-influenced behavior may be important for ERP engagement, whereas greater cognitive-control and motor circuit connectivity may generally facilitate response to psychotherapy. Finally, neural predictors of treatment response may differ by age.
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Affiliation(s)
- Stefanie Russman Block
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
| | - Luke J Norman
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
| | - Xiaoxi Zhang
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
| | - Kristin A Mannella
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
| | - Huan Yang
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
| | - Mike Angstadt
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
| | - James L Abelson
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
| | - Joseph A Himle
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
| | - Stephan F Taylor
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
| | - Kate D Fitzgerald
- Department of Psychiatry (Russman Block, Norman, Zhang, Mannella, Angstadt, Abelson, Himle, Taylor, Fitzgerald) and School of Social Work (Himle), University of Michigan, Ann Arbor; Changzhi Medical College, Changzhi, China (Zhang); Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China (Yang); Department of Psychiatry, Columbia University, and New York State Psychiatric Institute, New York (Fitzgerald)
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14
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Bıçakcı Ay Ş, Oğuz KK, Özçelik Eroğlu E, Has AC, Ertuğrul A. A diffusion tensor imaging study in schizophrenia patients with clozapine induced obsessive compulsive symptoms. Hum Psychopharmacol 2023; 38:e2857. [PMID: 36382404 DOI: 10.1002/hup.2857] [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: 03/28/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate brain connectivity by diffusion tensor imaging (DTI) in schizophrenia patients with clozapine-induced obsessive compulsive symptoms (OCS). METHODS Eighteen schizophrenia patients, nine of which had clozapine-induced OCS (Clz-OCS (+)), 9 without OCS (Clz-OCS (-)) and 9 healthy controls were included. Psychopathology was evaluated with Positive and Negative Syndrome Scale and Yale-Brown Obsession and Compulsion Scale in the patient groups. All groups were assesed with neurocognitive tests and DTI. RESULTS Tract-Based Spatial Statistics based comparison of DTI revealed lower fractional anisotropy in the genu of corpus callosum (CC), right cingulum, left frontal white matter (WM) in the Clz-OCS (+) group, compared to controls. Fractional anisotropy was found to be lower in the bilateral occipital WM and higher in the bilateral medial temporal regions, anterior limb of internal capsule, cingulum, frontoparietal peripheral WM, right external capsule and genu of CC in Clz-OCS (+) patients compared to Clz-OCS (-). CONCLUSIONS WM integrity in several pathways such as cortico-striato-thalamo-cortical circuitry and orbito-frontal tracts seems to be affected differently in patients with Clz-OCS (+). Different neuroplastic effects of clozapine leading to occurrence of OCS in a subgroup of patients is possible, and needs further evaluation by longitudinal follow-up studies.
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Affiliation(s)
- Şule Bıçakcı Ay
- Department of Psychiatry, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Kader K Oğuz
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.,National MR Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Elçin Özçelik Eroğlu
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Arzu Ceylan Has
- National MR Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Aygün Ertuğrul
- Department of Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
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15
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Tan V, Dockstader C, Moxon-Emre I, Mendlowitz S, Schacter R, Colasanto M, Voineskos AN, Akingbade A, Nishat E, Mabbott DJ, Arnold PD, Ameis SH. Preliminary Observations of Resting-State Magnetoencephalography in Nonmedicated Children with Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol 2022; 32:522-532. [PMID: 36548364 PMCID: PMC9917323 DOI: 10.1089/cap.2022.0036] [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] [Indexed: 12/24/2022]
Abstract
Background: Cortico-striato-thalamo-cortical (CSTC) network alterations are hypothesized to contribute to symptoms of obsessive-compulsive disorder (OCD). To date, very few studies have examined whether CSTC network alterations are present in children with OCD, who are medication naive. Medication-naive pediatric imaging samples may be optimal to study neural correlates of illness and identify brain-based markers, given the proximity to illness onset. Methods: Magnetoencephalography (MEG) data were analyzed at rest, in 18 medication-naive children with OCD (M = 12.1 years ±2.0 standard deviation [SD]; 10 M/8 F) and 13 typically developing children (M = 12.3 years ±2.2 SD; 6 M/7 F). Whole-brain MEG-derived resting-state functional connectivity (rs-fc), for alpha- and gamma-band frequencies were compared between OCD and typically developing (control) groups. Results: Increased MEG-derived rs-fc across alpha- and gamma-band frequencies was found in the OCD group compared to the control group. Increased MEG-derived rs-fc at alpha-band frequencies was evident across a number of regions within the CSTC circuitry and beyond, including the cerebellum and limbic regions. Increased MEG-derived rs-fc at gamma-band frequencies was restricted to the frontal and temporal cortices. Conclusions: This MEG study provides preliminary evidence of altered alpha and gamma networks, at rest, in medication-naive children with OCD. These results support prior findings pointing to the relevance of CSTC circuitry in pediatric OCD and further support accumulating evidence of altered connectivity between regions that extend beyond this network, including the cerebellum and limbic regions. Given the substantial portion of children and youth whose OCD symptoms do not respond to conventional treatments, our findings have implications for future treatment innovation research aiming to target and track whether brain patterns associated with having OCD may change with treatment and/or predict treatment response.
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Affiliation(s)
- Vinh Tan
- Human Biology Program, Faculty of Arts and Science, University of Toronto, Toronto, Canada
- Kimel Family Translational Imaging Genetics Research Laboratory, Centre for Addiction and Mental Health, Toronto, Canada
| | - Colleen Dockstader
- Human Biology Program, Faculty of Arts and Science, University of Toronto, Toronto, Canada
| | - Iska Moxon-Emre
- Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sandra Mendlowitz
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Reva Schacter
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Marlena Colasanto
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| | - Aristotle N. Voineskos
- Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Aquila Akingbade
- Human Biology Program, Faculty of Arts and Science, University of Toronto, Toronto, Canada
| | - Eman Nishat
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, Canada
- Department of Physiology, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Donald J. Mabbott
- Department of Physiology, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Paul D. Arnold
- Department of Psychiatry, Cumming School of Medicine, The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Stephanie H. Ameis
- Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, Canada
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16
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Alexander-Bloch AF, Sood R, Shinohara RT, Moore TM, Calkins ME, Chertavian C, Wolf DH, Gur RC, Satterthwaite TD, Gur RE, Barzilay R. Connectome-wide Functional Connectivity Abnormalities in Youth With Obsessive-Compulsive Symptoms. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1068-1077. [PMID: 34375730 PMCID: PMC8821731 DOI: 10.1016/j.bpsc.2021.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/16/2021] [Accepted: 07/29/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Obsessive-compulsive symptomatology (OCS) is common in adolescence but usually does not meet the diagnostic threshold for obsessive-compulsive disorder. Nevertheless, both obsessive-compulsive disorder and subthreshold OCS are associated with increased likelihood of experiencing other serious psychiatric conditions, including depression and suicidal ideation. Unfortunately, there is limited information on the neurobiology of OCS. METHODS Here, we undertook one of the first brain imaging studies of OCS in a large adolescent sample (analyzed n = 832) from the Philadelphia Neurodevelopmental Cohort. We investigated resting-state functional magnetic resonance imaging functional connectivity using complementary analytic approaches that focus on different neuroanatomical scales, from known functional systems to connectome-wide tests. RESULTS We found a robust pattern of connectome-wide, OCS-related differences, as well as evidence of specific abnormalities involving known functional systems, including dorsal and ventral attention, frontoparietal, and default mode systems. Analysis of cerebral perfusion imaging and high-resolution structural imaging did not show OCS-related differences, consistent with domain specificity to functional connectivity. CONCLUSIONS The brain connectomic associations with OCS reported here, together with early studies of its clinical relevance, support the potential for OCS as an early marker of psychiatric risk that may enhance our understanding of mechanisms underlying the onset of adolescent psychopathology.
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Affiliation(s)
- Aaron F Alexander-Bloch
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Rahul Sood
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Russell T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Statistics in Imaging and Visualization Center, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Casey Chertavian
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Theodore D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raquel E Gur
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
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Liu J, Cao L, Li H, Gao Y, Bu X, Liang K, Bao W, Zhang S, Qiu H, Li X, Hu X, Lu L, Zhang L, Hu X, Huang X, Gong Q. Abnormal resting-state functional connectivity in patients with obsessive-compulsive disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 135:104574. [DOI: 10.1016/j.neubiorev.2022.104574] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/12/2021] [Accepted: 02/07/2022] [Indexed: 12/31/2022]
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18
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Weeland CJ, van den Heuvel OA, White T, Tiemeier H, Vriend C. Obsessive-compulsive symptoms and resting-state functional characteristics in pre-adolescent children from the general population. Brain Imaging Behav 2022; 16:2715-2724. [PMID: 36319909 PMCID: PMC9712396 DOI: 10.1007/s11682-022-00732-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/17/2022] [Accepted: 10/05/2022] [Indexed: 12/04/2022]
Abstract
While functional brain characteristics of obsessive-compulsive disorder have been extensively studied, literature on network topology and subnetwork connectivity related to obsessive-compulsive symptoms (OCS) is sparse. Here we investigated the functional brain characteristics of OCS in children from the general population using a multiscale approach. Since we previously observed OCS-related differences in thalamus morphology, we also focused on the network participation of thalamic subregions. The study included 1701 participants (9-12 years) from the population-based Generation R study. OCS were measured using the Short Obsessive-Compulsive Disorder Screener. We studied the brain network at multiple scales: global network topology, subnetwork connectivity and network participation of thalamic nodes (pre-registration: https://osf.io/azr9c ). Modularity, small-worldness and average participation coefficient were calculated on the global scale. We used a data-driven consensus community approach to extract a partition of five subnetworks involving thalamic subregions and calculate the within- and between-subnetwork functional connectivity and topology. Multiple linear regression models were fitted to model the relationship between OCS and functional brain measures. No significant associations were found when using our preregistered definition of probable OCS. However, post-hoc analyses showed that children endorsing at least one OCS (compared with controls) had higher modularity, lower connectivity between frontoparietal, limbic and visual networks as well as altered participation of the lateral prefrontal thalamus node. Our results suggest that network characteristics of OCS in children from the general population are partly symptom-specific and severity-dependent. Thorough assessment of symptom dimensions can deepen our understanding of OCS-related brain networks.
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Affiliation(s)
- Cees J Weeland
- Department of Anatomy and Neurosciences, Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, PO Box 7057, 1007 MB, De Boelelaan 1117, 1081HV, Amsterdam, Netherlands.
- Dept. Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Wytemaweg 8, 3015 GD, Rotterdam, the Netherlands.
- The Generation R Study Group, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.
| | - Odile A van den Heuvel
- Department of Anatomy and Neurosciences, Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, PO Box 7057, 1007 MB, De Boelelaan 1117, 1081HV, Amsterdam, Netherlands
| | - T White
- Dept. Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Wytemaweg 8, 3015 GD, Rotterdam, the Netherlands
| | - H Tiemeier
- Harvard TH Chan School of Public Health, 677 Huntington Ave, 02115, Boston, MA, USA
| | - C Vriend
- Department of Anatomy and Neurosciences, Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, PO Box 7057, 1007 MB, De Boelelaan 1117, 1081HV, Amsterdam, Netherlands
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19
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Rasmussen SA, Goodman WK. The prefrontal cortex and neurosurgical treatment for intractable OCD. Neuropsychopharmacology 2022; 47:349-360. [PMID: 34433915 PMCID: PMC8616947 DOI: 10.1038/s41386-021-01149-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/14/2021] [Accepted: 07/29/2021] [Indexed: 01/03/2023]
Abstract
Over the past two decades, circuit-based neurosurgical procedures have gained increasing acceptance as a safe and efficacious approach to the treatment of the intractable obsessive-compulsive disorder (OCD). Lesions and deep brain stimulation (DBS) of the longitudinal corticofugal white matter tracts connecting the prefrontal cortex with the striatum, thalamus, subthalamic nucleus (STN), and brainstem implicate orbitofrontal, medial prefrontal, frontopolar, and ventrolateral cortical networks in the symptoms underlying OCD. The highly parallel distributed nature of these networks may explain the relative lack of adverse effects observed following surgery. Additional pre-post studies of cognitive tasks in more surgical patients are needed to confirm the role of these networks in OCD and to define therapeutic responses to surgical intervention.
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Affiliation(s)
- Steven A. Rasmussen
- grid.40263.330000 0004 1936 9094Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI USA ,grid.40263.330000 0004 1936 9094Carney Brain Science Institute, Brown University, Providence, RI USA
| | - Wayne K. Goodman
- grid.39382.330000 0001 2160 926XMenninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX USA
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20
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Gilbert KE, Wheelock MD, Kandala S, Eggebrecht AT, Luby JL, Barch DM. Associations of observed preschool performance monitoring with brain functional connectivity in adolescence. Cortex 2021; 142:15-27. [PMID: 34174721 PMCID: PMC8405590 DOI: 10.1016/j.cortex.2021.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/12/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
Monitoring one's performance helps detect errors and adapt to prevent future mistakes. However, elevated performance monitoring is associated with increased checking behaviors and perfectionism and is characteristic of multiple psychiatric disorders. Understanding how heightened performance monitoring in early childhood relates to subsequent brain connectivity may elucidate mechanistic risk factors that influence brain and psychiatric outcomes. The aim of this study was to examine the association between performance monitoring in preschool-aged children and functional connectivity during adolescence. In the current prospective longitudinal study, we performed seed-based functional connectivity analysis using a dorsal anterior cingulate cortex (dACC) seed to assess brain-behavior relationships between observationally coded performance monitoring in preschool-aged children and adolescent functional connectivity (n = 79). We also utilized enrichment analysis to investigate network-level connectome-wide associations. Seed-based analysis revealed negative correlations between preschool performance monitoring and adolescent fc between dACC and orbitofrontal and dorsolateral prefrontal cortex while a positive correlation was observed between dACC-occipital cortex connectivity. Enrichment analysis revealed a negative correlation between preschool performance monitoring and connectivity between motor (MOT) - cingulo-opercular (CO) and salience (SN) - Reward (REW) and a positive correlation with MOT-DMN, and cerebellum (CB) - motor connectivity. Elevated performance monitoring in early childhood is associated with functional connectivity during adolescence in regions and networks associated with cognitive control, sensorimotor processing and cortico-striatal-thalamic-cortico (CTSC) aberrations. These regions and networks are implicated in psychiatric disorders characterized by elevated performance monitoring. Findings shed light on a mechanistic risk factor in early childhood with long-term associations with neural functioning.
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Affiliation(s)
- Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Muriah D Wheelock
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sridhar Kandala
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
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21
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Duan LY, Horst NK, Cranmore SAW, Horiguchi N, Cardinal RN, Roberts AC, Robbins TW. Controlling one's world: Identification of sub-regions of primate PFC underlying goal-directed behavior. Neuron 2021; 109:2485-2498.e5. [PMID: 34171290 PMCID: PMC8346232 DOI: 10.1016/j.neuron.2021.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 04/13/2021] [Accepted: 06/02/2021] [Indexed: 12/30/2022]
Abstract
Impaired detection of causal relationships between actions and their outcomes can lead to maladaptive behavior. However, causal roles of specific prefrontal cortex (PFC) sub-regions and the caudate nucleus in mediating such relationships in primates are unclear. We inactivated and overactivated five PFC sub-regions, reversibly and pharmacologically: areas 24 (perigenual anterior cingulate cortex), 32 (medial PFC), 11 (anterior orbitofrontal cortex, OFC), 14 (rostral ventromedial PFC/medial OFC), and 14-25 (caudal ventromedial PFC) and the anteromedial caudate to examine their role in expressing learned action-outcome contingencies using a contingency degradation paradigm in marmoset monkeys. Area 24 or caudate inactivation impaired the response to contingency change, while area 11 inactivation enhanced it, and inactivation of areas 14, 32, or 14-25 had no effect. Overactivation of areas 11 and 24 impaired this response. These findings demonstrate the distinct roles of PFC sub-regions in goal-directed behavior and illuminate the candidate neurobehavioral substrates of psychiatric disorders, including obsessive-compulsive disorder. Monkey pgACC-24 is necessary for detecting causal control of actions over outcomes Its projection target in the caudate nucleus is also implicated Three other subregions of the ventromedial prefrontal cortex are not necessary Anterior OFC-11 may mediate Pavlovian influences on goal-directed behavior
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Affiliation(s)
- Lisa Y Duan
- Department of Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK; Behavioural and Clinical Neuroscience Institute, Downing Street, University of Cambridge, Cambridge CB2 3EB, UK.
| | - Nicole K Horst
- Department of Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK; Behavioural and Clinical Neuroscience Institute, Downing Street, University of Cambridge, Cambridge CB2 3EB, UK
| | - Stacey A W Cranmore
- Department of Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK; Behavioural and Clinical Neuroscience Institute, Downing Street, University of Cambridge, Cambridge CB2 3EB, UK
| | - Naotaka Horiguchi
- Department of Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK; Behavioural and Clinical Neuroscience Institute, Downing Street, University of Cambridge, Cambridge CB2 3EB, UK
| | - Rudolf N Cardinal
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK; Behavioural and Clinical Neuroscience Institute, Downing Street, University of Cambridge, Cambridge CB2 3EB, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Liaison Psychiatry Service, Box 190, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK
| | - Angela C Roberts
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge CB2 3DY, UK; Behavioural and Clinical Neuroscience Institute, Downing Street, University of Cambridge, Cambridge CB2 3EB, UK
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Downing Street, Cambridge CB2 3EB, UK; Behavioural and Clinical Neuroscience Institute, Downing Street, University of Cambridge, Cambridge CB2 3EB, UK
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22
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Geller DA, Homayoun S, Johnson G. Developmental Considerations in Obsessive Compulsive Disorder: Comparing Pediatric and Adult-Onset Cases. Front Psychiatry 2021; 12:678538. [PMID: 34248714 PMCID: PMC8269156 DOI: 10.3389/fpsyt.2021.678538] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/17/2021] [Indexed: 12/12/2022] Open
Abstract
There appear to be two peaks of incidence of Obsessive Compulsive Disorder (OCD), one with a pre-adolescent onset and another in early adulthood. As new cases are added, the cumulative prevalence of OCD increases, but the great majority of cases have an onset in youth. The notion that early onset OCD represents a unique developmental subtype of the disorder has been considered by many researchers based on several specific age-related factors. Ascertainment and early intervention in affected youth is critical to abbreviate the functional impairments associated with untreated illness. In this paper we review the clinical, familial and translational biomarker correlates seen in early onset OCD that support the notion of a developmental subtype and discuss implications for research and treatment aimed at this cohort. The importance of cognitive, academic and social development tasks of childhood and adolescence, illness-specific and familial factors, and immune-mediated inflammatory factors are discussed, with their implications for management.
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Affiliation(s)
- Daniel A. Geller
- Pediatric OCD and Tic Disorder Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Saffron Homayoun
- Harvard Medical School, Boston, MA, United States
- Psychiatry and Neuroimmunology Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Gabrielle Johnson
- Pediatric OCD and Tic Disorder Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
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23
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Specialty knowledge and competency standards for pharmacotherapy for pediatric obsessive-compulsive disorder. Psychiatry Res 2021; 299:113858. [PMID: 33770712 DOI: 10.1016/j.psychres.2021.113858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/06/2021] [Indexed: 12/28/2022]
Abstract
Evidence based treatments for pediatric Obsessive-Compulsive Disorder (OCD) are delivered with varying levels of expertise. This paper is part of the phase two series by the International OCD Accreditation Task Force (ATF) to advance a standardized high level of care globally. This paper presents specific knowledge and competencies recommended for specialized practice for pediatric psychopharmacologists working with OCD, developed by an international group of clinicians with extensive expertise in assessment and treatment of OCD. Tabulated knowledge and competency standards are operationalized as clinician abilities with specification of evidence for each standard. The distinction between current practice guidelines and ATF standards is discussed. Drug treatment has a solid evidence base. However, it should not be applied isolated, but informed by broad competence in general child and adolescent psychiatry and pediatrics. Other treatment relevant areas such as specialty CBT, family functioning, developmental issues, and neurobiology require consideration. Drug treatment includes several phases with varying degrees of evidence: Starting up medication, titration to maximum tolerated dose, maintenance, termination, and relapse prevention. In complex cases, pharmacotherapy with weak evidence may be needed to target symptoms and/or co-morbidity. The ATF knowledge and competency standards presented will be reviewed and updated commensurate with research.
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24
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Vanes LD, Dolan RJ. Transdiagnostic neuroimaging markers of psychiatric risk: A narrative review. NEUROIMAGE-CLINICAL 2021; 30:102634. [PMID: 33780864 PMCID: PMC8022867 DOI: 10.1016/j.nicl.2021.102634] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/03/2021] [Accepted: 03/12/2021] [Indexed: 02/07/2023]
Abstract
We review the literature on neural correlates of a general psychopathology factor General psychopathology relates to structural and functional neurodevelopment Disrupted network connectivity maturation may underlie psychiatric vulnerability
Several decades of neuroimaging research in psychiatry have shed light on structural and functional neural abnormalities associated with individual psychiatric disorders. However, there is increasing evidence for substantial overlap in the patterns of neural dysfunction seen across disorders, suggesting that risk for psychiatric illness may be shared across diagnostic boundaries. Gaining insights on the existence of shared neural mechanisms which may transdiagnostically underlie psychopathology is important for psychiatric research in order to tease apart the unique and common aspects of different disorders, but also clinically, so as to help identify individuals early on who may be biologically vulnerable to psychiatric disorder in general. In this narrative review, we first evaluate recent studies investigating the functional and structural neural correlates of a general psychopathology factor, which is thought to reflect the shared variance across common mental health symptoms and therefore index psychiatric vulnerability. We then link insights from this research to existing meta-analytic evidence for shared patterns of neural dysfunction across categorical psychiatric disorders. We conclude by providing an integrative account of vulnerability to mental illness, whereby delayed or disrupted maturation of large-scale networks (particularly default-mode, executive, and sensorimotor networks), and more generally between-network connectivity, results in a compromised ability to integrate and switch between internally and externally focused tasks.
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Affiliation(s)
- Lucy D Vanes
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, United Kingdom.
| | - Raymond J Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom
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25
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Piantadosi SC, Chamberlain BL, Glausier JR, Lewis DA, Ahmari SE. Lower excitatory synaptic gene expression in orbitofrontal cortex and striatum in an initial study of subjects with obsessive compulsive disorder. Mol Psychiatry 2021; 26:986-998. [PMID: 31168067 DOI: 10.1038/s41380-019-0431-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/04/2019] [Accepted: 04/03/2019] [Indexed: 12/19/2022]
Abstract
Obsessive compulsive disorder (OCD) is a severe illness that affects 2-3% of people worldwide. OCD neuroimaging studies have consistently shown abnormal activity in brain regions involved in decision-making (orbitofrontal cortex [OFC]) and action selection (striatum). However, little is known regarding molecular changes that may contribute to abnormal function. We therefore examined expression of synaptic genes in post-mortem human brain samples of these regions from eight pairs of unaffected comparison and OCD subjects. Total grey matter tissue samples were obtained from medial OFC (BA11), lateral OFC (BA47), head of caudate, and nucleus accumbens (NAc). Quantitative polymerase chain reaction (qPCR) was then performed on a panel of transcripts encoding proteins related to excitatory synaptic structure, excitatory synaptic receptors/transporters, and GABA synapses. Relative to unaffected comparison subjects, OCD subjects had significantly lower levels of several transcripts related to excitatory signaling in both cortical and striatal regions. However, a majority of transcripts encoding excitatory synaptic proteins were lower in OFC but not significantly different in striatum of OCD subjects. Composite transcript level measures supported these findings by revealing that reductions in transcripts encoding excitatory synaptic structure proteins and excitatory synaptic receptors/transporters occurred primarily in OFC of OCD subjects. In contrast, transcripts associated with inhibitory synaptic neurotransmission showed minor differences between groups. The observed lower levels of multiple glutamatergic transcripts across both medial and lateral OFC may suggest an upstream causal event. Together, these data provide the first evidence of molecular abnormalities in brain regions consistently implicated in OCD human imaging studies.
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Affiliation(s)
- Sean C Piantadosi
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Jill R Glausier
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - David A Lewis
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Susanne E Ahmari
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA. .,Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
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26
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Nishat E, Dockstader C, Wheeler AL, Tan T, Anderson JAE, Mendlowitz S, Mabbott DJ, Arnold PD, Ameis SH. Visuomotor Activation of Inhibition-Processing in Pediatric Obsessive Compulsive Disorder: A Magnetoencephalography Study. Front Psychiatry 2021; 12:632736. [PMID: 33995145 PMCID: PMC8116532 DOI: 10.3389/fpsyt.2021.632736] [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: 11/23/2020] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Response inhibition engages the cortico-striato-thalamo-cortical (CSTC) circuit, which has been implicated in children, and youth with obsessive compulsive disorder (OCD). This study explored whether CSTC engagement during response inhibition, measured using magnetoencephalography (MEG), differed in a sample of medication-naïve youth with OCD, compared to typically developing controls (TDC). Methods: Data was analyzed in 17 medication-naïve children and youth with OCD (11.7 ± 2.2 SD years) and 13 TDC (12.6 ± 2.2 SD years). MEG was used to localize and characterize neural activity during a Go/No-Go task. Task performance on Go/No-Go conditions and regional differences in amplitude of activity during Go and No-Go condition between OCD vs. TDC were examined using two-sample t-tests. Post-hoc analysis with Bayesian t-tests was used to estimate the certainty of outcomes. Results: No differences in Go/No-Go performance were found between OCD and TDC groups. In response to the visual cue presented during the Go condition, participants with OCD showed significantly increased amplitude of activity in the primary motor (MI) cortex compared to TDC. In addition, significantly reduced amplitude of PCu was found following successful stopping to No-Go cues in OCD vs. TDC during No-Go task performance. Bayesian t-tests indicated high probability and large effect sizes for the differences in MI and PCu amplitude found between groups. Conclusion: Our preliminary study in a small medication-naïve sample extends previous work indicating intact response inhibition in pediatric OCD. While altered neural response in the current study was found during response inhibition performance in OCD, differences localized to regions outside of the CSTC. Our findings suggest that additional imaging research in medication-naïve samples is needed to clarify regional differences associated with OCD vs. influenced by medication effects, and suggest that MEG may be sensitive to detecting such differences.
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Affiliation(s)
- Eman Nishat
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Colleen Dockstader
- Department of Human Biology, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Anne L Wheeler
- Department of Physiology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Thomas Tan
- Kimel Family Translational Imaging Genetics Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - John A E Anderson
- Kimel Family Translational Imaging Genetics Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sandra Mendlowitz
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Donald J Mabbott
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Stephanie H Ameis
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
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27
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Abstract
Obsessive-compulsive disorder (OCD) is a common, chronic, and oftentimes disabling disorder. The only established first-line treatments for OCD are exposure and response prevention, and serotonin reuptake inhibitor medications (SRIs). However, a subset of patients fails to respond to either modality, and few experience complete remission. Beyond SRI monotherapy, antipsychotic augmentation is the only medication approach for OCD with substantial empirical support. Our incomplete understanding of the neurobiology of OCD has hampered efforts to develop new treatments or enhance extant interventions. This review focuses on several promising areas of research that may help elucidate the pathophysiology of OCD and advance treatment. Multiple studies support a significant genetic contribution to OCD, but pinpointing the specific genetic determinants requires additional investigation. The preferential efficacy of SRIs in OCD has neither led to discovery of serotonergic abnormalities in OCD nor to development of new serotonergic medications for OCD. Several lines of preclinical and clinical evidence suggest dysfunction of the glutamatergic system in OCD, prompting testing of several promising glutamate modulating agents. Functional imaging studies in OCD show consistent evidence for increased activity in brain regions that form a cortico-striato-thalamo-cortical (CSTC) loop. Neuromodulation treatments with either noninvasive devices (e.g., transcranial magnetic stimulation) or invasive procedures (e.g., deep brain stimulation) provide further support for the CSTC model of OCD. A common substrate for various interventions (whether drug, behavioral, or device) may be modulation (at different nodes or connections) of the CSTC circuit that mediates the symptoms of OCD.
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Affiliation(s)
- Wayne K. Goodman
- Menninger Department of Psychiatry and Behavioral Sciences (all authors) and Department of Neurosurgery (Sheth), Baylor College of Medicine, Houston
| | - Eric A. Storch
- Menninger Department of Psychiatry and Behavioral Sciences (all authors) and Department of Neurosurgery (Sheth), Baylor College of Medicine, Houston
| | - Sameer A. Sheth
- Menninger Department of Psychiatry and Behavioral Sciences (all authors) and Department of Neurosurgery (Sheth), Baylor College of Medicine, Houston
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28
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Resting-state functional connectivity in drug-naive pediatric patients with Tourette syndrome and obsessive-compulsive disorder. J Psychiatr Res 2020; 129:129-140. [PMID: 32912593 DOI: 10.1016/j.jpsychires.2020.06.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/11/2020] [Accepted: 06/24/2020] [Indexed: 12/16/2022]
Abstract
Previous studies in cohorts of Tourette syndrome (TS) or obsessive-compulsive disorder (OCD) patients have not clarified whether these two disorders represent two clinical conditions or they are distinct clinical phenotypes of a common disease spectrum. The study aimed to compare functional connectivity (FC) patterns in a pediatric drug-naive cohort of 16 TS patients without any comorbidity (TS), 14 TS patients with OCD (TS + OCD), and 10 pure OCD patients as well as 11 matched controls that underwent resting state fMRI. Via independent component analysis, we examined FC in the basal ganglia (BGN), sensorimotor (SMN), cerebellum (CBN), frontoparietal (FPN), default-mode (DMN), orbitofrontal (OBFN), and salience (SAN) networks among the above cohorts and their association with clinical measures. Compared to controls, TS and TS + OCD patients showed higher FC in the BGN, SMN, CBN and DMN and lower FC in the FPN and SAN. The TS and TS + OCD groups showed comparable FC in all networks. In contrast to controls, OCD patients exhibited increased FC in the BGN, SMN, CBN, DMN, FPN, and SAN. OCD patients also showed higher FC in CBN and FPN when compared with TS and TS + OCD patients both separately and as one group. Tic severity negatively correlated with FC in CBN and FPN in the TS group, while the compulsiveness scores positively correlated with the same two networks in OCD patients. Our findings suggest common FC changes in TS and TS + OCD patients. In contrast, OCD is characterized by a distinctive pattern of FC changes prominently involving the CBN and FPN.
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29
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Loosen AM, Hauser TU. Towards a computational psychiatry of juvenile obsessive-compulsive disorder. Neurosci Biobehav Rev 2020; 118:631-642. [PMID: 32942176 DOI: 10.1016/j.neubiorev.2020.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/14/2020] [Accepted: 07/18/2020] [Indexed: 01/22/2023]
Abstract
Obsessive-Compulsive Disorder (OCD) most often emerges during adolescence, but we know little about the aberrant neural and cognitive developmental mechanisms that underlie its emergence during this critical developmental period. To move towards a computational psychiatry of juvenile OCD, we review studies on the computational, neuropsychological and neural alterations in juvenile OCD and link these findings to the adult OCD and cognitive neuroscience literature. We find consistent difficulties in tasks entailing complex decision making and set shifting, but limited evidence in other areas that are altered in adult OCD, such as habit and confidence formation. Based on these findings, we establish a neurocomputational framework that illustrates how cognition can go awry and lead to symptoms of juvenile OCD. We link these possible aberrant neural processes to neuroimaging findings in juvenile OCD and show that juvenile OCD is mainly characterised by disruptions of complex reasoning systems.
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Affiliation(s)
- Alisa M Loosen
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, United Kingdom.
| | - Tobias U Hauser
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, United Kingdom.
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30
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Sha Z, Versace A, Edmiston EK, Fournier J, Graur S, Greenberg T, Santos JPL, Chase HW, Stiffler RS, Bonar L, Hudak R, Yendiki A, Greenberg BD, Rasmussen S, Liu H, Quirk G, Haber S, Phillips ML. Functional disruption in prefrontal-striatal network in obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2020; 300:111081. [PMID: 32344156 PMCID: PMC7266720 DOI: 10.1016/j.pscychresns.2020.111081] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 01/09/2023]
Abstract
Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive, compulsive behaviors. While a cortico-striatal-limbic network has been implicated in the pathophysiology of OCD, the neural correlates of this network in OCD are not well understood. In this study, we examined resting state functional connectivity among regions within the cortico-striatal-limbic OCD neural network, including the rostral anterior cingulate cortex, dorsolateral prefrontal cortex, ventrolateral prefrontal cortex, orbitofrontal cortex, ventromedial prefrontal cortex, amygdala, thalamus and caudate, in 44 OCD and 43 healthy participants. We then examined relationships between OCD neural network connectivity and OCD symptom severity in OCD participants. OCD relative to healthy participants showed significantly greater connectivity between the left caudate and bilateral dorsolateral prefrontal cortex. We also found a positive correlation between left caudate-bilateral dorsolateral prefrontal cortex connectivity and depression scores in OCD participants, such that greater positive connectivity was associated with more severe symptoms. This study makes a significant contribution to our understanding of functional networks and their relationship with depression in OCD.
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Affiliation(s)
- Zhiqiang Sha
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Amelia Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - E Kale Edmiston
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jay Fournier
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Simona Graur
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tsafrir Greenberg
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - João Paulo Lima Santos
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Henry W Chase
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Richelle S Stiffler
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lisa Bonar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert Hudak
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anastasia Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, RI, USA
| | - Steven Rasmussen
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, RI, USA
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gregory Quirk
- Departments of Psychiatry and Anatomy & Neurobiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, USA
| | - Suzanne Haber
- Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, New York 14642, USA
| | - Mary L Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA
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Abstract
Olfactory reference syndrome (ORS) describes a constellation of emotional and behavioral symptoms that cause clinically significant distress or impairment arising from the false belief that one is emitting an offensive odor. Despite cases of ORS reported throughout the world over the last century, our knowledge and understanding of ORS remain relatively poor because of the limited literature-mostly case studies and series, but no clinical trials. ORS continues to pose significant diagnostic challenges within our current frameworks of categorizing mental disorders, including the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases. We review the ORS literature and discuss diagnostic parallels and challenges of placing ORS within specific categories. We also review the current research on the neurocircuitry of olfaction and of disorders with potential clinical relevance to patients presenting with ORS. While no primary neuroscientific research has specifically investigated ORS, an overlapping circuitry has been implicated in the neurobiology of obsessive-compulsive, trauma and stressor, and psychotic spectrum disorders, suggesting that the phenomenology of ORS can best be understood through a dimensional, rather than categorical, approach.
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Gürsel DA, Reinholz L, Bremer B, Schmitz-Koep B, Franzmeier N, Avram M, Koch K. Frontoparietal and salience network alterations in obsessive–compulsive disorder: insights from independent component and sliding time window analyses. J Psychiatry Neurosci 2020; 45:214-221. [PMID: 32167267 PMCID: PMC7828976 DOI: 10.1503/jpn.190038] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Resting-state functional MRI (fMRI) studies commonly report alterations in 3 core networks in obsessive–compulsive disorder (OCD) — the frontoparietal network, the default mode network and the salience network — defined by functionally connected infraslow oscillations in ongoing brain activity. However, most of these studies observed static functional connectivity in the brains of patients with OCD. METHODS To investigate dynamic functional connectivity alterations and widen the evidence base toward the triple network model in OCD, we performed group-based independent component and sliding time window analyses in 49 patients with OCD and 41 healthy controls. RESULTS The traditional independent component analysis showed alterations in the left frontoparietal network as well as between the left and right frontoparietal networks in patients with OCD compared with healthy controls. For dynamic functional connectivity, the sliding time window approach revealed peak dysconnectivity between the left and right frontoparietal networks and between the left frontoparietal network and the salience network. LIMITATIONS The number of independent components, noise in the resting-state fMRI images, the heterogeneity of the OCD sample, and comorbidities and medication status in the patients could have biased the results. CONCLUSION Disrupted modulation of these intrinsic brain networks may contribute to the pathophysiology of OCD.
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Affiliation(s)
- Deniz A. Gürsel
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Lena Reinholz
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Benno Bremer
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Benita Schmitz-Koep
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Nicolai Franzmeier
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Mihai Avram
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Kathrin Koch
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
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Sha Z, Edmiston EK, Versace A, Fournier JC, Graur S, Greenberg T, Lima Santos JP, Chase HW, Stiffler RS, Bonar L, Hudak R, Yendiki A, Greenberg BD, Rasmussen S, Liu H, Quirk G, Haber S, Phillips ML. Functional Disruption of Cerebello-thalamo-cortical Networks in Obsessive-Compulsive Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:438-447. [PMID: 32033923 PMCID: PMC7150632 DOI: 10.1016/j.bpsc.2019.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/28/2019] [Accepted: 12/03/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive, compulsive behaviors. Neuroimaging studies have implicated altered connectivity among the functional networks of the cerebral cortex in the pathophysiology of OCD. However, there has been no comprehensive investigation of the cross-talk between the cerebellum and functional networks in the cerebral cortex. METHODS This functional neuroimaging study was completed by 44 adult participants with OCD and 43 healthy control participants. We performed large-scale data-driven brain network analysis to identify functional connectivity patterns using resting-state functional magnetic resonance imaging data. RESULTS Participants with OCD showed lower functional connectivity within the somatomotor network and greater functional connectivity among the somatomotor network, cerebellum, and subcortical network (e.g., thalamus and pallidum; all p < .005). Network-based statistics analyses demonstrated one component comprising connectivity within the somatomotor network that showed lower connectivity and a second component comprising connectivity among the somatomotor network, and motor regions in particular, and the cerebellum that showed greater connectivity in participants with OCD relative to healthy control participants. In participants with OCD, abnormal connectivity across both network-based statistics-derived components positively correlated with OCD symptom severity (p = .006). CONCLUSIONS To our knowledge, this study is the first comprehensive investigation of large-scale network alteration across the cerebral cortex, subcortical regions, and cerebellum in OCD. Our findings highlight a critical role of the cerebellum in the pathophysiology of OCD.
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Affiliation(s)
- Zhiqiang Sha
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - E Kale Edmiston
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Amelia Versace
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jay C Fournier
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Simona Graur
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tsafrir Greenberg
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - João Paulo Lima Santos
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Henry W Chase
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Richelle S Stiffler
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lisa Bonar
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Robert Hudak
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anastasia Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Steven Rasmussen
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gregory Quirk
- Department of Psychiatry, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico; Department of Anatomy & Neurobiology, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico
| | - Suzanne Haber
- Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, New York
| | - Mary L Phillips
- Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania
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The functional connectivity profile of tics and obsessive-compulsive symptoms in Tourette Syndrome. J Psychiatr Res 2020; 123:128-135. [PMID: 32065948 DOI: 10.1016/j.jpsychires.2020.01.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/24/2020] [Accepted: 01/29/2020] [Indexed: 11/24/2022]
Abstract
Tourette Syndrome (TS) is characterized by the presence of tics and sensory phenomena, such as premonitory urges, and is often accompanied by significant obsessive-compulsive symptoms (OCS). The goal of this exploratory study was to determine the association between functional connectivity and the different symptom domains of TS, as little is currently known about how they differ. Resting-state functional magnetic resonance imaging was performed in 39 patients with TS and 20 matched healthy controls. Seed-based functional connectivity of the supplementary motor area (SMA), orbitofrontal cortex (OFC), insula, caudate and putamen were compared between the groups, and correlated with clinical measures within the patient group. When compared to controls, patients with TS exhibited greater connectivity between the temporal gyri, insula and putamen, and between the OFC and cingulate cortex. Tic severity was associated with greater connectivity between the putamen and the sensorimotor cortex; OCS severity was associated with less connectivity between the SMA and thalamus and between the caudate and precuneus; and premonitory urge severity was associated with less connectivity between the OFC and sensorimotor cortex and between the inferior frontal gyrus and the putamen and insula seeds. Functional connectivity within sensorimotor processing regions were associated with all of the investigated symptom domains, including OCS, suggesting dysfunctions in the sensorimotor system may explain most of the observed symptoms in TS, and not just tics.
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Straathof M, Blezer ELA, van Heijningen C, Smeele CE, van der Toorn A, Buitelaar JK, Glennon JC, Otte WM, Dijkhuizen RM. Structural and functional MRI of altered brain development in a novel adolescent rat model of quinpirole-induced compulsive checking behavior. Eur Neuropsychopharmacol 2020; 33:58-70. [PMID: 32151497 DOI: 10.1016/j.euroneuro.2020.02.004] [Citation(s) in RCA: 4] [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: 08/19/2019] [Revised: 02/07/2020] [Accepted: 02/17/2020] [Indexed: 01/31/2023]
Abstract
Obsessive-compulsive disorder (OCD) is increasingly considered to be a neurodevelopmental disorder. However, despite insights in neural substrates of OCD in adults, less is known about mechanisms underlying compulsivity during brain development in children and adolescents. Therefore, we developed an adolescent rat model of compulsive checking behavior and investigated developmental changes in structural and functional measures in the frontostriatal circuitry. Five-weeks old Sprague Dawley rats were subcutaneously injected with quinpirole (n = 21) or saline (n = 20) twice a week for five weeks. Each injection was followed by placement in the middle of an open field table, and compulsive behavior was quantified as repeated checking behavior. Anatomical, resting-state functional and diffusion MRI at 4.7T were conducted before the first and after the last quinpirole/saline injection to measure regional volumes, functional connectivity and structural integrity in the brain, respectively. After consecutive quinpirole injections, adolescent rats demonstrated clear checking behavior and repeated travelling between two open-field zones. MRI measurements revealed an increase of regional volumes within the frontostriatal circuits and an increase in fractional anisotropy (FA) in white matter areas during maturation in both experimental groups. Quinpirole-injected rats showed a larger developmental increase in FA values in the internal capsule and forceps minor compared to control rats. Our study points toward a link between development of compulsive behavior and altered white matter maturation in quinpirole-injected adolescent rats, in line with observations in pediatric patients with compulsive phenotypes. This novel animal model provides opportunities to investigate novel treatments and underlying mechanisms for patients with early-onset OCD specifically.
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Affiliation(s)
- Milou Straathof
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.
| | - Erwin L A Blezer
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Caroline van Heijningen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Christel E Smeele
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Annette van der Toorn
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Center, Nijmegen, the Netherlands
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Willem M Otte
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands; Department of Pediatric Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
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van der Straten A, van Leeuwen W, Denys D, van Marle H, van Wingen G. The effect of distress on the balance between goal-directed and habit networks in obsessive-compulsive disorder. Transl Psychiatry 2020; 10:73. [PMID: 32094333 PMCID: PMC7039895 DOI: 10.1038/s41398-020-0744-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 01/08/2020] [Indexed: 11/09/2022] Open
Abstract
The classical cognitive-behavioral theory of obsessive-compulsive disorder (OCD) holds that compulsions are performed to reduce distress that is evoked by obsessions, whereas a recent neuroscience-inspired theory suggests that compulsivity results from a disbalance between goal-directed and habit-related neural networks. To bridge these theories, we investigated whether the balance between goal-directed and habit networks in patients with OCD was affected during psychological distress. Twenty-three OCD patients and twenty-three healthy controls participated in a controlled stress induction paradigm using the socially evaluated cold-pressor test in a crossover design. Stress responses were evaluated through cortisol levels, blood pressure, and anxiety ratings. Functional connectivity of the caudate nucleus and posterior putamen was assessed using seed region analysis of resting-state functional magnetic resonance imaging data, which are hubs of the goal-directed and habit network, respectively. Stress induction increased blood pressure and psychological stress measures across groups and resulted in blunted cortisol responses in patients. Furthermore, patients showed a blunted reduction in connectivity between the caudate nucleus and precuneus during psychological distress, which was positively correlated with compulsivity but not obsession severity. The posterior putamen showed no significant group differences in distress-induced connectivity. These results suggest that compulsivity in OCD is associated with altered connectivity between the goal-directed and default mode networks during psychological distress.
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Affiliation(s)
- Anouk van der Straten
- Amsterdam UMC, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Netherlands. .,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands. .,Spinoza Centre for Neuroimaging, Royal Netherlands Academy for Arts and Sciences, Amsterdam, Netherlands.
| | - Wieke van Leeuwen
- grid.7177.60000000084992262Amsterdam UMC, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Netherlands ,grid.7177.60000000084992262Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands ,grid.418101.d0000 0001 2153 6865Spinoza Centre for Neuroimaging, Royal Netherlands Academy for Arts and Sciences, Amsterdam, Netherlands
| | - Damiaan Denys
- grid.7177.60000000084992262Amsterdam UMC, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Netherlands ,grid.7177.60000000084992262Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands ,grid.418101.d0000 0001 2153 6865Spinoza Centre for Neuroimaging, Royal Netherlands Academy for Arts and Sciences, Amsterdam, Netherlands
| | - Hein van Marle
- grid.7177.60000000084992262Amsterdam UMC, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Guido van Wingen
- grid.7177.60000000084992262Amsterdam UMC, Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, Netherlands ,grid.7177.60000000084992262Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands ,grid.418101.d0000 0001 2153 6865Spinoza Centre for Neuroimaging, Royal Netherlands Academy for Arts and Sciences, Amsterdam, Netherlands
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Sen B, Bernstein GA, Mueller BA, Cullen KR, Parhi KK. Sub-graph entropy based network approaches for classifying adolescent obsessive-compulsive disorder from resting-state functional MRI. Neuroimage Clin 2020; 26:102208. [PMID: 32065968 PMCID: PMC7025090 DOI: 10.1016/j.nicl.2020.102208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 01/17/2020] [Accepted: 02/04/2020] [Indexed: 11/16/2022]
Abstract
This paper presents a novel approach for classifying obsessive-compulsive disorder (OCD) in adolescents from resting-state fMRI data. Currently, the state-of-the-art for diagnosing OCD in youth involves interviews with adolescent patients and their parents by an experienced clinician, symptom rating scales based on Diagnostic and Statistical Manual of Mental Disorders (DSM), and behavioral observation. Discovering signal processing and network-based biomarkers from functional magnetic resonance imaging (fMRI) scans of patients has the potential to assist clinicians in their diagnostic assessments of adolescents suffering from OCD. This paper investigates the clinical diagnostic utility of a set of univariate, bivariate and multivariate features extracted from resting-state fMRI using an information-theoretic approach in 15 adolescents with OCD and 13 matched healthy controls. Results indicate that an information-theoretic approach based on sub-graph entropy is capable of classifying OCD vs. healthy subjects with high accuracy. Mean time-series were extracted from 85 brain regions and were used to calculate Shannon wavelet entropy, Pearson correlation matrix, network features and sub-graph entropy. In addition, two special cases of sub-graph entropy, namely node and edge entropy, were investigated to identify important brain regions and edges from OCD patients. A leave-one-out cross-validation method was used for the final predictor performance. The proposed methodology using differential sub-graph (edge) entropy achieved an accuracy of 0.89 with specificity 1 and sensitivity 0.80 using leave-one-out cross-validation with in-fold feature ranking and selection. The high classification accuracy indicates the predictive power of the sub-network as well as edge entropy metric.
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Affiliation(s)
- Bhaskar Sen
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis
| | - Gail A Bernstein
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis
| | - Bryon A Mueller
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis
| | - Kathryn R Cullen
- Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis
| | - Keshab K Parhi
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis.
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Marzuki AA, Pereira de Souza AMFL, Sahakian BJ, Robbins TW. Are candidate neurocognitive endophenotypes of OCD present in paediatric patients? A systematic review. Neurosci Biobehav Rev 2019; 108:617-645. [PMID: 31821834 DOI: 10.1016/j.neubiorev.2019.12.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/01/2019] [Accepted: 12/06/2019] [Indexed: 01/03/2023]
Abstract
To-date it has been difficult to ascertain the exact cognitive profile of childhood OCD as studies report variable results. Adult OCD research lately utilises the endophenotype approach; studying cognitive traits that are present in both patients and their unaffected first-degree relatives, and are thought to lie closer to the genotype than the full-blown disorder. By observing whether candidate endopenotypes of adult OCD are present in child patients, we can determine whether the two subtypes show cognitive overlap. We conducted a systematic review of the paediatric OCD literature focussing on proposed neurocognitive endophenotypes of OCD: cognitive flexibility, response inhibition, memory, planning, decision-making, action monitoring, and reversal learning. We found that paediatric patients present robust increases in brain error related negativity associated with abnormal action monitoring, impaired decision-making under uncertainty, planning, and visual working memory, but there is less evidence for deficits in other cognitive domains. This implies that children with OCD show some cognitive similarities with adult patients, but other dysfunctions may only manifest later in the disorder trajectory.
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Affiliation(s)
- Aleya A Marzuki
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EL, Cambridge, UK; Department of Psychology, Downing Site, University of Cambridge, CB2 3EB, Cambridge, UK.
| | - Ana Maria Frota Lisboa Pereira de Souza
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EL, Cambridge, UK; Department of Psychology, Downing Site, University of Cambridge, CB2 3EB, Cambridge, UK.
| | - Barbara J Sahakian
- Herchel Smith Building, Department of Psychiatry, University of Cambridge, CB2 0SZ, Cambridge, UK.
| | - Trevor W Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, CB2 3EL, Cambridge, UK; Department of Psychology, Downing Site, University of Cambridge, CB2 3EB, Cambridge, UK.
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Escobar AP, Wendland JR, Chávez AE, Moya PR. The Neuronal Glutamate Transporter EAAT3 in Obsessive-Compulsive Disorder. Front Pharmacol 2019; 10:1362. [PMID: 31803055 PMCID: PMC6872633 DOI: 10.3389/fphar.2019.01362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/28/2019] [Indexed: 01/03/2023] Open
Abstract
Obsessive compulsive disorder (OCD) is a heterogeneous psychiatric disorder affecting 1%–3% of the population worldwide. About half of OCD afflicted individuals do not respond to currently available pharmacotherapy, which is mainly based on serotonin reuptake inhibition. Therefore, there is a critical need to search novel and improved therapeutic targets to treat this devastating disorder. In recent years, accumulating evidence has supported the glutamatergic hypothesis of OCD, and particularly pointing a potential role for the neuronal glutamate transporter EAAT3. This mini-review summarizes recent findings regarding the neurobiological basis of OCD, with an emphasis on the glutamatergic neurotransmission and EAAT3 as a key player in OCD etiology.
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Affiliation(s)
- Angélica P Escobar
- Centro Interdisciplinario de Neurociencia de Valparaíso CINV, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Jens R Wendland
- Centro Interdisciplinario de Neurociencia de Valparaíso CINV, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Andrés E Chávez
- Centro Interdisciplinario de Neurociencia de Valparaíso CINV, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Pablo R Moya
- Centro Interdisciplinario de Neurociencia de Valparaíso CINV, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile.,Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaiso, Chile
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Converging evidence points towards a role of insulin signaling in regulating compulsive behavior. Transl Psychiatry 2019; 9:225. [PMID: 31515486 PMCID: PMC6742634 DOI: 10.1038/s41398-019-0559-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 02/28/2018] [Accepted: 07/24/2018] [Indexed: 01/04/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder with childhood onset, and is characterized by intrusive thoughts and fears (obsessions) that lead to repetitive behaviors (compulsions). Previously, we identified insulin signaling being associated with OCD and here, we aim to further investigate this link in vivo. We studied TALLYHO/JngJ (TH) mice, a model of type 2 diabetes mellitus, to (1) assess compulsive and anxious behaviors, (2) determine neuro-metabolite levels by 1 H magnetic resonance spectroscopy (MRS) and brain structural connectivity by diffusion tensor imaging (DTI), and (3) investigate plasma and brain protein levels for molecules previously associated with OCD (insulin, Igf1, Kcnq1, and Bdnf) in these subjects. TH mice showed increased compulsivity-like behavior (reduced spontaneous alternation in the Y-maze) and more anxiety (less time spent in the open arms of the elevated plus maze). In parallel, their brains differed in the white matter microstructure measures fractional anisotropy (FA) and mean diffusivity (MD) in the midline corpus callosum (increased FA and decreased MD), in myelinated fibers of the dorsomedial striatum (decreased FA and MD), and superior cerebellar peduncles (decreased FA and MD). MRS revealed increased glucose levels in the dorsomedial striatum and increased glutathione levels in the anterior cingulate cortex in the TH mice relative to their controls. Igf1 expression was reduced in the cerebellum of TH mice but increased in the plasma. In conclusion, our data indicates a role of (abnormal) insulin signaling in compulsivity-like behavior.
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Macpherson T, Hikida T. Role of basal ganglia neurocircuitry in the pathology of psychiatric disorders. Psychiatry Clin Neurosci 2019; 73:289-301. [PMID: 30734985 DOI: 10.1111/pcn.12830] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/22/2019] [Accepted: 02/05/2019] [Indexed: 12/21/2022]
Abstract
Over the last few decades, advances in human and animal-based techniques have greatly enhanced our understanding of the neural mechanisms underlying psychiatric disorders. Many of these studies have indicated connectivity between and alterations within basal ganglia structures to be particularly pertinent to the development of symptoms associated with several of these disorders. Here we summarize the connectivity, molecular composition, and function of sites within basal ganglia neurocircuits. Then we review the current literature from both human and animal studies concerning altered basal ganglia function in five common psychiatric disorders: obsessive-compulsive disorder, substance-related and addiction disorders, major depressive disorder, generalized anxiety disorder, and schizophrenia. Finally, we present a model based upon the findings of these studies that highlights the striatum as a particularly attractive target for restoring normal function to basal ganglia neurocircuits altered within psychiatric disorder patients.
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Affiliation(s)
- Tom Macpherson
- Laboratory for Advanced Brain Functions, Institute for Protein Research, Osaka University, Osaka, Japan
| | - Takatoshi Hikida
- Laboratory for Advanced Brain Functions, Institute for Protein Research, Osaka University, Osaka, Japan
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Norman LJ, Taylor SF, Liu Y, Radua J, Chye Y, De Wit SJ, Huyser C, Karahanoglu FI, Luks T, Manoach D, Mathews C, Rubia K, Suo C, van den Heuvel OA, Yücel M, Fitzgerald K. Error Processing and Inhibitory Control in Obsessive-Compulsive Disorder: A Meta-analysis Using Statistical Parametric Maps. Biol Psychiatry 2019; 85:713-725. [PMID: 30595231 PMCID: PMC6474799 DOI: 10.1016/j.biopsych.2018.11.010] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/26/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Error processing and inhibitory control enable the adjustment of behaviors to meet task demands. Functional magnetic resonance imaging studies report brain activation abnormalities in patients with obsessive-compulsive disorder (OCD) during both processes. However, conclusions are limited by inconsistencies in the literature and small sample sizes. Therefore, the aim here was to perform a meta-analysis of the existing literature using unthresholded statistical maps from previous studies. METHODS A voxelwise seed-based d mapping meta-analysis was performed using t-maps from studies comparing patients with OCD and healthy control subjects (HCs) during error processing and inhibitory control. For the error processing analysis, 239 patients with OCD (120 male; 79 medicated) and 229 HCs (129 male) were included, while the inhibitory control analysis included 245 patients with OCD (120 male; 91 medicated) and 239 HCs (135 male). RESULTS Patients with OCD, relative to HCs, showed longer inhibitory control reaction time (standardized mean difference = 0.20, p = .03, 95% confidence interval = 0.016, 0.393) and more inhibitory control errors (standardized mean difference = 0.22, p = .02, 95% confidence interval = 0.039, 0.399). In the brain, patients showed hyperactivation in the bilateral dorsal anterior cingulate cortex, supplementary motor area, and pre-supplementary motor area as well as right anterior insula/frontal operculum and anterior lateral prefrontal cortex during error processing but showed hypoactivation during inhibitory control in the rostral and ventral anterior cingulate cortices and bilateral thalamus/caudate, as well as the right anterior insula/frontal operculum, supramarginal gyrus, and medial orbitofrontal cortex (all seed-based d mapping z value >2, p < .001). CONCLUSIONS A hyperactive error processing mechanism in conjunction with impairments in implementing inhibitory control may underlie deficits in stopping unwanted compulsive behaviors in the disorder.
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Affiliation(s)
- Luke J. Norman
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, USA,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Stephan F. Taylor
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, USA
| | - Yanni Liu
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, USA
| | - Joaquim Radua
- Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Yann Chye
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Stella J. De Wit
- Amsterdam University Medical Centers, Vrije Universiteit, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Chaim Huyser
- Bascule, Academic Centre for Children and Adolescent Psychiatry, Amsterdam, Netherlands
| | - F. Isik Karahanoglu
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Tracy Luks
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Dara Manoach
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, USA
| | - Carol Mathews
- Department of Psychiatry and Center for OCD, Anxiety and Related Disorders, University of Florida, Gainesville, Florida, USA
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Chao Suo
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Odile A. van den Heuvel
- Amsterdam University Medical Centers, Vrije Universiteit, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands,OCD-Team, Haukeland University Hospital, Bergen, Norway
| | - Murat Yücel
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia,Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Kate Fitzgerald
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, USA
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Sertraline Effects on Striatal Resting-State Functional Connectivity in Youth With Obsessive-Compulsive Disorder: A Pilot Study. J Am Acad Child Adolesc Psychiatry 2019; 58:486-495. [PMID: 30768407 PMCID: PMC6487209 DOI: 10.1016/j.jaac.2018.07.897] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/23/2018] [Accepted: 08/15/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Foundational knowledge on neural circuitry underlying pediatric obsessive-compulsive disorder (OCD) and how it changes during standard treatment is needed to provide the basis for conceptualization and development of novel targeted treatments. This study explored the effects of sertraline, a selective serotonin reuptake inhibitor, on resting-state functional connectivity in cortico-striatal-thalamic-cortical circuits in pediatric OCD. METHOD Medication-free youths with OCD (n = 14) and healthy controls (n = 14) were examined at baseline and 12 weeks with resting-state functional magnetic resonance imaging. Between scan sessions, participants with OCD received 12 weeks of sertraline. For each scan, seed-based whole-brain resting-state functional connectivity analyses were conducted with 6 striatal seeds. Analysis of variance examined the interaction between group and time on striatal connectivity, including cluster-based thresholding to correct for multiple tests. Connectivity changes within circuits identified in group analyses were correlated with clinical change. RESULTS Two significant group-by-time effects in the OCD group showed increased striatal connectivity from baseline to 12 weeks compared with controls. Circuits demonstrating this pattern included the right putamen with the left frontal cortex and insula and the left putamen with the left frontal cortex and pre- and post-central cortices. Increase in connectivity in the left putamen circuit was significantly correlated with clinical improvement on the Children's Yale-Brown Obsessive-Compulsive Scale score (r = -0.58, p = .03). CONCLUSION Sertraline appears to affect specific striatal-based circuits in pediatric OCD, and these changes in part could account for clinical improvement. Future work is needed to confirm these preliminary findings, which would facilitate identification of circuit-based targets for novel treatment development. CLINICAL TRIAL REGISTRATION INFORMATION Effects of Sertraline on Brain Connectivity in Adolescents with OCD; https://clinicaltrials.gov/; NCT02797808.
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Tan B, Liu Q, Wan C, Jin Z, Yang Y, Li L. Altered Functional Connectivity of Alpha Rhythm in Obsessive-Compulsive Disorder During Rest. Clin EEG Neurosci 2019; 50:88-99. [PMID: 30280595 DOI: 10.1177/1550059418804378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a common inheritable psychiatric disorder characteristic of repetitive thinking, imagination (obsession), and stereotyped behaviors (compulsive). To explore whether there is an alteration of brain functional connectivity (BFC) in patients with OCD during rest, electroencephalogram (EEG) data of healthy controls (HCs) and patients with OCD were collected during rest in both eyes-closed and eyes-open states. Synchronization likelihood and graph theory were applied to construct and analyze brain functional networks of patients with OCD and HCs. Patients with OCD showed abnormal graph-theoretic parameters and impaired small world features in the alpha and beta bands. In addition, the topological analysis consistently showed that the long-range BFC of alpha rhythm was significantly reduced in the bilateral posterior areas in patients with OCD in comparison with HCs, while the BFC in the beta rhythm was significantly increased only in the eyes-open state. The findings suggest that the BFC of patients with OCD show abnormal small-world features and altered topological structure during rest, mainly in alpha and beta bands, which may provide a new insight for the diagnosis and treatment of OCD.
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Affiliation(s)
- Bo Tan
- Key Laboratory for NeuroInformation of Ministry of Education, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qingxiao Liu
- Hospital of Chengdu University of TCM, Chengdu, China
| | - Chaoyang Wan
- Key Laboratory for NeuroInformation of Ministry of Education, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhenlan Jin
- Key Laboratory for NeuroInformation of Ministry of Education, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yanchun Yang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Ling Li
- Key Laboratory for NeuroInformation of Ministry of Education, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, China
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Chen Y, Meng Z, Zhang Z, Zhu Y, Gao R, Cao X, Tan L, Wang Z, Zhang H, Li Y, Fan Q. The right thalamic glutamate level correlates with functional connectivity with right dorsal anterior cingulate cortex/middle occipital gyrus in unmedicated obsessive-compulsive disorder: A combined fMRI and 1H-MRS study. Aust N Z J Psychiatry 2019; 53:207-218. [PMID: 30354192 DOI: 10.1177/0004867418806370] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The imbalance in neurotransmitter and neuronal metabolite concentration within cortico-striato-thalamo-cortical (CSTC) circuit contributes to obsessive-compulsive disorder's (OCD) onset. Previous studies showed that glutamate mediated upregulation of resting-state activity in healthy people. However, there have been few studies investigating the correlational features between functional and neurochemical alterations in OCD. METHODS We utilize a combined resting-state functional magnetic resonance imaging (rs-fMRI) and proton magnetic resonance spectroscopy (1H-MRS) approach to investigate the altered functional connectivity (FC) in association with glutamatergic dysfunction in OCD pathophysiology. Three regions of interest are investigated, i.e., medial prefrontal cortex and bilateral thalamus, for seed-based whole-brain FC analysis as well as MRS data acquisition. There are 23 unmedicated adult OCD patients and 23 healthy controls recruited for brain FC analysis. Among them, 12 OCD and 8 controls are performed MRS data acquisition. RESULTS Besides abnormal FC within CSTC circuit, we also find altered FCs in large-scale networks outside CSTC circuit, including occipital area and limbic and motor systems. The decreased FC between right thalamus and right middle occipital gyrus (MOG) is correlated with glutamatergic signal within right thalamus in OCD patients. Moreover, the FC between right thalamus and right dorsal anterior cingulate cortex (dACC) is associated with glutamate level in right thalamus, specifically in patient's group. Finally, the FC between right thalamus and right MOG is correlated with patient's Yale-Brown Obsessive Compulsive Scale (YBOCS) compulsion and total scores, while the right thalamic glutamatergic signal is associated with YBOCS-compulsion score. CONCLUSION Our findings showed that the coupled intrinsic functional-biochemical alterations existed both within CSTC circuit and from CSTC to occipital lobe in OCD pathophysiology.
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Affiliation(s)
- Yongjun Chen
- 1 Rehabilitation Department, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,2 Department of Developmental Behavioral Pediatric and Children Healthcare, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ziyu Meng
- 3 School of Biomedical Engineering and Institute for Medical Imaging Technology, Shanghai Jiao Tong University, Shanghai, China
| | - Zongfeng Zhang
- 1 Rehabilitation Department, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yajing Zhu
- 3 School of Biomedical Engineering and Institute for Medical Imaging Technology, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Gao
- 1 Rehabilitation Department, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuan Cao
- 1 Rehabilitation Department, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Tan
- 4 Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Wang
- 1 Rehabilitation Department, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyin Zhang
- 1 Rehabilitation Department, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Li
- 3 School of Biomedical Engineering and Institute for Medical Imaging Technology, Shanghai Jiao Tong University, Shanghai, China
| | - Qing Fan
- 1 Rehabilitation Department, Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Calzà J, Gürsel DA, Schmitz-Koep B, Bremer B, Reinholz L, Berberich G, Koch K. Altered Cortico-Striatal Functional Connectivity During Resting State in Obsessive-Compulsive Disorder. Front Psychiatry 2019; 10:319. [PMID: 31133898 PMCID: PMC6524661 DOI: 10.3389/fpsyt.2019.00319] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/24/2019] [Indexed: 01/30/2023] Open
Abstract
Background: Neuroimaging studies show that obsessive-compulsive disorder (OCD) is characterized by an alteration of the cortico-striato-thalamo-cortical (CSTC) system in terms of an imbalance of activity between the direct and the indirect loop of the CSTC. As resting-state functional connectivity (FC) studies investigated only specific parts of the CSTC in patients with OCD up to now, the present study aimed at exploring FC in the CSTC as a whole. Methods: We investigated potential alterations in resting-state FC within the CSTC system in 44 OCD patients and 40 healthy controls by taking into consideration all relevant nodes of the direct and indirect CSTC loop. Results: Compared to healthy controls, OCD patients showed an increased FC between the left subthalamic nucleus (STN) and the left external globus pallidus (GPe), as well as an increased FC between the left GPe and the left internal globus pallidus (GPi). Conclusion: These findings may contribute to a better understanding of the OCD pathophysiology by providing further information on the connectivity alterations within specific regions of the CSTC system. In particular, increased FC between the STN and the left GPe may play a major role in OCD pathology. This assumption is consistent with the fact that these regions are also the main target sites of therapeutic deep brain stimulation in OCD.
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Affiliation(s)
- Jessica Calzà
- Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.,TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany
| | - Deniz A Gürsel
- Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.,TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany
| | - Benita Schmitz-Koep
- Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Benno Bremer
- Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany
| | - Lena Reinholz
- Department of Psychology, Ludwigs-Maximilians-Universität, Munich, Germany
| | - Götz Berberich
- Windach Institute and Hospital of Neurobehavioural Research and Therapy (WINTR), Windach, Germany
| | - Kathrin Koch
- Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.,TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universität München (TUM), Munich, Germany.,Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich, Germany
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Yin D, Zhang C, Lv Q, Chen X, Zeljic K, Gong H, Zhan S, Jin H, Wang Z, Sun B. Dissociable Frontostriatal Connectivity: Mechanism and Predictor of the Clinical Efficacy of Capsulotomy in Obsessive-Compulsive Disorder. Biol Psychiatry 2018; 84:926-936. [PMID: 29778276 DOI: 10.1016/j.biopsych.2018.04.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/09/2018] [Accepted: 04/11/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Little is known about the neural mechanism and response variability underlying neurosurgical interventions for intractable obsessive-compulsive disorder (OCD). METHODS Of 81 OCD patients screened for capsulotomy identified in our institutional database, 36 patients with clinical assessment before and after capsulotomy and imaging data (9 of 36 patients without postoperative imaging data used as an independent test group), and 29 healthy control subjects were retrospectively recruited. Twenty of 36 patients (56%) responded to the lesion procedure (determined as a ≥35% reduction in Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score). Seed-based (i.e., ventral and dorsal caudate, medial dorsal thalamus, and ventral and dorsal putamen) resting-state functional connectivity was used to examine alterations in frontostriatal circuitry after capsulotomy. RESULTS The Y-BOCS score significantly decreased (p < .001) after capsulotomy in OCD patients. Functional connectivity between the ventral striatum/nucleus accumbens and the dorsal anterior cingulate cortex was reduced (p < .05, corrected) after the surgical procedure. Moreover, change in connectivity significantly correlated with alteration in Y-BOCS score (r = .41, p = .033). In addition, preoperative connectivity between the dorsal caudate and the dorsal anterior cingulate cortex could differentiate nonresponders from responders and predict changes in Y-BOCS score (R2 = .23, F1,25 = 7.56, p = .011), which was generalized in an independent test group. CONCLUSIONS We demonstrated that restoration of ventral frontostriatal connectivity was associated with clinical improvement in refractory OCD, suggesting a therapeutic mechanism of capsulotomy. Moreover, preoperative variations in dorsal frontostriatal connectivity predicted clinical response, which may offer a predictor of treatment outcome.
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Affiliation(s)
- Dazhi Yin
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Chinese Academy of Sciences Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - ChenCheng Zhang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiming Lv
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Chinese Academy of Sciences Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China; University of Chinese Academy of Sciences, Beijing, China
| | - Xiaoyu Chen
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Chinese Academy of Sciences Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China; University of Chinese Academy of Sciences, Beijing, China
| | - Kristina Zeljic
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Chinese Academy of Sciences Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China; University of Chinese Academy of Sciences, Beijing, China
| | - Hengfen Gong
- Department of Psychiatry, Pudong District Mental Health Center, Shanghai, China
| | - Shikun Zhan
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyan Jin
- Department of Psychiatry, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Wang
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Chinese Academy of Sciences Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
| | - Bomin Sun
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Kaczkurkin AN, Moore TM, Calkins ME, Ciric R, Detre JA, Elliott MA, Foa EB, Garcia de la Garza A, Roalf DR, Rosen A, Ruparel K, Shinohara RT, Xia CH, Wolf DH, Gur RE, Gur RC, Satterthwaite TD. Common and dissociable regional cerebral blood flow differences associate with dimensions of psychopathology across categorical diagnoses. Mol Psychiatry 2018; 23:1981-1989. [PMID: 28924181 PMCID: PMC5858960 DOI: 10.1038/mp.2017.174] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 05/24/2017] [Accepted: 06/23/2017] [Indexed: 11/08/2022]
Abstract
The high comorbidity among neuropsychiatric disorders suggests a possible common neurobiological phenotype. Resting-state regional cerebral blood flow (CBF) can be measured noninvasively with magnetic resonance imaging (MRI) and abnormalities in regional CBF are present in many neuropsychiatric disorders. Regional CBF may also provide a useful biological marker across different types of psychopathology. To investigate CBF changes common across psychiatric disorders, we capitalized upon a sample of 1042 youths (ages 11-23 years) who completed cross-sectional imaging as part of the Philadelphia Neurodevelopmental Cohort. CBF at rest was quantified on a voxelwise basis using arterial spin labeled perfusion MRI at 3T. A dimensional measure of psychopathology was constructed using a bifactor model of item-level data from a psychiatric screening interview, which delineated four factors (fear, anxious-misery, psychosis and behavioral symptoms) plus a general factor: overall psychopathology. Overall psychopathology was associated with elevated perfusion in several regions including the right dorsal anterior cingulate cortex (ACC) and left rostral ACC. Furthermore, several clusters were associated with specific dimensions of psychopathology. Psychosis symptoms were related to reduced perfusion in the left frontal operculum and insula, whereas fear symptoms were associated with less perfusion in the right occipital/fusiform gyrus and left subgenual ACC. Follow-up functional connectivity analyses using resting-state functional MRI collected in the same participants revealed that overall psychopathology was associated with decreased connectivity between the dorsal ACC and bilateral caudate. Together, the results of this study demonstrate common and dissociable CBF abnormalities across neuropsychiatric disorders in youth.
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Affiliation(s)
- A N Kaczkurkin
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - T M Moore
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M E Calkins
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R Ciric
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - J A Detre
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - M A Elliott
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - E B Foa
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - A Garcia de la Garza
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D R Roalf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - A Rosen
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - K Ruparel
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - C H Xia
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - D H Wolf
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - R C Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Philadelphia Veterans Administration Medical Center, Philadelphia, PA, USA
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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Zhou F, Zimmermann K, Xin F, Scheele D, Dau W, Banger M, Weber B, Hurlemann R, Kendrick KM, Becker B. Shifted balance of dorsal versus ventral striatal communication with frontal reward and regulatory regions in cannabis-dependent males. Hum Brain Mapp 2018; 39:5062-5073. [PMID: 30277629 DOI: 10.1002/hbm.24345] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/15/2018] [Accepted: 07/26/2018] [Indexed: 12/15/2022] Open
Abstract
The transition from voluntary to addictive behavior is characterized by a loss of regulatory control in favor of reward driven behavior. Animal models indicate that this process is neurally underpinned by a shift in ventral-dorsal striatal control of behavior; however, this shift has not been directly examined in humans. The present resting state functional magnetic resonance imaging (fMRI) study employed a two-step approach to: (a) precisely map striatal alterations using a novel, data-driven network classification strategy combining intrinsic connectivity contrast with multivoxel pattern analysis and, (b) to determine whether a ventral to dorsal striatal shift in connectivity with reward and regulatory control regions can be observed in abstinent (28 days) male cannabis-dependent individuals (n = 24) relative to matched controls (n = 28). Network classification revealed that the groups can be reliably discriminated by global connectivity profiles of two striatal regions that mapped onto the ventral (nucleus accumbens) and dorsal striatum (caudate). Subsequent functional connectivity analysis demonstrated a relative shift between ventral and dorsal striatal communication with fronto-limbic regions that have been consistently involved in reward processing (rostral anterior cingulate cortex [ACC]) and executive/regulatory functions (dorsomedial prefrontal cortex [PFC]). Specifically, in the cannabis-dependent subjects, connectivity between the ventral striatum with the rostral ACC increased, whereas both striatal regions were uncoupled from the regulatory dorsomedial PFC. Together, these findings suggest a shift in the balance between dorsal and ventral striatal control in cannabis dependence. Similar changes have been observed in animal models and may promote the loss of control central to addictive behavior.
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Affiliation(s)
- Feng Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Kaeli Zimmermann
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany
| | - Fei Xin
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Dirk Scheele
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany
| | - Wolfgang Dau
- Department of Addiction and Psychotherapy, LVR-Clinic Bonn, Bonn, Germany
| | - Markus Banger
- Department of Addiction and Psychotherapy, LVR-Clinic Bonn, Bonn, Germany
| | - Bernd Weber
- Center for Economics and Neuroscience, Department of Epileptology, University of Bonn, Bonn, Germany.,Department of Neurocognition, Life & Brain Center, Bonn, Germany
| | - René Hurlemann
- Department of Psychiatry and Division of Medical Psychology, University of Bonn, Bonn, Germany
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Geller DA, Abramovitch A, Mittelman A, Stark A, Ramsey K, Cooperman A, Baer L, Stewart SE. Neurocognitive function in paediatric obsessive-compulsive disorder. World J Biol Psychiatry 2018; 19:142-151. [PMID: 28090807 PMCID: PMC5555842 DOI: 10.1080/15622975.2017.1282173] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The small body of neuropsychological research in paediatric obsessive-compulsive disorder (OCD) yields inconsistent results. A recent meta-analysis found small effect sizes, concluding that paediatric OCD may not be associated with cognitive impairments, stressing the need for more research. We investigated neuropsychological performance in a large sample of youths with OCD, while assessing potential moderators. METHODS Participants with OCD (n = 102) and matched controls (n = 161) were thoroughly screened and blindly evaluated for comorbidities, and completed a neuropsychological battery assessing processing speed, visuospatial abilities (VSA), working memory (WM), non-verbal memory (NVM), and executive functions (EF). RESULTS Compared to controls, youths with OCD exhibited underperformance on tasks assessing processing speed. On tests of VSA and WM, underperformance was found only on timed tasks. There were no differences on NVM and EF tasks. Notably, the OCD group's standardised scores were in the normative range. Test performance was not associated with demographic or clinical variables. CONCLUSIONS Youths with OCD exhibited intact performance on memory and EF tests, but slower processing speed, and underperformance only on timed VSA and WM tasks. While the OCD group performed in the normative range, these findings reveal relative weaknesses that may be overlooked. Such an oversight may be of particular importance in clinical and school settings.
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Affiliation(s)
- Daniel A. Geller
- Department of Psychiatry Massachusetts General Hospital & Harvard Medical School, 185 Cambridge St. Boston, MA, 02114, US A; phone:+1(617)726-6766
| | - Amitai Abramovitch
- Department of Psychiatry Massachusetts General Hospital & Harvard Medical School, 185 Cambridge St. Boston, MA, 02114, US A; phone:+1(617)726-6766,Department of Psychology, Texas State University, UAC 253, San Marcos, TX, 78666, USA; phone +1(512)245-2526,Address for correspondence: Amitai Abramovitch, Department of Psychology, Texas State University, San Marcos, Texas 78666, USA; Phone: +1(512)245-2526, Fax: +1(512)245-3153;
| | - Andrew Mittelman
- Department of Psychiatry Massachusetts General Hospital & Harvard Medical School, 185 Cambridge St. Boston, MA, 02114, US A; phone:+1(617)726-6766
| | - Abigail Stark
- Department of Psychiatry Massachusetts General Hospital & Harvard Medical School, 185 Cambridge St. Boston, MA, 02114, US A; phone:+1(617)726-6766
| | - Kesley Ramsey
- Department of Psychiatry Massachusetts General Hospital & Harvard Medical School, 185 Cambridge St. Boston, MA, 02114, US A; phone:+1(617)726-6766
| | - Allison Cooperman
- Department of Psychiatry Massachusetts General Hospital & Harvard Medical School, 185 Cambridge St. Boston, MA, 02114, US A; phone:+1(617)726-6766
| | - Lee Baer
- Department of Psychiatry Massachusetts General Hospital & Harvard Medical School, 185 Cambridge St. Boston, MA, 02114, US A; phone:+1(617)726-6766
| | - S. Evelyn Stewart
- Department of Psychiatry, University of British Columbia, BC Children's Hospital, A3-118, 950 West 28th Av., Vancouver, BC, V5Z4H4, Canada; phone:+1(604)-875-2000
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