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Stephenson C, Philipp-Muller A, Moghimi E, Nashed JY, Cook DJ, Shirazi A, Milev R, Alavi N. Effects of cognitive behavioural therapy and exposure-response prevention on brain activation in obsessive-compulsive disorder patients: systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01852-6. [PMID: 38935215 DOI: 10.1007/s00406-024-01852-6] [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: 04/17/2023] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
Current psychotherapeutic treatments for OCD, while effective, have complex outcomes with mixed efficacy. Previous research has observed baseline brain activation patterns in OCD patients, elucidating some of the implications of this disorder. Observing the effects of evidence-based psychotherapeutics for OCD on brain activation (through MRI) may provide a more comprehensive outline of pathology. This systematic review and meta-analysis evaluated the effects of cognitive behavioural therapy (CBT) with exposure-response prevention (ERP) on brain activation in OCD patients. Academic databases were systematically searched, and the outcomes evaluated included changes in brain activation and symptom severity between baseline and post-treatment. Patients (n = 193) had confirmed OCD diagnosis and underwent protocolized CBT with ERP programs delivered by trained therapists. Participants in the CBT with ERP programs demonstrated significant improvements in symptom severity (Cohen's d = - 1.91). In general, CBT with ERP resulted in decreased activation post-treatment in the frontal (Cohen's d = 0.40), parietal (Cohen's d = 0.79), temporal (Cohen's d = 1.02), and occipital lobe (Cohen's d = 0.76), and cerebellum (Cohen's d = - 0.78). The findings support CBT with ERP's ability to improve brain activation abnormalities in OCD patients. By identifying regions that improved activation levels, psychotherapy programs may benefit from the addition of function-specific features that could improve treatment outcomes.
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Masjoodi S, Farrokhi M, Afkham BV, Koohsar JS. Advances in DTI studies for diagnoses and treatment of obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2024; 340:111794. [PMID: 38422871 DOI: 10.1016/j.pscychresns.2024.111794] [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: 07/01/2023] [Revised: 11/15/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
This review summarizes the current state of neuroimaging research on obsessive-compulsive disorder (OCD) using diffusion tensor imaging (DTI), which allows for the examination of white matter abnormalities in the brain. DTI studies on individuals with obsessive-compulsive disorder (OCD) consistently demonstrate widespread reductions in white matter integrity in various regions of the brain, including the corpus callosum, anterior and posterior cingulate cortex, and prefrontal cortex, which are involved in emotion regulation, decision-making, and cognitive control. However, the reviewed studies often have small sample sizes, and findings vary between studies, highlighting the need for larger and more standardized studies. Furthermore, discerning between causal and consequential effects of OCD on white matter integrity poses a challenge. Addressing this issue may be facilitated through longitudinal studies, including those evaluating the impact of treatment interventions, to enhance the accuracy of DTI data acquisition and processing, thereby improving the validity and comparability of study outcomes. In summary, DTI studies provide valuable insights into the neural circuits and connectivity disruptions in OCD, and future studies may benefit from standardized data analysis and larger sample sizes to determine whether structural abnormalities could be potential biomarkers for early identification and treatment of OCD.
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Affiliation(s)
- Sadegh Masjoodi
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, 7194815644, Iran.
| | - MajidReza Farrokhi
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, 7194815644, Iran; Department of Neurosurgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, 7194815644, Iran
| | - Behrouz Vejdani Afkham
- NeuroPoly, Inistitute of Biomedical Engineering, Polytechnical Montreal, Montreal, QC, H3T 1J4, Canada
| | - Javad Sheikhi Koohsar
- School of Advanced medical technology, Isfahan University of Medical Sciences, Isfahan, 8415683111, Iran
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3
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Robbins TW, Banca P, Belin D. From compulsivity to compulsion: the neural basis of compulsive disorders. Nat Rev Neurosci 2024; 25:313-333. [PMID: 38594324 DOI: 10.1038/s41583-024-00807-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/11/2024]
Abstract
Compulsive behaviour, an apparently irrational perseveration in often maladaptive acts, is a potential transdiagnostic symptom of several neuropsychiatric disorders, including obsessive-compulsive disorder and addiction, and may reflect the severe manifestation of a dimensional trait termed compulsivity. In this Review, we examine the psychological basis of compulsions and compulsivity and their underlying neural circuitry using evidence from human neuroimaging and animal models. Several main elements of this circuitry are identified, focused on fronto-striatal systems implicated in goal-directed behaviour and habits. These systems include the orbitofrontal, prefrontal, anterior cingulate and insular cortices and their connections with the basal ganglia as well as sensoriomotor and parietal cortices and cerebellum. We also consider the implications for future classification of impulsive-compulsive disorders and their treatment.
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Affiliation(s)
- Trevor W Robbins
- Behavioural and Clinical Neuroscience Institute, Department of Psychology, University of Cambridge, Cambridge, UK.
| | - Paula Banca
- Behavioural and Clinical Neuroscience Institute, Department of Psychology, University of Cambridge, Cambridge, UK
| | - David Belin
- Behavioural and Clinical Neuroscience Institute, Department of Psychology, University of Cambridge, Cambridge, UK
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4
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Chou T, Kochanowski BJ, Hayden A, Borron BM, Barbeiro MC, Xu J, Kim JW, Zhang X, Bouchard RR, Phan KL, Goodman WK, Dougherty DD. A Low-Intensity Transcranial Focused Ultrasound Parameter Exploration Study of the Ventral Capsule/Ventral Striatum. Neuromodulation 2024:S1094-7159(24)00067-9. [PMID: 38691076 DOI: 10.1016/j.neurom.2024.03.004] [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: 11/27/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is effective for treatment-resistant obsessive-compulsive disorder (OCD); however, DBS is associated with neurosurgical risks. Transcranial focused ultrasound (tFUS) is a newer form of noninvasive (ie, nonsurgical) stimulation that can modulate deeper regions, such as the VC/VS. tFUS parameters have just begun to be studied and have often not been compared in the same participants. We explored the effects of three VC/VS tFUS protocols and an entorhinal cortex (ErC) tFUS session on the VC/VS and cortico-striato-thalamo-cortical circuit (CSTC) in healthy individuals for later application to patients with OCD. MATERIALS AND METHODS Twelve individuals participated in a total of 48 sessions of tFUS in this exploratory multisite, within-subject parameter study. We collected resting-state, reward task, and arterial spin-labeled (ASL) magnetic resonance imaging scans before and after ErC tFUS and three VC/VS tFUS sessions with different pulse repetition frequencies (PRFs), pulse widths (PWs), and duty cycles (DCs). RESULTS VC/VS protocol A (PRF = 10 Hz, PW = 5 ms, 5% DC) was associated with increased putamen activation during a reward task (p = 0.003), and increased VC/VS resting-state functional connectivity (rsFC) with the anterior cingulate cortex (p = 0.022) and orbitofrontal cortex (p = 0.004). VC/VS protocol C (PRF = 125 Hz, PW = 4 ms, 50% DC) was associated with decreased VC/VS rsFC with the putamen (p = 0.017), and increased VC/VS rsFC with the globus pallidus (p = 0.008). VC/VS protocol B (PRF = 125 Hz, PW = 0.4 ms, 5% DC) was not associated with changes in task-related CSTC activation or rsFC. None of the protocols affected CSTC ASL perfusion. CONCLUSIONS This study began to explore the multidimensional parameter space of an emerging form of noninvasive brain stimulation, tFUS. Our preliminary findings in a small sample suggest that VC/VS tFUS should continue to be investigated for future noninvasive treatment of OCD.
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Affiliation(s)
- Tina Chou
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA.
| | - Brian J Kochanowski
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Ashley Hayden
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Benjamin M Borron
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Miguel C Barbeiro
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
| | - Junqian Xu
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Joo-Won Kim
- Department of Radiology, Baylor College of Medicine, Houston, TX, USA; Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Xuefeng Zhang
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Richard R Bouchard
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kinh Luan Phan
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine, Columbus, OH, USA
| | - Wayne K Goodman
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA, USA
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5
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Baldi S, Schuhmann T, Goossens L, Schruers KRJ. Individualized, connectome-based, non-invasive stimulation of OCD deep-brain targets: A proof-of-concept. Neuroimage 2024; 288:120527. [PMID: 38286272 DOI: 10.1016/j.neuroimage.2024.120527] [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: 09/08/2023] [Revised: 12/09/2023] [Accepted: 01/26/2024] [Indexed: 01/31/2024] Open
Abstract
Treatment-resistant obsessive-compulsive disorder (OCD) generally improves with deep-brain stimulation (DBS), thought to modulate neural activity at both the implantation site and in connected brain regions. However, its invasive nature, side-effects, and lack of customization, make non-invasive treatments preferable. Harnessing the established remote effects of cortical transcranial magnetic stimulation (TMS), connectivity-based approaches have emerged for depression that aim at influencing distant regions connected to the stimulation site. We here investigated whether effective OCD DBS targets (here subthalamic nucleus [STN] and nucleus accumbens [NAc]) could be modulated non-invasively with TMS. In a proof-of-concept study with nine healthy individuals, we used 7T magnetic resonance imaging (MRI) and probabilistic tractography to reconstruct the fiber tracts traversing manually segmented STN/NAc. Two TMS targets were individually selected based on the strength of their structural connectivity to either the STN, or both the STN and NAc. In a sham-controlled, within-subject cross-over design, TMS was administered over the personalized targets, located around the precentral and middle frontal gyrus. Resting-state functional 3T MRI was acquired before, and at 5 and 25 min after stimulation to investigate TMS-induced changes in the functional connectivity of the STN and NAc with other regions of the brain. Static and dynamic seed-to-voxel correlation analyses were conducted. TMS over both targets was able to modulate the functional connectivity of the STN and NAc, engaging both overlapping and distinct regions, and unfolding following different temporal dynamics. Given the relevance of the engaged connected regions to OCD pathology, we argue that a personalized, connectivity-based procedure is worth investigating as potential treatment for refractory OCD.
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Affiliation(s)
- Samantha Baldi
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| | - Teresa Schuhmann
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands; Maastricht Brain Imaging Centre, Maastricht, the Netherlands
| | - Liesbet Goossens
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Koen R J Schruers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
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Lazarov A, Liberman N, Dar R. The Seeking Proxies for Internal States (SPIS) Model of OCD - A Comprehensive Review of Current Findings and Implications for Future Directions. Curr Neuropharmacol 2024; 22:1807-1825. [PMID: 37881091 DOI: 10.2174/1570159x21666230920165403] [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: 01/25/2023] [Revised: 04/17/2023] [Accepted: 05/19/2023] [Indexed: 10/27/2023] Open
Abstract
The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) explains symptoms of OCD as stemming from attenuated access to internal states, which is compensated for by using proxies, which are indices of these states that are more discernible or less ambiguous. Internal states in the SPIS model are subjective states that are not accessible to others, encompassing physiological states, motivations, preferences, memories, and emotions. Compensatory proxies in OCD include fixed rules and rituals as well as seeking and relying on external information. In the present review, we outline the SPIS model and describe its basic tenets. We then use the SPIS conceptualization to explain two pivotal OCD-related phenomena - obsessive doubt and compulsive rituals. Next, we provide a detailed overview of current empirical evidence supporting the SPIS in several domains, including physiological states, emotions, sense of understanding, decision-making, and sense of agency. We conclude by discussing possible neural correlates of the difficulty in accessing internal states, focusing on the anterior insular cortex (AIC) and highlighting potential clinical implications of the model to the treatment of OCD.
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Affiliation(s)
- Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Nira Liberman
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
| | - Reuven Dar
- School of Psychological Sciences, Tel Aviv University, Tel Aviv 69978, Israel
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Ding Z, Ding Z, Chen Y, Lv D, Li T, Shang T, Ma J, Zhan C, Yang X, Xiao J, Sun Z, Wang N, Guo W, Li C, Yu Z, Li P. Decreased gray matter volume and dynamic functional alterations in medicine-free obsessive-compulsive disorder. BMC Psychiatry 2023; 23:289. [PMID: 37098479 PMCID: PMC10131325 DOI: 10.1186/s12888-023-04740-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/31/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Previous studies discovered the presence of abnormal structures and functions in the brain regions of patients with obsessive-compulsive disorder (OCD). Nevertheless, whether structural changes in brain regions are coupled with alterations in dynamic functional connectivity (dFC) at rest in medicine-free patients with OCD remains vague. METHODS Three-dimensional T1-weighed magnetic resonance imaging (MRI) and resting-state functional MRI were performed on 50 medicine-free OCD and 50 healthy controls (HCs). Firstly, the differences in gray matter volume (GMV) between OCD and HCs were compared. Then, brain regions with aberrant GMV were used as seeds for dFC analysis. The relationship of altered GMV and dFC with clinical parameters in OCD was explored using partial correlation analysis. Finally, support vector machine was applied to examine whether altered multimodal imaging data might be adopted to distinguish OCD from HCs. RESULTS Our findings indicated that GMV in the left superior temporal gyrus (STG) and right supplementary motor area (SMA) was reduced in OCD, and the dFC between the left STG and the left cerebellum Crus I and left thalamus, and between the right SMA and right dorsolateral prefrontal cortex (DLPFC) and left precuneus was decreased at rest in OCD. The brain regions both with altered GMV and dFC values could discriminate OCD from HCs with the accuracy of 0.85, sensitivity of 0.90 and specificity of 0.80. CONCLUSION The decreased gray matter structure coupling with dynamic function in the left STG and right SMA at rest may be crucial in the pathophysiology of OCD. TRIAL REGISTRATION Study on the mechanism of brain network in obsessive-compulsive disorder with multi-model magnetic resonance imaging (registration date: 08/11/2017; registration number: ChiCTR-COC-17,013,301).
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Affiliation(s)
- Zhenning Ding
- Medical Technology Department, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Zhipeng Ding
- Medical Technology Department, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Yunhui Chen
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Dan Lv
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Tong Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Tinghuizi Shang
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Jidong Ma
- Department of Psychiatry, Baiyupao Psychiatric Hospital of Harbin, Harbin, Heilongjiang, 150050, China
| | - Chuang Zhan
- Department of Psychiatry, Baiyupao Psychiatric Hospital of Harbin, Harbin, Heilongjiang, 150050, China
| | - Xu Yang
- Medical Technology Department, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Jian Xiao
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Zhenghai Sun
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Na Wang
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Wenbin Guo
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Chengchong Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China.
| | - Zengyan Yu
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China.
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China.
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8
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Cognitive Neuroscience of Obsessive-Compulsive Disorder. Psychiatr Clin North Am 2023; 46:53-67. [PMID: 36740355 DOI: 10.1016/j.psc.2022.11.001] [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] [Indexed: 12/29/2022]
Abstract
Cognitive neuroscientific research has the ability to yield important insights into the complex neurobiological processes underlying obsessive-compulsive disorder (OCD). This article provides an updated review of neuroimaging studies in seven neurocognitive domains. Findings from the literature are discussed in the context of obsessive-compulsive phenomenology and treatment. Expanding our knowledge of the neural mechanisms involved in OCD could help optimize treatment outcomes and guide the development of novel interventions.
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Gupta R, Mehan S, Chhabra S, Giri A, Sherawat K. Role of Sonic Hedgehog Signaling Activation in the Prevention of Neurological Abnormalities Associated with Obsessive-Compulsive Disorder. Neurotox Res 2022; 40:1718-1738. [PMID: 36272053 DOI: 10.1007/s12640-022-00586-4] [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: 04/02/2022] [Revised: 09/15/2022] [Accepted: 10/07/2022] [Indexed: 12/31/2022]
Abstract
The smoothened sonic hedgehog (Smo-Shh) pathway is one mechanism that influences neurogenesis, including brain cell differentiation and development during childhood. Shh signaling dysregulation leads to decreased target gene transcription, which contributes to increased neuronal excitation, apoptosis, and neurodegeneration, eventually leading to neurological deficits. Neuropsychiatric disorders such as OCD and related neurological dysfunctions are characterized by neurotransmitter imbalance, neuroinflammation, oxidative stress, and impaired neurogenesis, disturbing the cortico-striato-thalamo-cortical (CSTC) link neuronal network. Despite the availability of several treatments, such as selective serotonin reuptake inhibitors, some individuals may not benefit much from them. Several trials on the use of antipsychotics in the treatment of OCD have also produced inadequate findings. This evidence-based review focuses on a potential pharmacological approach to alleviating OCD and associated neuronal deficits by preventing neurochemical alterations, in which sonic hedgehog activators are neuroprotective, lowering neuronal damage while increasing neuronal maintenance and survival. As a result, stimulating SMO-Shh via its potential activators may have neuroprotective effects on neurological impairment associated with OCD. This review investigates the link between SMO-Shh signaling and the neurochemical abnormalities associated with the progression of OCD and associated neurological dysfunctions. Role of Smo-Shh signaling in serotonergic neurogenesis and in maintaining their neuronal identity. The Shh ligand activates two main transcriptional factors known as Foxa2 and Nkx2.2, which again activates another transcriptional factor, GATA (GATA2 and GATA3), in post mitotic precursor cells of serotonergic neurons-following increased expression of Pet-1 and Lmx1b after GATA regulates the expression of many serotonergic enzymes such as TPH2, SERT, VMAT, slc6a4, Htr1a, Htr1b (Serotonin receptor enzymes), and MAO that regulate and control the release of serotonin and maintain their neuronal identity after their maturation. Abbreviation: Foxa2: Forkhead box; GATA: Globin transcription factor; Lmx1b: LIM homeobox transcription factor 1 beta; TPH2: Tryptophan hydroxylase 2; Htr1a: Serotonin receptor 1a; Htr1b: Serotonin receptor 1b; SERT: Serotonin transporter; VMAT: Vesicular monoamine transporter; MAO: Monoamine oxidase.
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Affiliation(s)
- Ria Gupta
- Division of Neuroscience, Department of Pharmacology, ISF College of Pharmacy, Moga, 142001, Punjab, India
| | - Sidharth Mehan
- Division of Neuroscience, Department of Pharmacology, ISF College of Pharmacy, Moga, 142001, Punjab, India.
| | - Swesha Chhabra
- Division of Neuroscience, Department of Pharmacology, ISF College of Pharmacy, Moga, 142001, Punjab, India
| | - Aditi Giri
- Division of Neuroscience, Department of Pharmacology, ISF College of Pharmacy, Moga, 142001, Punjab, India
| | - Kajal Sherawat
- Division of Neuroscience, Department of Pharmacology, ISF College of Pharmacy, Moga, 142001, Punjab, India
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10
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Murphy MD, Heller EA. Convergent actions of stress and stimulants via epigenetic regulation of neural circuitry. Trends Neurosci 2022; 45:955-967. [PMID: 36280459 PMCID: PMC9671852 DOI: 10.1016/j.tins.2022.10.001] [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: 07/18/2022] [Revised: 09/21/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022]
Abstract
The dorsal striatum integrates prior and current information to guide appropriate decision-making. Chronic stress and stimulant exposure interferes with decision-making, and can confer similar cognitive and behavioral inflexibilities. This review examines the literature on acute and chronic regulation of the epigenome by stress and stimulants. Recent evidence suggests that exposures to stress and stimulants share similarities in the manners in which they regulate the dorsal striatum epigenome through DNA methylation, transposable element activity, and histone post-translational modifications. These findings suggest that chronic stress and stimulant exposure leads to the accumulation of epigenetic modifications that impair immediate and future neuron function and activity. Such epigenetic mechanisms represent potential therapeutic targets for ameliorating convergent symptoms of stress and addiction.
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Affiliation(s)
- Michael D Murphy
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, 19104, USA; Institute for Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, PA, 19104, USA; Penn Epigenetics Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Elizabeth A Heller
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, PA, 19104, USA; Penn Epigenetics Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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11
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Zhou Z, Li B, Jiang J, Li H, Cao L, Zhang S, Gao Y, Zhang L, Qiu C, Huang X, Gong Q. Abnormal resting-state functional connectivity of the insula in medication-free patients with obsessive-compulsive disorder. BMC Psychiatry 2022; 22:742. [PMID: 36447147 PMCID: PMC9710058 DOI: 10.1186/s12888-022-04341-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/13/2022] [Accepted: 10/26/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The function of the insula has been increasingly mentioned in neurocircuitry models of obsessive-compulsive disorder (OCD) for its role in affective processing and regulating anxiety and its wide interactions with the classic cortico-striato-thalamo-cortical circuit. However, the insular resting-state functional connectivity patterns in OCD remain unclear. Therefore, we aimed to investigate characteristic intrinsic connectivity alterations of the insula in OCD and their associations with clinical features. METHODS We obtained resting-state functional magnetic resonance imaging data from 85 drug-free OCD patients and 85 age- and sex-matched healthy controls (HCs). We performed a general linear model to compare the whole-brain intrinsic functional connectivity maps of the bilateral insula between the OCD and HC groups. In addition, we further explored the relationship between the intrinsic functional connectivity alterations of the insula and clinical features using Pearson or Spearman correlation analysis. RESULTS Compared with HCs, patients with OCD exhibited increased intrinsic connectivity between the bilateral insula and bilateral precuneus gyrus extending to the inferior parietal lobule and supplementary motor area. Decreased intrinsic connectivity was only found between the right insula and bilateral lingual gyrus in OCD patients relative to HC subjects, which was negatively correlated with the severity of depression symptoms in the OCD group. CONCLUSION In the current study, we identified impaired insular intrinsic connectivity in OCD patients and the dysconnectivity of the right insula and bilateral lingual gyrus associated with the depressive severity of OCD patients. These findings provide neuroimaging evidence for the involvement of the insula in OCD and suggest its potential role in the depressive symptoms of OCD.
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Affiliation(s)
- Zilin Zhou
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041 Chengdu, China
| | - Bin Li
- grid.412901.f0000 0004 1770 1022Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Jiaxin Jiang
- grid.412901.f0000 0004 1770 1022Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, China
| | - Hailong Li
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041 Chengdu, China
| | - Lingxiao Cao
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041 Chengdu, China
| | - Suming Zhang
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041 Chengdu, China
| | - Yingxue Gao
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041 Chengdu, China
| | - Lianqing Zhang
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041 Chengdu, China
| | - Changjian Qiu
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, 610041, Chengdu, China.
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041, Chengdu, China. .,Psychoradiology Research Unit of the Chinese Academy of Medical Science (2018RU011), West China Hospital of Sichuan University, Chengdu, China. .,Frontiers Science Center for Disease-related Molecular Network, West China Hospital of Sichuan University, Chengdu, China.
| | - Qiyong Gong
- grid.412901.f0000 0004 1770 1022Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041 Chengdu, China ,grid.412901.f0000 0004 1770 1022Psychoradiology Research Unit of the Chinese Academy of Medical Science (2018RU011), West China Hospital of Sichuan University, Chengdu, China
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12
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Bekhbat M, Li Z, Mehta ND, Treadway MT, Lucido MJ, Woolwine BJ, Haroon E, Miller AH, Felger JC. Functional connectivity in reward circuitry and symptoms of anhedonia as therapeutic targets in depression with high inflammation: evidence from a dopamine challenge study. Mol Psychiatry 2022; 27:4113-4121. [PMID: 35927580 PMCID: PMC9718669 DOI: 10.1038/s41380-022-01715-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 07/06/2022] [Accepted: 07/19/2022] [Indexed: 02/07/2023]
Abstract
Increased inflammation in major depressive disorder (MDD) has been associated with low functional connectivity (FC) in corticostriatal reward circuits and symptoms of anhedonia, relationships which may involve the impact of inflammation on synthesis and release of dopamine. To test this hypothesis while establishing a platform to examine target engagement of potential therapies in patients with increased inflammation, medically stable unmedicated adult MDD outpatients enrolled to have a range of inflammation (as indexed by plasma C-reactive protein [CRP] levels) were studied at two visits involving acute challenge with the dopamine precursor levodopa (L-DOPA; 250 mg) and placebo (double-blind, randomized order ~1-week apart). The primary outcome of resting-state (rs)FC in a classic ventral striatum to ventromedial prefrontal cortex reward circuit was calculated using a targeted, a priori approach. Data available both pre- and post-challenge (n = 31/40) established stability of rsFC across visits and determined CRP > 2 mg/L as a cut-point for patients exhibiting positive FC responses (post minus pre) to L-DOPA versus placebo (p < 0.01). Higher post-L-DOPA FC in patients with CRP > 2 mg/L was confirmed in all patients (n = 40) where rsFC data were available post-challenge (B = 0.15, p = 0.006), and in those with task-based (tb)FC during reward anticipation (B = 0.15, p = 0.013). While effort-based motivation outside the scanner positively correlated with rsFC independent of treatment or CRP, change in anhedonia scores negatively correlated with rsFC after L-DOPA only in patients with CRP > 2 mg/L (r = -0.56, p = 0.012). FC in reward circuitry should be further validated in larger samples as a biomarker of target engagement for potential treatments including dopaminergic agents in MDD patients with increased inflammation.
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Affiliation(s)
- Mandakh Bekhbat
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30322, USA
| | - Zhihao Li
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30322, USA
- School of Psychology and Sociology, Shenzhen University, Shenzhen, 518060, Guangdong Sheng, China
| | - Namrataa D Mehta
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30322, USA
- Neuroscience Graduate Program, Graduate Division of Biological and Biomedical Sciences, Emory University, Atlanta, GA, 30322, USA
| | - Michael T Treadway
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30322, USA
- Department of Psychology, Emory University, Atlanta, GA, 30322, USA
- The Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
| | - Michael J Lucido
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30322, USA
| | - Bobbi J Woolwine
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30322, USA
| | - Ebrahim Haroon
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30322, USA
- The Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
| | - Andrew H Miller
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30322, USA
- The Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
| | - Jennifer C Felger
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, 30322, USA.
- The Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA.
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13
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Kammen A, Cavaleri J, Lam J, Frank AC, Mason X, Choi W, Penn M, Brasfield K, Van Noppen B, Murray SB, Lee DJ. Neuromodulation of OCD: A review of invasive and non-invasive methods. Front Neurol 2022; 13:909264. [PMID: 36016538 PMCID: PMC9397524 DOI: 10.3389/fneur.2022.909264] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/19/2022] [Indexed: 12/27/2022] Open
Abstract
Early research into neural correlates of obsessive compulsive disorder (OCD) has focused on individual components, several network-based models have emerged from more recent data on dysfunction within brain networks, including the the lateral orbitofrontal cortex (lOFC)-ventromedial caudate, limbic, salience, and default mode networks. Moreover, the interplay between multiple brain networks has been increasingly recognized. As the understanding of the neural circuitry underlying the pathophysiology of OCD continues to evolve, so will too our ability to specifically target these networks using invasive and noninvasive methods. This review discusses the rationale for and theory behind neuromodulation in the treatment of OCD.
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Affiliation(s)
- Alexandra Kammen
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jonathon Cavaleri
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jordan Lam
- Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States
| | - Adam C. Frank
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Xenos Mason
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Wooseong Choi
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Marisa Penn
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Kaevon Brasfield
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Barbara Van Noppen
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Stuart B. Murray
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Darrin Jason Lee
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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14
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Wang Z, Fontaine M, Cyr M, Rynn MA, Simpson HB, Marsh R, Pagliaccio D. Subcortical shape in pediatric and adult obsessive-compulsive disorder. Depress Anxiety 2022; 39:504-514. [PMID: 35485920 PMCID: PMC9813975 DOI: 10.1002/da.23261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/22/2022] [Accepted: 04/16/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) implicates alterations in cortico-striato-thalamo-cortical and fronto-limbic circuits. Building on prior structural findings, this is the largest study to date examining subcortical surface morphometry in OCD. METHODS Structural magnetic resonance imaging data were collected from 200 participants across development (5-55 years): 28 youth and 75 adults with OCD and 27 psychiatrically healthy youth and 70 adults. General linear models were used to assess group differences and group-by-age interactions on subcortical shape (FSL FIRST). RESULTS Compared to healthy participants, those with OCD exhibited surface expansions on the right nucleus accumbens and inward left amygdala deformations, which were associated with greater OCD symptom severity ([Children's] Yale-Brown Obsessive-Compulsive Scale). Group-by-age interactions indicated that accumbens group differences were driven by younger participants and that right pallidum shape was associated inversely with age in healthy participants, but not in participants with OCD. No differences in the shape of other subcortical regions or in volumes (FreeSurfer) were detected in supplementary analyses. CONCLUSIONS This study is the largest to date examining subcortical shape in OCD and the first to do so across the developmental spectrum. NAcc and amygdala shape deformation builds on extant neuroimaging findings and suggests subtle, subregional alterations beyond volumetric findings. Results shed light on morphometric alterations in OCD, informing current pathophysiological models.
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Affiliation(s)
- Zhishun Wang
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Martine Fontaine
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Marilyn Cyr
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Moira A. Rynn
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Helen Blair Simpson
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Rachel Marsh
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - David Pagliaccio
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
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15
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Kim T, Kim M, Jung WH, Kwak YB, Moon SY, Kyungjin Lho S, Lee J, Kwon JS. Unbalanced fronto-pallidal neurocircuit underlying set shifting in obsessive-compulsive disorder. Brain 2022; 145:979-990. [PMID: 35484084 DOI: 10.1093/brain/awab483] [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: 05/26/2021] [Revised: 11/19/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Maladaptive habitual behaviours of obsessive-compulsive disorder are characterized by cognitive inflexibility, which hypothetically arises from dysfunctions of a certain cortico-basal ganglia-thalamo-cortical circuit including the ventrolateral prefrontal region. Inside this neurocircuit, an imbalance between distinct striatal projections to basal ganglia output nuclei, either directly or indirectly via the external globus pallidus, is suggested to be relevant for impaired arbitration between facilitation and inhibition of cortically initiated activity. However, current evidence of individually altered cortico-striatal or thalamo-cortical connectivities is insufficient to understand how cortical dysconnections are linked to the imbalanced basal ganglia system in patients. In this study, we aimed to identify aberrant ventrolateral prefronto-basal ganglia-thalamic subnetworks representing direct-indirect imbalance and its association with cognitive inflexibility in patients. To increase network detection sensitivity, we constructed a cortico-basal ganglia-thalamo-cortical network model incorporating striatal, pallidal and thalamic subregions defined by unsupervised clustering in 105 medication-free patients with obsessive-compulsive disorder (age = 25.05 ± 6.55 years, male/female = 70/35) and 99 healthy controls (age = 23.93 ± 5.80 years, male/female = 64/35). By using the network-based statistic method, we analysed group differences in subnetworks formed by suprathreshold dysconnectivities. Using linear regression models, we tested subnetwork dysconnectivity effects on symptom severity and set-shifting performance assessed by well-validated clinical and cognitive tests. Compared with the healthy controls, patients were slower to track the Part B sequence of the Trail Making Test when the effects of psychomotor and visuospatial functions were adjusted (t = 3.89, P < 0.001) and made more extradimensional shift errors (t = 4.09, P < 0.001). In addition to reduced fronto-striatal and striato-external pallidal connectivities and hypoconnected striato-thalamic subnetwork [P = 0.001, family-wise error rate (FWER) corrected], patients had hyperconnected fronto-external pallidal (P = 0.012, FWER corrected) and intra-thalamic (P = 0.015, FWER corrected) subnetworks compared with the healthy controls. Among the patients, the fronto-pallidal subnetwork alteration, especially ventrolateral prefronto-external globus pallidal hyperconnectivity, was associated with relatively fewer extradimensional shifting errors (β = -0.30, P = 0.001). Our findings suggest that the hyperconnected fronto-external pallidal subnetwork may have an opposite effect to the imbalance caused by the reduced indirect pathway (fronto-striato-external pallidal) connectivities in patients. This ventrolateral prefrontal hyperconnectivity may help the external globus pallidus disinhibit basal ganglia output nuclei, which results in behavioural inhibition, so as to compensate for the impaired set shifting. We suggest the ventrolateral prefrontal and external globus pallidus as neuromodulatory targets for inflexible habitual behaviours in obsessive-compulsive disorder.
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Affiliation(s)
- Taekwan Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Republic of Korea.,Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, Republic of Korea
| | - Minah Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Wi Hoon Jung
- Department of Psychology, Gachon University, Seongnam 13120, Republic of Korea
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Republic of Korea
| | - Sun-Young Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Silvia Kyungjin Lho
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Junhee Lee
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul 03080, Republic of Korea
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 08826, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.,Institute of Human Behavioral Medicine, SNU-MRC, Seoul 03080, Republic of Korea
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16
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Shephard E, Stern ER, Miguel EC. Obsessive-Compulsive Disorder Treatment Based on Neurocircuits. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220317-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Distinct alterations of amygdala subregional functional connectivity in early- and late-onset obsessive-compulsive disorder. J Affect Disord 2022; 298:421-430. [PMID: 34748823 DOI: 10.1016/j.jad.2021.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Age of onset may be an important feature associated with distinct subtypes of obsessive-compulsive disorder (OCD). The amygdala joined neurocircuitry models of OCD for its role in mediating fear and regulating anxiety. The present study aims to identify the underlying pathophysiological specifics in OCD with different onset times by assessing amygdala subregional functional connectivity (FC) alterations in early-onset OCD (EO-OCD) and late-onset OCD (LO-OCD). METHODS Resting-state functional magnetic resonance imaging data were acquired from 88 medication-free OCD patients (including 30 EO-OCD and 58 LO-OCD) and age- and sex-matched healthy controls (HC) for each patient group. Onset-by-diagnosis interactions were examined and comparisons between each OCD group and the corresponding HC group were performed regarding the FC of amygdala subregions including the basolateral amygdala (BLA), centromedial amygdala (CMA), superficial amygdala (SFA) and amygdalostriatal transition area (Astr). RESULTS Significant onset-by-diagnosis interactions were found in FC between bilateral SFA, right CMA, left Astr and the cerebellum. EO-OCD patients showed abnormally increased BLA/SFA-cerebellum, BLA-precuneus and BLA/SFA-fusiform connectivity in addition to decreased BLA/SFA-orbitofrontal cortex connectivity. In contrast, LO-OCD patients exhibited increased CMA/Astr-precentral/postcentral gyrus and CMA-cuneus connectivity as well as decreased CMA/Astr-cerebellum and BLA-striatum connectivity. LIMITATIONS The exclusion of comorbidity may reduce the generalizability of our results. CONCLUSIONS These findings emphasized the different patterns of amygdala subregional connectivity alterations associated with EO-OCD and LO-OCD patients. These results provide unique insights into constructing evidence-based distinct OCD subtypes based on brain intrinsic connectivity and point to the need of specified management for EO-OCD and LO-OCD in clinical setting.
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18
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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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19
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Childhood adversity affects symptomatology via behavioral inhibition in patients with obsessive-compulsive disorder. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02718-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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20
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Li N, Hollunder B, Baldermann JC, Kibleur A, Treu S, Akram H, Al-Fatly B, Strange BA, Barcia JA, Zrinzo L, Joyce EM, Chabardes S, Visser-Vandewalle V, Polosan M, Kuhn J, Kühn AA, Horn A. A Unified Functional Network Target for Deep Brain Stimulation in Obsessive-Compulsive Disorder. Biol Psychiatry 2021; 90:701-713. [PMID: 34134839 DOI: 10.1016/j.biopsych.2021.04.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Multiple deep brain stimulation (DBS) targets have been proposed for treating intractable obsessive-compulsive disorder (OCD). Here, we investigated whether stimulation effects of different target sites would be mediated by one common or several segregated functional brain networks. METHODS First, seeding from active electrodes of 4 OCD patient cohorts (N = 50) receiving DBS to anterior limb of the internal capsule or subthalamic nucleus zones, optimal functional connectivity profiles for maximal Yale-Brown Obsessive Compulsive Scale improvements were calculated and cross-validated in leave-one-cohort-out and leave-one-patient-out designs. Second, we derived optimal target-specific connectivity patterns to determine brain regions mutually predictive of clinical outcome for both targets and others predictive for either target alone. Functional connectivity was defined using resting-state functional magnetic resonance imaging data acquired in 1000 healthy participants. RESULTS While optimal functional connectivity profiles showed both commonalities and differences between target sites, robust cross-predictions of clinical improvements across OCD cohorts and targets suggested a shared network. Connectivity to the anterior cingulate cortex, insula, and precuneus, among other regions, was predictive regardless of stimulation target. Regions with maximal connectivity to these commonly predictive areas included the insula, superior frontal gyrus, anterior cingulate cortex, and anterior thalamus, as well as the original stereotactic targets. CONCLUSIONS Pinpointing the network modulated by DBS for OCD from different target sites identified a set of brain regions to which DBS electrodes associated with optimal outcomes were functionally connected-regardless of target choice. On these grounds, we establish potential brain areas that could prospectively inform additional or alternative neuromodulation targets for obsessive-compulsive disorder.
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Affiliation(s)
- Ningfei Li
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany.
| | - Barbara Hollunder
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany; Charité - Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany; Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Juan Carlos Baldermann
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne; Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Astrid Kibleur
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut des Neurosciences (AK, SC, MP), Grenoble; and OpenMind Innovation (AK), Paris, France; OpenMind Innovation, Paris, France
| | - Svenja Treu
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
| | - Harith Akram
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust (UCLH), London, United Kingdom
| | - Bassam Al-Fatly
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany
| | - Bryan A Strange
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
| | - Juan A Barcia
- Neurosurgery Department, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Ludvic Zrinzo
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust (UCLH), London, United Kingdom
| | - Eileen M Joyce
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust (UCLH), London, United Kingdom
| | - Stephan Chabardes
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut des Neurosciences (AK, SC, MP), Grenoble; and OpenMind Innovation (AK), Paris, France
| | | | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut des Neurosciences (AK, SC, MP), Grenoble; and OpenMind Innovation (AK), Paris, France
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Johanniter Hospital Oberhausen, Evangelisches Klinikum Niederrhein, Oberhausen, Germany
| | - Andrea A Kühn
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany; Charité - Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany; Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Horn
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany; Charité - Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
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Jung WH, Lee TY, Kim M, Lee J, Oh S, Lho SK, Moon SY, Kwon JS. Sex Differences in the Behavioral Inhibition System and Ventromedial Prefrontal Cortex Connectivity. Soc Cogn Affect Neurosci 2021; 17:571-578. [PMID: 34718814 PMCID: PMC9164205 DOI: 10.1093/scan/nsab118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 10/07/2021] [Accepted: 10/26/2021] [Indexed: 01/08/2023] Open
Abstract
The reinforcement sensitivity theory proposes brain–behavioral systems that underlie individual differences in sensitivity to punishment and reward. Such trait sensitivity is assessed using the behavioral inhibition/activation system (BIS/BAS) scales. Recent studies have reported sex-linked neuroanatomical correlates of the BIS/BAS, especially in the regions belonging to the valuation and salience networks that are associated with the representation of subjective value (SV), whereas less effort has been focused on investigating the neurofunctional aspects associated with sex differences in the BIS/BAS. We tested whether functional connectivity (FC) of the regions associated with the representation of SV mediates the relationship between sex and BIS sensitivity in healthy young adults by using resting-state functional magnetic resonance imaging data and self-reported BIS/BAS measures. Compared with males, females had heightened BIS sensitivity and increased FC between the ventromedial prefrontal cortex (vmPFC) seed and posterior parietal areas; this FC mediated the impact of sex on BIS sensitivity. Given that the observed vmPFC FC maps are considered part of the default-mode network, which is involved in ruminative processes, and that the BIS is associated with rumination and negative affect, our results may have implications for psychiatric disorders such as depression and anxiety, both of which have high incidence in females.
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Affiliation(s)
- Wi Hoon Jung
- Department of Psychology, Daegu University, Gyeongsan 38453, Republic of Korea
| | - Tae Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Minah Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Junhee Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sanghoon Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Silvia Kyungjin Lho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun-Young Moon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Science, Seoul, Republic of Korea.,Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
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22
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Shephard E, Stern ER, van den Heuvel OA, Costa DL, Batistuzzo MC, Godoy PB, Lopes AC, Brunoni AR, Hoexter MQ, Shavitt RG, Reddy JY, Lochner C, Stein DJ, Simpson HB, Miguel EC. Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder. Mol Psychiatry 2021; 26:4583-4604. [PMID: 33414496 PMCID: PMC8260628 DOI: 10.1038/s41380-020-01007-8] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022]
Abstract
An important challenge in mental health research is to translate findings from cognitive neuroscience and neuroimaging research into effective treatments that target the neurobiological alterations involved in psychiatric symptoms. To address this challenge, in this review we propose a heuristic neurocircuit-based taxonomy to guide the treatment of obsessive-compulsive disorder (OCD). We do this by integrating information from several sources. First, we provide case vignettes in which patients with OCD describe their symptoms and discuss different clinical profiles in the phenotypic expression of the condition. Second, we link variations in these clinical profiles to underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider behavioral, pharmacological, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions. Finally, we suggest methods of testing this neurocircuit-based taxonomy as well as important limitations to this approach that should be considered in future research.
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Affiliation(s)
- Elizabeth Shephard
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. .,Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
| | - Emily R. Stern
- Department of Psychiatry, The New York University School of Medicine, New York, USA.,Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
| | - Odile A. van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Daniel L.C. Costa
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C. Batistuzzo
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Priscilla B.G. Godoy
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Antonio C. Lopes
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Andre R. Brunoni
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Q. Hoexter
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roseli G. Shavitt
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Janardhan Y.C Reddy
- Department of Psychiatry OCD Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Christine Lochner
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - H. Blair Simpson
- Center for OCD and Related Disorders, New York State Psychiatric Institute and the Department of Psychiatry, Columbia University Irving Medical Center, New York New York
| | - Euripedes C. Miguel
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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23
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Peng Z, Guo Y, Wu X, Yang Q, Wei Z, Seger CA, Chen Q. Abnormal brain functional network dynamics in obsessive-compulsive disorder patients and their unaffected first-degree relatives. Hum Brain Mapp 2021; 42:4387-4398. [PMID: 34089285 PMCID: PMC8356985 DOI: 10.1002/hbm.25555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/14/2021] [Accepted: 05/26/2021] [Indexed: 01/01/2023] Open
Abstract
We utilized dynamic functional network connectivity (dFNC) analysis to compare participants with obsessive–compulsive disorder (OCD) with their unaffected first‐degree relative (UFDR) and healthy controls (HC). Resting state fMRI was performed on 46 OCD, 24 UFDR, and 49 HCs, along with clinical assessments. dFNC analyses revealed two distinct connectivity states: a less frequent, integrated state characterized by the predominance of between‐network connections (State I), and a more frequent, segregated state with strong within‐network connections (State II). OCD patients spent more time in State II and less time in State I than HC, as measured by fractional windows and mean dwell time. Time in each state for the UFDR were intermediate between OCD patients and HC. Within the OCD group, fractional windows of time spent in State I was positively correlated with OCD symptoms (as measured by the obsessive compulsive inventory‐revised [OCI‐R], r = .343, p<.05, FDR correction) and time in State II was negatively correlated with symptoms (r = −.343, p<.05, FDR correction). Within each state we also examined connectivity within and between established intrinsic connectivity networks, and found that UFDR were similar to the OCD group in State I, but more similar to the HC groups in State II. The similarities between OCD and UFDR groups in temporal properties and State I connectivity indicate that these features may reflect the endophenotype for OCD. These results indicate that the temporal dynamics of functional connectivity could be a useful biomarker to identify those at risk.
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Affiliation(s)
- Ziwen Peng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Ya Guo
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xiangshu Wu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Qiong Yang
- Department of Psychiatry, Southern Medical University, Guangzhou, China.,Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhen Wei
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Carol A Seger
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Qi Chen
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
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24
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Decreased Nucleus Accumbens Connectivity at Rest in Medication-Free Patients with Obsessive-Compulsive Disorder. Neural Plast 2021; 2021:9966378. [PMID: 34158811 PMCID: PMC8187042 DOI: 10.1155/2021/9966378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/08/2021] [Accepted: 05/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background Patients with obsessive-compulsive disorder (OCD) experience deficiencies in reward processing. The investigation of the reward circuit and its essential connectivity may further clarify the pathogenesis of OCD. Methods The current research was designed to analyze the nucleus accumbens (NAc) functional connectivity at rest in medicine-free patients with OCD. Forty medication-free patients and 38 gender-, education-, and age-matched healthy controls (HCs) were recruited for resting-state functional magnetic resonance imaging. Seed-based functional connectivity (FC) was used to analyze the data. LIBSVM (library for support vector machines) was designed to identify whether altered FC could be applied to differentiate OCD. Results Patients with OCD showed remarkably decreased FC values between the left NAc and the bilateral orbitofrontal cortex (OFC) and bilateral medial prefrontal cortex (MPFC) and between the right NAc and the left OFC at rest in the reward circuit. Moreover, decreased left NAc-bilateral MPFC connectivity can be deemed as a potential biomarker to differentiate OCD from HCs with a sensitivity of 80.00% and a specificity of 76.32%. Conclusion The current results emphasize the importance of the reward circuit in the pathogenesis of OCD.
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25
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Frontoparietal hyperconnectivity during cognitive regulation in obsessive-compulsive disorder followed by reward valuation inflexibility. J Psychiatr Res 2021; 137:657-666. [PMID: 33187688 DOI: 10.1016/j.jpsychires.2020.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 10/01/2020] [Accepted: 11/01/2020] [Indexed: 12/11/2022]
Abstract
Obsessive-compulsive disorder (OCD) is characterized by cognitive deficits and altered reward processing systems. An imbalance between cognitive and reward pathways may explain the lack of control over obsessions followed by rewarding compulsive behaviors. While the processes of emotional cognitive regulation are widely studied in OCD, the mechanisms of cognitive regulation of reward are poorly described. Our goal was to investigate the OCD impact on cognitive regulation of reward at behavioral and neural functioning levels. OCD and control participants performed a functional magnetic resonance imaging task where they cognitively modulated their craving for food pictures under three cognitive regulation conditions: indulge/increase craving, distance/decrease craving, and natural/no regulation of craving. After regulation, the participants gave each picture a monetary value. We found that OCD patients had fixed food valuation scores while the control group modulated these values accordingly to the regulation conditions. Moreover, we observed frontoparietal hyperconnectivity during cognitive regulation. Our results suggest that OCD is characterized by deficits in cognitive regulation of internal states associated with inflexible behavior during reward processing. These findings bring new insights into the nature of compulsive behaviors in OCD.
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26
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Kryza-Lacombe M, Pearson N, Lyubomirsky S, Stein MB, Wiggins JL, Taylor CT. Changes in neural reward processing following Amplification of Positivity treatment for depression and anxiety: Preliminary findings from a randomized waitlist controlled trial. Behav Res Ther 2021; 142:103860. [PMID: 33894554 DOI: 10.1016/j.brat.2021.103860] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/17/2021] [Accepted: 03/30/2021] [Indexed: 11/16/2022]
Abstract
Positive valence system (PVS) deficits are increasingly recognized as important treatment targets for depression and anxiety. Emerging behavioral treatments designed to upregulate the PVS show initial promise; however, neural mechanisms underlying these approaches remain unknown. This study investigated neural reward-processing-related changes following Amplification of Positivity (AMP)-a treatment designed to enhance positive thinking, emotions and behaviors through positive activity interventions (Clinicaltrials.gov: NCT02330627). Individuals with depression and/or anxiety (N = 29) were randomized to 10 sessions of AMP (n = 16) or waitlist (WL; n = 13). Participants completed a monetary incentive delay task during fMRI at baseline and post-assessment. Hypothesis-driven region of interest (ventral striatum, insula, anterior cingulate) and exploratory whole-brain activation and connectivity analyses evaluated pre-to-post changes for AMP vs. WL when anticipating potential monetary gain or loss. No between-group brain activation changes emerged in regions of interest or whole-brain analyses. Increased neural connectivity from pre-to-post-treatment was observed in AMP vs. WL, including ventral striatum, anterior insula, and anterior cingulate connectivity with prefrontal, limbic, occipital and parietal regions-predominantly during loss anticipation. This preliminary study is the first to examine neural mechanisms of positive activity interventions in depression and anxiety and suggests that AMP may strengthen brain connectivity in reward processing, attention, and emotion regulation networks.
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Affiliation(s)
- Maria Kryza-Lacombe
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States
| | - Nana Pearson
- Department of Psychiatry, University of California, San Diego, United States
| | - Sonja Lyubomirsky
- Department of Psychology, University of California, Riverside, United States
| | - Murray B Stein
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychiatry, University of California, San Diego, United States
| | - Jillian Lee Wiggins
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychology, San Diego State University, United States
| | - Charles T Taylor
- San Diego State University, University of California, San Diego Joint Doctoral Program in Clinical Psychology, United States; Department of Psychiatry, University of California, San Diego, United States.
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27
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Clinical risk factors, phenomenology and the impact of clozapine induced obsessive compulsive symptoms. Psychiatry Res 2021; 296:113665. [PMID: 33465593 DOI: 10.1016/j.psychres.2020.113665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/19/2020] [Indexed: 11/23/2022]
Abstract
The aim of this study was to investigate the clinical risk factors, phenomenology and the impact of clozapine induced obsessive-compulsive symptoms (OCS) in patients with schizophrenia. One hundred twenty-two patients receiving clozapine treatment for at least 6 weeks were assessed with Structured Clinical Interview for Axis-I Disorders for DSM-IV, Positive and Negative Syndrome Scale, Yale-Brown Obsessive Compulsive Scale and Checklist, Calgary Depression Scale, Clinical Global Impression Scale and WHO-Disability Assessment Schedule-II. Information about past and current clinical status were gathered through clinical interviews and medical records. With clozapine 44.3% of the patients had de novo OCS, 33.6% had OCS both before and after clozapine, 21.3% didn't report any OCS. Clozapine doses, clozapine and norclozapine plasma levels were not significantly different. Severity of OCS was affected by clozapine and norclozapine plasma levels, and correlated with increased disability. Obsessions were less in clozapine induced OCS group, and compulsions, especially of checking subtypes, were predominant, compared to the group with prior history of OCS, who reported a significant increase in checking compulsion after clozapine treatment. Clozapine induced OCS should be considered during cost/benefit assessment of clozapine treatment, and understanding the risk factors and its different phenomenology may shed light into the underlying mechanisms.
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28
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Abstract
In the last 20 years, functional magnetic resonance imaging (fMRI) has been extensively used to investigate system-level abnormalities in the brain of patients with obsessive-compulsive disorder (OCD). In this chapter, we start by reviewing the studies assessing regional brain differences between patients with OCD and healthy controls in task-based fMRI. Specifically, we review studies on executive functioning and emotional processing, protocols in which these patients have been described to show alterations at the behavioral level, as well as research using symptom provocation protocols. Next, we review studies on brain connectivity alterations, focusing on resting-state studies evaluating disruptions in fronto-subcortical functional connectivity and in cortical networks. Likewise, we also review research on effective connectivity, which, different from functional connectivity, allows for ascertaining the directionality of inter-regional connectivity alterations. We conclude by reviewing the most significant findings on a topic of translational impact, such as the use of different fMRI measurements to predict response across a variety of treatment approaches. Overall, results suggest that there exists a pattern of regions, involving, but not limited to, different nodes of the cortico-striatal-thalamo-cortical circuits, showing robust evidence of functional alteration across studies, although the nature of the alterations critically depends on the specific tasks and their particular demands. Moreover, such findings have been, to date, poorly translated into clinical practice. It is suggested that this may be partially accounted for by the difficulty to integrate into a common framework results obtained under a wide variety of analysis approaches.
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Affiliation(s)
- Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain. .,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain.
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29
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Karapanagiotidis T, Jefferies E, Smallwood J. Interactions between the neural correlates of dispositional internally directed thought and visual imagery. Philos Trans R Soc Lond B Biol Sci 2020; 376:20190691. [PMID: 33308072 DOI: 10.1098/rstb.2019.0691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Cognition is not always directed to the events in the here and now and we often self-generate thoughts and images in imagination. Important aspects of these self-generated experiences are associated with various dispositional traits. In this study, we explored whether these psychological associations relate to a common underlying neurocognitive mechanism. We acquired resting state functional magnetic resonance imaging data from a large cohort of participants and asked them to retrospectively report their experience during the scan. Participants also completed questionnaires reflecting a range of dispositional traits. We found thoughts emphasizing visual imagery at rest were associated with dispositional tendency towards internally directed attention (self-consciousness and attentional problems) and linked to a stronger correlation between a posterior parietal network and a lateral fronto-temporal network. Furthermore, decoupling between the brainstem and a lateral visual network was associated with dispositional internally directed attention. Critically, these brain-cognition associations were related: the correlation between parietal-frontal regions and reports of visual imagery was stronger for individuals with increased connectivity between brainstem and visual cortex. Our results highlight neural mechanisms linked to the dispositional basis for patterns of self-generated thought, and suggest that accounting for dispositional traits is important when exploring the neural substrates of self-generated experience (and vice versa). This article is part of the theme issue 'Offline perception: voluntary and spontaneous perceptual experiences without matching external stimulation'.
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Affiliation(s)
| | - Elizabeth Jefferies
- Department of Psychology, York Neuroimaging Centre, University of York, York YO10 5DD, UK
| | - Jonathan Smallwood
- Department of Psychology, York Neuroimaging Centre, University of York, York YO10 5DD, UK
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30
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Intelligence quotient level and treatment of obsessive-compulsive disorders: Meta-analyses. Med Hypotheses 2020; 144:109995. [DOI: 10.1016/j.mehy.2020.109995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 11/22/2022]
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31
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Beucke JC, Simon D, Sepulcre J, Talukdar T, Feusner JD, Kaufmann C, Kathmann N. Heightened degree connectivity of the striatum in obsessive-compulsive disorder induced by symptom provocation. J Affect Disord 2020; 276:1069-1076. [PMID: 32768879 DOI: 10.1016/j.jad.2020.07.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/10/2020] [Accepted: 07/05/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Neurosurgical intervention studies have provided direct evidence that the ventral striatum/nucleus accumbens (NAc) mediates symptoms of obsessive-compulsive disorder (OCD), yet meta-analysis of functional neuroimaging studies using symptom provocation revealed no striatal activation differences, and the existing studies reporting hyperactivity found abnormalities in dorsal but not ventral striatal subdivisions. Resting-state neuroimaging evidence holds that corticostriatal areas are more connected both locally and to distant regions, but the functional inferences to be drawn from these altered network characteristics regarding the present experience of OCD symptoms remain limited. METHODS The present study tested whether symptom provocation induces abnormally high striatal network connectivity using two independent datasets of unmedicated patients with OCD. One study (14 patients, 14 matched controls) required passive viewing of OC-related, emotionally aversive and neutral pictures, the other (21 patients, 21 controls) involved self-referential evaluation of the same picture types, as well as distraction from these stimuli (engagement in a simple task). RESULTS Heightened local connectivity of the dorsal striatum occurred during passive viewing of briefly presented OC-related pictures in patients, however group differences were also observed in a neutral control condition. In contrast, distracted symptom provocation selectively yielded local connectivity differences of the ventral striatum, as heightened NAc connectivity to its immediate neighborhood was exclusively observed when OC-related pictures were accompanied by concurrent task demands. LIMITATIONS Small samples sizes. CONCLUSIONS In moderately affected patients with OCD, symptom provocation induces a discrete, condition-specific network abnormality anchored in NAc, the location targeted by deep brain stimulation for refractory patients with OCD.
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Affiliation(s)
- Jan C Beucke
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Daniela Simon
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jorge Sepulcre
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
| | - Tanveer Talukdar
- Decision Neuroscience Laboratory, Beckman Institute, Urbana, IL, United States
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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32
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Fajnerova I, Gregus D, Francova A, Noskova E, Koprivova J, Stopkova P, Hlinka J, Horacek J. Functional Connectivity Changes in Obsessive-Compulsive Disorder Correspond to Interference Control and Obsessions Severity. Front Neurol 2020; 11:568. [PMID: 32973642 PMCID: PMC7468468 DOI: 10.3389/fneur.2020.00568] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 05/19/2020] [Indexed: 12/20/2022] Open
Abstract
Introduction: Deficits in neurocognitive mechanisms such as inhibition control and cognitive flexibility have been suggested to mediate the symptoms in obsessive-compulsive disorder (OCD). These mechanisms are proposedly controlled by the "affective" and "executive" orbitofronto-striato-thalamo-cortical (CSTC) circuits with well-documented morphological and functional alterations in OCD that are associated with OCD symptoms. The precuneus region has been suggested in OCD as another key structure associated with the mechanism of "thought-action fusion." Our study aimed to elucidate the association of the altered functional coupling of the CSTC nodes (and precuneus), the OCD symptoms, and interference control/cognitive flexibility. Methods: In a group of 36 (17 medicated and 19 drug-free) OCD patients and matched healthy volunteers, we tested functional connectivity (FC) within the constituents of the dorsolateral prefrontal cortex "executive" CSTC, the orbitofrontal cortex/anterior cingulate "affective" CSTC, and precuneus. The functional connections showing the strongest effects were subsequently entered as explanatory variables to multiple regression analyses to identify possible associations between observed alterations of functional coupling and cognitive (Stroop test) and clinical measures (obsessions, compulsions, and anxiety level). Results: We observed increased FC (FWE p < 0.05 corr.) between CSTC seeds and regions of the parieto-occipital cortex, and between the precuneus and the angular gyrus and dorsolateral prefrontal cortex. Decreased FC was observed within the CSTC loop (caudate nucleus and thalamus) and between the anterior cingulate cortex and the limbic lobe. Linear regression identified a relationship between the altered functional coupling of thalamus with the right somatomotor parietal cortex and the Stroop color-word score. Similar association of thalamus FC has been identified also for obsessions severity. No association was observed for compulsions and anxiety. Conclusions: Our findings demonstrate altered FC in OCD patients with a prevailing increase in FC originating in CSTC regions toward other cortical areas, and a decrease in FC within the constituents of CSTC loops. Moreover, our results support the role of precuneus in OCD. The association of the cognitive and clinical symptoms with the FC between the thalamus and somatomotor cortex indicates that cognitive flexibility and inhibitory control are strongly linked and both mechanisms might contribute to the symptomatology of OCD.
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Affiliation(s)
- Iveta Fajnerova
- National Institute of Mental Health (NIMH), Klecany, Czechia
| | - David Gregus
- National Institute of Mental Health (NIMH), Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Anna Francova
- National Institute of Mental Health (NIMH), Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Eliska Noskova
- National Institute of Mental Health (NIMH), Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Jana Koprivova
- National Institute of Mental Health (NIMH), Klecany, Czechia
| | - Pavla Stopkova
- National Institute of Mental Health (NIMH), Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Jaroslav Hlinka
- National Institute of Mental Health (NIMH), Klecany, Czechia.,Institute of Computer Science, Czech Academy of Sciences, Prague, Czechia
| | - Jiri Horacek
- National Institute of Mental Health (NIMH), Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
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33
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Drăgoi AM, Pecie LG, Patrichi BE, Ladea M. Morphopathological changes in obsessive-compulsive disorder. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2020; 61:51-60. [PMID: 32747895 PMCID: PMC7728136 DOI: 10.47162/rjme.61.1.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The pathophysiology of the obsessive-compulsive disorder (OCD) has been studied for many years using several structural magnetic resonance imaging, discovering that the anomalies of function and structure of the brain are widespread, they involve different areas, structures and circuits with a complex interconnectivity. More than that, these anomalies cover all the life of a patient, from early childhood, due to variations of developmental stages until adult life. The research is highly important also because OCD has a major hereditary factor, with the phenotype variance between 27–47% due to hereditary factors. Under this paper, that follows last 10 years studies in this area, we will find some relevant findings consisting on neuroanatomic changes, the morphology findings of striatum, globus pallidus and thalamus, the blood flow circuit changes in various regions of the brain, brain connectivity and various correlations of them. Not to forget that OCD must be understand as an emotional disorder but in the same time as a cognitive disorder too. This approach highlights the abnormalities that have been found in brain regions involved in the cognitive and emotional behavior, as for example: extended temporal, parietal, and occipital regions, anterior cingulate, frontal gyrus, amygdala.
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Affiliation(s)
- Ana Miruna Drăgoi
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital for Psychiatry, Bucharest, Romania;
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34
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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: 14] [Impact Index Per Article: 3.5] [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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Cyr M, Pagliaccio D, Yanes-Lukin P, Fontaine M, Rynn MA, Marsh R. Altered network connectivity predicts response to cognitive-behavioral therapy in pediatric obsessive-compulsive disorder. Neuropsychopharmacology 2020; 45:1232-1240. [PMID: 31952071 PMCID: PMC7235012 DOI: 10.1038/s41386-020-0613-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/21/2019] [Accepted: 01/08/2020] [Indexed: 12/12/2022]
Abstract
Obsessive-compulsive disorder (OCD) is commonly associated with alterations in cortico-striato-thalamo-cortical brain networks. Yet, recent investigations of large-scale brain networks suggest that more diffuse alterations in brain connectivity may underlie its pathophysiology. Few studies have assessed functional connectivity within or between networks across the whole brain in pediatric OCD or how patterns of connectivity associate with treatment response. Resting-state functional magnetic resonance imaging scans were acquired from 25 unmedicated, treatment-naive children and adolescents with OCD (12.8 ± 2.9 years) and 23 matched healthy control (HC) participants (11.0 ± 3.3 years) before participants with OCD completed a course of cognitive-behavioral therapy (CBT). Participants were re-scanned after 12-16 weeks. Whole-brain connectomic analyses were conducted to assess baseline group differences and group-by-time interactions, corrected for multiple comparisons. Relationships between functional connectivity and OCD symptoms pre- and post-CBT were examined using longitudinal cross-lagged panel modeling. Reduced connectivity in OCD relative to HC participants was detected between default mode and task-positive network regions. Greater (less altered) connectivity between left angular gyrus and left frontal pole predicted better response to CBT in the OCD group. Altered connectivity between task-positive and task-negative networks in pediatric OCD may contribute to the impaired control over intrusive thoughts early in the illness. This is the first study to show that altered connectivity between large-scale network regions may predict response to CBT in pediatric OCD, highlighting the clinical relevance of these networks as potential circuit-based targets for the development of novel treatments.
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Affiliation(s)
- Marilyn Cyr
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA. .,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
| | - David Pagliaccio
- grid.413734.60000 0000 8499 1112Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Paula Yanes-Lukin
- grid.413734.60000 0000 8499 1112Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Martine Fontaine
- grid.413734.60000 0000 8499 1112Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Moira A. Rynn
- grid.26009.3d0000 0004 1936 7961Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC USA
| | - Rachel Marsh
- grid.413734.60000 0000 8499 1112Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
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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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Jansen M, Overgaauw S, De Bruijn ERA. Social Cognition and Obsessive-Compulsive Disorder: A Review of Subdomains of Social Functioning. Front Psychiatry 2020; 11:118. [PMID: 32231594 PMCID: PMC7082418 DOI: 10.3389/fpsyt.2020.00118] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
Disturbances in social cognitive processes such as the ability to infer others' mental states importantly contribute to social and functional impairments in psychiatric disorders. Yet, despite established social, emotional, and cognitive problems, the role of social cognition in obsessive-compulsive disorder is largely overlooked. The current review provides a first comprehensive overview of social (neuro)cognitive disturbances in adult patients with obsessive-compulsive disorder. Results of our review indicate various social cognitive alterations. Patients with obsessive-compulsive disorder show deficits in the recognition of affective social cues, specifically facial expressions of disgust, and more general deficits in theory of mind/mentalizing. Additionally, patients show heightened affective reactions and altered neural responding to emotions of self and others, as well as poor emotion regulation skills, which may contribute to poor social functioning of patients. However, the discrepancies in findings and scarcity of studies make it difficult to draw firm conclusions with regard to the specificity of social cognitive disturbances. The review offers directions for future research and highlights the need to investigate obsessive-compulsive disorder from an interactive social neurocognitive perspective in addition to the prevalent passive spectator perspective to advance our understanding of this intricate and burdensome disorder.
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Affiliation(s)
- Myrthe Jansen
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Sandy Overgaauw
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Ellen R A De Bruijn
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
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Erdman A, Abend R, Jalon I, Artzi M, Gazit T, Avirame K, Ais ED, Levokovitz H, Gilboa-Schechtman E, Hendler T, Harel EV. Ruminative Tendency Relates to Ventral Striatum Functionality: Evidence From Task and Resting-State fMRI. Front Psychiatry 2020; 11:67. [PMID: 32153443 PMCID: PMC7044182 DOI: 10.3389/fpsyt.2020.00067] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Ruminative responding involves repetitive and passive thinking about one's negative affect. This tendency interferes with initiation of goal-directed rewarding strategies, which could alleviate depressive states. Such reward-directed response selection has been shown to be mediated by ventral striatum/nucleus accumbens (VS/NAcc) function. However, to date, no study has examined whether trait rumination relates to VS/NAcc functionality. Here, we tested whether rumination moderates VS/NAcc function both in response to reward and during a ruminative state. METHODS Trait rumination was considered dimensionally using Rumination Response Scale (RRS) scores. Our sample (N = 80) consisted of individuals from a community sample and from patients diagnosed with major depressive disorder, providing a broad range of RRS scores. Participants underwent fMRI to assess two modes of VS/NAcc functionality: 1) in response to reward, and 2) during resting-state, as a proxy for ruminative state. We then tested for associations between RRS scores and VS/NAcc functional profiles, statistically controlling for overall depressive symptom severity. RESULTS RRS scores correlated positively with VS/NAcc response to reward. Furthermore, we noted that higher RRS scores were associated with increased ruminative-dependent resting-state functional connectivity of the VS/NAcc with the left orbitofrontal cortex. CONCLUSIONS These findings suggest that ruminative tendencies manifest in VS/NAcc reward- and rumination-related functions, providing support for a theoretical-clinical perspective of rumination as a habitual impairment in selection of rewarding, adaptive coping strategies.
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Affiliation(s)
- Alon Erdman
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Psychology Department, Bar-Ilan University, Ramat Gan, Israel
| | - Rany Abend
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, United States
| | - Itamar Jalon
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,School of Psychological Science, Tel Aviv University, Tel Aviv, Israel
| | - Moran Artzi
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Gazit
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Keren Avirame
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Beer Yaakov Mental Health Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ezequiel Diego Ais
- Beer Yaakov Mental Health Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hilik Levokovitz
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Beer Yaakov Mental Health Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Talma Hendler
- Sagol Brain Institute Tel Aviv, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,School of Psychological Science, Tel Aviv University, Tel Aviv, Israel.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Eiran Vadim Harel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Beer Yaakov Mental Health Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abnormal spontaneous neural activity in the medial prefrontal cortex and right superior temporal gyrus correlates with anhedonia severity in obsessive-compulsive disorder. J Affect Disord 2019; 259:47-55. [PMID: 31437701 DOI: 10.1016/j.jad.2019.08.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 08/11/2019] [Accepted: 08/13/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUD Converging evidence indicated the presence of clinically significant anhedonia in patients with obsessive-compulsive disorder (OCD). Studying anhedonia and its neural correlates in OCD may be beneficial in understanding the pathophysiology and treatment of OCD. However, the neural mechanisms that underlie anhedonia in OCD still remain unclear. The present study was designed to bridge this research gap by using resting-state functional magnetic resonance imaging (fMRI). METHODS 29 OCD patients with anhedonia (OCD-AH), 31 OCD patients with normal hedonia (OCD-NH), and 30 healthy controls (HC) received the fMRI scan. The low-frequency fluctuation (ALFF) approach was applied to compare spontaneous neural activity among the three groups. Relationships between the regional ALFFs and anhedonia levels were examined in OCD patients. RESULT OCD-AH and OCD-NH manifested overlapping but partially distinct brain alterations. Notably, compared to OCD-NH, the OCD-AH showed decreased ALFF in right superior temporal gyrus (STG) and increased ALFF in medial prefontal cortex (MPFC). Moreover, ALFF values in the right STG were negatively correlated with social anhedonia severity, and ALFFs in the MPFC were positively correlated with both physical and social anhedonia severity in patients with OCD. LIMITATIONS Relatively small sample size; ALFF could not provide more holistic information of brain network. CONCLUSION The present study revealed that abnormal spontaneous neural activity in MPFC is associated with both physical and social anhedonia, while altered intrinsic brain function in right STG is specifically associated with social anhedonia in OCD. These findings contribute to our understandings of the neurobiological mechanisms underlying anhedonia in OCD.
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Alves-Pinto A, Rus OG, Reess TJ, Wohlschläger A, Wagner G, Berberich G, Koch K. Altered reward-related effective connectivity in obsessive-compulsive disorder: an fMRI study. J Psychiatry Neurosci 2019; 44:395-406. [PMID: 30964615 PMCID: PMC6821506 DOI: 10.1503/jpn.180195] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Obsessive–compulsive disorder (OCD) is characterized by anxiety-provoking, obsessive thoughts. Patients usually react to these thoughts with repetitive behaviours that reduce anxiety and are perceived as rewarding. Hence, reward plays a major role in the psychopathology of OCD. Previous studies showed altered activation in frontostriatal networks, among others, in association with the processing of reward in patients with OCD. Potential alterations in connectivity within these networks have, however, barely been explored. METHODS We investigated a sample of patients with OCD and healthy controls using functional MRI and a reward learning task presented in an event-related design. Dynamic causal modelling (DCM) was used to estimate effective connectivity. RESULTS Our sample included 37 patients with OCD and 39 healthy controls. Analyses of task-related changes in connectivity showed a significantly altered effective connectivity between the ventromedial prefrontal cortex (vmPFC) and the orbitofrontal cortex (OFC), among others, both in terms of endogenous connectivity as well as modulatory effects under positive feedback. Clinical measures of compulsion correlated with the effect of feedback input on visual sensory areas. LIMITATIONS The reported alterations should be interpreted within the context of the task and the a priori–defined network considered in the analysis. CONCLUSION This disrupted connectivity in parts of the default mode network and the frontostriatal network may indicate increased rumination and self-related processing impairing the responsiveness toward external rewards. This, in turn, may underlie the general urge for reinforcement accompanying compulsive behaviours.
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Affiliation(s)
- Ana Alves-Pinto
- From the Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Rus, Reess, Wohlschläger, Koch); the TUM-Neuroimaging Center (TUM-NIC) School of Medicine of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675 Munich, Germany (Rus, Reess, Wohlschläger, Koch); the Research Unit of the Buhl-Strohmaier Foundation for Pediatric Neuroorthopaedics and Cerebral Palsy, Department of Orthopedics and Sports Orthopedics, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Alves-Pinto); the Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich, Germany (Rus, Reess, Koch); the Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany (Wagner); the Windach Institute and Hospital of Neurobehavioural Research and Therapy (WINTR), Windach, Germany (Berberich); and the Department of Neuroradiology, University of Zürich, Zürich, Switzerland (Rus)
| | - Oana Georgiana Rus
- From the Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Rus, Reess, Wohlschläger, Koch); the TUM-Neuroimaging Center (TUM-NIC) School of Medicine of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675 Munich, Germany (Rus, Reess, Wohlschläger, Koch); the Research Unit of the Buhl-Strohmaier Foundation for Pediatric Neuroorthopaedics and Cerebral Palsy, Department of Orthopedics and Sports Orthopedics, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Alves-Pinto); the Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich, Germany (Rus, Reess, Koch); the Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany (Wagner); the Windach Institute and Hospital of Neurobehavioural Research and Therapy (WINTR), Windach, Germany (Berberich); and the Department of Neuroradiology, University of Zürich, Zürich, Switzerland (Rus)
| | - Tim Jonas Reess
- From the Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Rus, Reess, Wohlschläger, Koch); the TUM-Neuroimaging Center (TUM-NIC) School of Medicine of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675 Munich, Germany (Rus, Reess, Wohlschläger, Koch); the Research Unit of the Buhl-Strohmaier Foundation for Pediatric Neuroorthopaedics and Cerebral Palsy, Department of Orthopedics and Sports Orthopedics, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Alves-Pinto); the Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich, Germany (Rus, Reess, Koch); the Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany (Wagner); the Windach Institute and Hospital of Neurobehavioural Research and Therapy (WINTR), Windach, Germany (Berberich); and the Department of Neuroradiology, University of Zürich, Zürich, Switzerland (Rus)
| | - Afra Wohlschläger
- From the Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Rus, Reess, Wohlschläger, Koch); the TUM-Neuroimaging Center (TUM-NIC) School of Medicine of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675 Munich, Germany (Rus, Reess, Wohlschläger, Koch); the Research Unit of the Buhl-Strohmaier Foundation for Pediatric Neuroorthopaedics and Cerebral Palsy, Department of Orthopedics and Sports Orthopedics, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Alves-Pinto); the Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich, Germany (Rus, Reess, Koch); the Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany (Wagner); the Windach Institute and Hospital of Neurobehavioural Research and Therapy (WINTR), Windach, Germany (Berberich); and the Department of Neuroradiology, University of Zürich, Zürich, Switzerland (Rus)
| | - Gerd Wagner
- From the Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Rus, Reess, Wohlschläger, Koch); the TUM-Neuroimaging Center (TUM-NIC) School of Medicine of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675 Munich, Germany (Rus, Reess, Wohlschläger, Koch); the Research Unit of the Buhl-Strohmaier Foundation for Pediatric Neuroorthopaedics and Cerebral Palsy, Department of Orthopedics and Sports Orthopedics, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Alves-Pinto); the Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich, Germany (Rus, Reess, Koch); the Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany (Wagner); the Windach Institute and Hospital of Neurobehavioural Research and Therapy (WINTR), Windach, Germany (Berberich); and the Department of Neuroradiology, University of Zürich, Zürich, Switzerland (Rus)
| | - Götz Berberich
- From the Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Rus, Reess, Wohlschläger, Koch); the TUM-Neuroimaging Center (TUM-NIC) School of Medicine of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675 Munich, Germany (Rus, Reess, Wohlschläger, Koch); the Research Unit of the Buhl-Strohmaier Foundation for Pediatric Neuroorthopaedics and Cerebral Palsy, Department of Orthopedics and Sports Orthopedics, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Alves-Pinto); the Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich, Germany (Rus, Reess, Koch); the Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany (Wagner); the Windach Institute and Hospital of Neurobehavioural Research and Therapy (WINTR), Windach, Germany (Berberich); and the Department of Neuroradiology, University of Zürich, Zürich, Switzerland (Rus)
| | - Kathrin Koch
- From the Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Rus, Reess, Wohlschläger, Koch); the TUM-Neuroimaging Center (TUM-NIC) School of Medicine of Klinikum rechts der Isar, Technische Universität München TUM, Ismaninger Strasse 22, 81675 Munich, Germany (Rus, Reess, Wohlschläger, Koch); the Research Unit of the Buhl-Strohmaier Foundation for Pediatric Neuroorthopaedics and Cerebral Palsy, Department of Orthopedics and Sports Orthopedics, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Alves-Pinto); the Graduate School of Systemic Neurosciences GSN, Ludwig-Maximilians-Universität, Biocenter, Munich, Germany (Rus, Reess, Koch); the Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany (Wagner); the Windach Institute and Hospital of Neurobehavioural Research and Therapy (WINTR), Windach, Germany (Berberich); and the Department of Neuroradiology, University of Zürich, Zürich, Switzerland (Rus)
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Leue A, Beauducel A. A meta-analysis of the P3 amplitude in tasks requiring deception in legal and social contexts. Brain Cogn 2019; 135:103564. [DOI: 10.1016/j.bandc.2019.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/01/2019] [Accepted: 05/05/2019] [Indexed: 10/26/2022]
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Akkermans SEA, Rheinheimer N, Bruchhage MMK, Durston S, Brandeis D, Banaschewski T, Boecker-Schlier R, Wolf I, Williams SCR, Buitelaar JK, van Rooij D, Oldehinkel M. Frontostriatal functional connectivity correlates with repetitive behaviour across autism spectrum disorder and obsessive-compulsive disorder. Psychol Med 2019; 49:2247-2255. [PMID: 30362446 DOI: 10.1017/s0033291718003136] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) are neurodevelopmental disorders with considerable overlap in terms of their defining symptoms of compulsivity/repetitive behaviour. Little is known about the extent to which ASD and OCD have common versus distinct neural correlates of compulsivity. Previous research points to potentially common dysfunction in frontostriatal connectivity, but direct comparisons in one study are lacking. Here, we assessed frontostriatal resting-state functional connectivity in youth with ASD or OCD, and healthy controls. In addition, we applied a cross-disorder approach to examine whether repetitive behaviour across ASD and OCD has common neural substrates. METHODS A sample of 78 children and adolescents aged 8-16 years was used (ASD n = 24; OCD n = 25; healthy controls n = 29), originating from the multicentre study COMPULS. We tested whether diagnostic group, repetitive behaviour (measured with the Repetitive Behavior Scale-Revised) or their interaction was associated with resting-state functional connectivity of striatal seed regions. RESULTS No diagnosis-specific differences were detected. The cross-disorder analysis, on the other hand, showed that increased functional connectivity between the left nucleus accumbens (NAcc) and a cluster in the right premotor cortex/middle frontal gyrus was related to more severe symptoms of repetitive behaviour. CONCLUSIONS We demonstrate the fruitfulness of applying a cross-disorder approach to investigate the neural underpinnings of compulsivity/repetitive behaviour, by revealing a shared alteration in functional connectivity in ASD and OCD. We argue that this alteration might reflect aberrant reward or motivational processing of the NAcc with excessive connectivity to the premotor cortex implementing learned action patterns.
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Affiliation(s)
- Sophie E A Akkermans
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Nicole Rheinheimer
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Muriel M K Bruchhage
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
| | - Sarah Durston
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Regina Boecker-Schlier
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Isabella Wolf
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Steven C R Williams
- Department of Neuroimaging, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Daan van Rooij
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Marianne Oldehinkel
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
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43
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Moreira PS, Marques P, Magalhães R, Esteves M, Sousa N, Soares JM, Morgado P. The resting-brain of obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2019; 290:38-41. [PMID: 31279239 DOI: 10.1016/j.pscychresns.2019.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/26/2019] [Accepted: 06/30/2019] [Indexed: 01/03/2023]
Abstract
Obsessive-compulsive disorder (OCD) is one of the most debilitating psychiatric conditions, having a dramatic impact on patients' daily living. In this work, we aimed to explore resting-state functional connectivity in OCD patients, using an independent component analysis. Eighty individuals (40 patients and 40 healthy controls) performed a resting state fMRI protocol. OCD patients displayed reduced functional connectivity (FC) in visual and sensorimotor networks. In addition, patients displayed decreased FC between sensory networks and increased FC between default-mode and cerebellar networks.
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Affiliation(s)
- Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal.
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - Madalena Esteves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - José Miguel Soares
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
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44
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Banasikowski TJ, Hawken ER. The Bed Nucleus of the Stria Terminalis, Homeostatic Satiety, and Compulsions: What Can We Learn From Polydipsia? Front Behav Neurosci 2019; 13:170. [PMID: 31417376 PMCID: PMC6686835 DOI: 10.3389/fnbeh.2019.00170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/12/2019] [Indexed: 12/28/2022] Open
Abstract
A compulsive phenotype characterizes several neuropsychiatric illnesses - including but not limited to - schizophrenia and obsessive compulsive disorder. Because of its perceived etiological heterogeneity, it is challenging to disentangle the specific neurophysiology that precipitates compulsive behaving. Using polydipsia (or non-regulatory water drinking), we describe candidate neural substrates of compulsivity. We further postulate that aberrant neuroplasticity within cortically projecting structures [i.e., the bed nucleus of the stria terminalis (BNST)] and circuits that encode homeostatic emotions (thirst, hunger, satiety, etc.) underlie compulsive drinking. By transducing an inaccurate signal that fails to represent true homeostatic state, cortical structures cannot select appropriate and adaptive actions. Additionally, augmented dopamine (DA) reactivity in striatal projections to and from the frontal cortex contribute to aberrant homeostatic signal propagation that ultimately biases cortex-dependent behavioral selection. Responding becomes rigid and corresponds with both erroneous, inflexible encoding in both bottom-up structures and in top-down pathways. How aberrant neuroplasticity in circuits that encode homeostatic emotion result in the genesis and maintenance of compulsive behaviors needs further investigation.
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Affiliation(s)
- Tomek J Banasikowski
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Providence Care Hospital, Kingston, ON, Canada
| | - Emily R Hawken
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Providence Care Hospital, Kingston, ON, Canada
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Koeckritz R, Beauducel A, Hundhausen J, Redolfi A, Leue A. Does concealing familiarity evoke other processes than concealing untrustworthiness? - Different forms of concealed information modulate P3 effects. PERSONALITY NEUROSCIENCE 2019; 2:e2. [PMID: 32435737 PMCID: PMC7219692 DOI: 10.1017/pen.2019.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/04/2019] [Accepted: 06/18/2019] [Indexed: 11/07/2022]
Abstract
It was investigated whether concealing learned stimulus attributes (i.e., trustworthiness vs. untrustworthiness) has similar effects on the P3 amplitude than concealing stimulus familiarity. According to salience hypothesis, known, deceptive stimuli (probe) are (perceived) more relevant than truthful, unknown stimuli (irrelevant) evoking a more positive probe P3 amplitude. When all stimuli are known, concealing information is more cognitively demanding than non-concealing information evoking a less positive P3 amplitude according to the mental effort account. Ninety-seven participants concealed knowledge of previously learned faces in the familiarity condition (probe vs. irrelevant stimuli). In the trustworthiness condition, participants concealed untrustworthiness to previously learned faces and responded truthfully to previously learned trustworthy and untrustworthy faces (known, concealed vs. known, truthful stimuli). The parietal mean P3 amplitude was more positive for probe stimuli than for irrelevant stimuli in the familiarity condition providing evidence for the salience hypothesis. In the trustworthiness condition, concealing untrustworthiness showed the smallest parietal mean P3 amplitude suggesting evidence for the mental effort hypothesis. Individual differences of perpetrator's sensitivity to injustice modulated the P3 amplitude in the trustworthiness condition.
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Affiliation(s)
- René Koeckritz
- Institute of Psychology, University of Kiel, Kiel, Germany
| | | | | | - Anika Redolfi
- Institute of Psychology, University of Kiel, Kiel, Germany
| | - Anja Leue
- Institute of Psychology, University of Kiel, Kiel, Germany
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46
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Neural dynamics in co-morbid schizophrenia and OCD: A computational approach. J Theor Biol 2019; 473:80-94. [PMID: 30738051 DOI: 10.1016/j.jtbi.2019.01.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 01/29/2019] [Accepted: 01/31/2019] [Indexed: 02/07/2023]
Abstract
The co-morbidity of obsessive-compulsive disorder (OCD) and schizophrenia is higher than what would be expected by chance and the common underlying neuropathophysiology is not well understood. Repetitive stereotypes and routines can be caused by perseverative thoughts and motor sequences in both of these disorders. We extended a previously published computational model to investigate cortico-striatal network dynamics. Given the considerable overlap in symptom phenomenology and the high degree of co-morbidity between OCD and schizophrenia, we examined the dynamical consequences of functional connectivity variations in the overlapping network. This was achieved by focusing on the emergence of network oscillatory activity and examining parameter sensitivity. Opposing activity levels are present in orbitofrontal cortex (OFC) and anterior cingulate cortex (ACC) in schizophrenia and OCD. We found that with over-compensation of the primary pathology, emergence of the other disorder can occur. The oscillatory behavior is delicately modulated by connections between the OFC/ACC to the ventral and dorsal striatum and by the coupling between the ACC and dorsolateral prefrontal cortex (DLPFC). Modulation on cortical self-inhibition (e.g. serotonin reuptake inhibitor treatment) together with dopaminergic input to the striatum (e.g. anti-dopaminergic medication) has non-trivial complex effects on the network oscillatory behavior, with an optimal modulatory window. Additionally, there are several disruption mechanisms and compensatory processes in the cortico-striato-thalamic network which may contribute to the underlying neuropathophysiology and clinical heterogeneity in schizo-obsessive spectrum disorders. Our mechanistic model predicts that dynamic over-compensation of the primarily occuring neuropathophysiology can lead to the secondary co-morbid disease.
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Kubota Y, Sato W, Kochiyama T, Uono S, Yoshimura S, Sawada R, Toichi M. Corticostriatal-limbic correlates of sub-clinical obsessive-compulsive traits. Psychiatry Res Neuroimaging 2019; 285:40-46. [PMID: 30731370 DOI: 10.1016/j.pscychresns.2019.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/14/2019] [Accepted: 01/29/2019] [Indexed: 11/18/2022]
Abstract
Obsessive-compulsive (OC) traits such as intrusive worrisome ideas or excessive concerns for threats are frequent in general population (5%-13%). However, the structural neural correlates of the sub-clinical OC traits remain largely unknown. Based on the data of obsessive-compulsive disorder (OCD), we hypothesized that the subcortical and cortical structures, constituting the cortico-striatal-thalamo-cortical circuit (CSTC) and the limbic system, could be associated with OC traits. Here we conducted voxel-based morphometry (VBM) in order to investigate fine grained volume changes of these structures in 49 non-clinical subjects. Analysis of structural covariances of these structures was also conducted. We identified volume changes associated with OC traits in the left putamen and the left amygdala. The results of structural covariance analysis revealed increased covariances in relation to the heightened OC traits between the left putamen to bilateral medial prefrontal cortex and to the left cerebellum, and between the left globus pallidus to the bilateral anterior cingulate cortices. The present finding of volume changes of the corticostriatal-limbic structures may reflect neuroplasticity associated with OC traits. Since the abnormality of these structures were also observed in the clinical OCD, the subclinical subjects with OC traits shared "neuronal obsessive traits" that might precondition OCD at the network level.
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Affiliation(s)
- Yasutaka Kubota
- Health and Medical Services Center, Shiga University, 1-1-1, Baba, Hikone, Shiga 522-8522, Japan.
| | - Wataru Sato
- Department of Neurodevelopmental Psychiatry, Habilitation and Rehabilitation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takanori Kochiyama
- ATR Brain Activity Imaging Center, 2-2-2, Hikaridai, Seika-cho, Souraku-gun, Kyoto 619-0288, Japan
| | - Shota Uono
- Department of Neurodevelopmental Psychiatry, Habilitation and Rehabilitation, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Organization for Promotion of Neurodevelopmental Disorder Research, Kyoto, Japan
| | - Sayaka Yoshimura
- Department of Neurodevelopmental Psychiatry, Habilitation and Rehabilitation, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Organization for Promotion of Neurodevelopmental Disorder Research, Kyoto, Japan
| | - Reiko Sawada
- Department of Neurodevelopmental Psychiatry, Habilitation and Rehabilitation, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Organization for Promotion of Neurodevelopmental Disorder Research, Kyoto, Japan
| | - Motomi Toichi
- Organization for Promotion of Neurodevelopmental Disorder Research, Kyoto, Japan; Faculty of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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48
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Janikova M, Brozka H, Radostova D, Svoboda J, Stuchlik A. No effect of riluzole and memantine on learning deficit following quinpirole sensitization - An animal model of obsessive-compulsive disorder. Physiol Behav 2019; 204:241-247. [PMID: 30826389 DOI: 10.1016/j.physbeh.2019.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 11/29/2022]
Abstract
RATIONALE Chronic quinpirole (QNP) sensitization is an established animal model relevant to obsessive-compulsive disorder (OCD) that has been previously shown to induce several OCD-like behavioral patterns, such as compulsive-like checking and increased locomotion. OBJECTIVES In current study we explored the effect of antiglutamatergic drugs, memantine and riluzole, on cognitive and behavioral performance of QNP sensitized rats. METHODS During habituation phase, the rats (N = 56) were injected with QNP (0.25 mg/kg) or saline solution (every other day up to 10 injections) and placed into rotating arena without foot shocks for 50-min exploration. Active place avoidance task in rotating arena with unmarked to-be-avoided shock sector was used during acquisition phase. Rats were injected with memantine (1 mg/kg or 5 mg/kg), riluzole (1 mg/kg or 5 mg/kg) or saline solution 30 min before the trial and with QNP (0.25 mg/kg) or saline right before they were placed inside the rotating arena with 60° unmarked shock sector. Locomotion and number of entrances into the shock sector were recorded. RESULTS QNP sensitization led to a robust deficit in place learning. However, neither memantine nor riluzole did reverse or alleviate the deficit induced by QNP. Contrarily, memantine significantly aggravated QNP induced deficit. CONCLUSIONS The exacerbation of cognitive deficit following antiglutamatergic agents could be mediated by decreased glutamate concentration in nucleus accumbens and decreased hippocampal activation in the QNP sensitization model.
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Affiliation(s)
- Martina Janikova
- Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic.
| | - Hana Brozka
- Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic
| | - Dominika Radostova
- Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic
| | - Jan Svoboda
- Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic
| | - Ales Stuchlik
- Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic.
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Dogan B, Ertekin E, Turkdogan FT, Memis CO, Sevincok L. Cortico-thalamo-striatal circuit components’ volumes and their correlations differ significantly among patients with obsessive–compulsive disorder: a case–control MRI study. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1583481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Bilge Dogan
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Ersen Ertekin
- Department of Radiology, Adnan Menderes University, Aydin, Turkey
| | | | | | - Levent Sevincok
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
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50
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Body mass index in obsessive-compulsive disorder. J Affect Disord 2019; 245:145-151. [PMID: 30388557 DOI: 10.1016/j.jad.2018.10.116] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/16/2018] [Accepted: 10/24/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Psychiatric disorders are associated with overweight/obesity. Obsessive-compulsive disorder (OCD) may be an exception, as anecdotal evidence suggests lower BMI in OCD. Additionally, depression is associated with elevated BMI, but effects of comorbid secondary depression are unknown. The aim of the present study was to assess BMI and risk for overweight/obesity in OCD and to assess the effect of comorbid depression on BMI. METHODS BMI, demographics, and clinical status were assessed in large samples of individuals with OCD, anxiety disorders, depressive disorders, comorbid anxiety/depressive disorders, and non-clinical controls (NCC). RESULTS Although no initial differences were found between the samples on BMI, the non-depressed OCD subsample had significantly lower BMI and risk for overweight/obesity compared to all other clinical samples. NCC were nearly twice as likely to be overweight compared to non-depressed OCD. LIMITATIONS Eating disorders were excluded in the OCD sample, but BMI < 17 was used as an exclusion criterion in the clinical control groups in lieu of screening for Anorexia. Group differences on demographics were controlled for. Recruitment methodology differed between samples. CONCLUSIONS OCD is associated with significantly lower rates of obesity and overweight, but this relationship was not found when comorbid depression was present. This suggests that the purer the phenotype of OCD, the more substantial protective factor against overweight/obesity emerges compared to other clinical samples and NCC. An OCD-specific reward/anhedonia model, previously offered to elucidate lower smoking rates in OCD, may account for lower BMI in OCD. These results warrant careful clinical attention to the negative impact of comorbid depression on OCD that spans from increasing risk for obesity and cigarette smoking, to hindering treatment response.
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