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Asefi MB, Heidari A, Hajikarim-Hamedani A, Mousavi Z, Ashabi G, Sadat-Shirazi MS, Zarrindast MR. Preconception ethanol exposure changes anxiety, depressive and checking-like behavior and alter the expression levels of MAO-B in male offspring. Neurotoxicol Teratol 2024; 104:107367. [PMID: 38866258 DOI: 10.1016/j.ntt.2024.107367] [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: 03/17/2024] [Revised: 05/18/2024] [Accepted: 06/08/2024] [Indexed: 06/14/2024]
Abstract
Alcohol use, which alters the epigenome, increases the probability that it could affect subsequent generations, even if they were never directly exposed to ethanol or even in utero. We explored the effects of parental ethanol exposure before conception on behavioral changes in the offspring. Considering the role of Monoamine oxidase-B (MAO-B) in dopamine turnover in the prefrontal cortex (PFC) and its influence on behavior, and taking into account that ethanol exposure could alter MAO-B, we assessed the protein levels in the offspring. Male and female rats were exposed to ethanol for 30 days and then allowed ten days of abstinence. Afterward, they were mated with either control or ethanol-exposed rats. The F1 and F2 male offspring underwent tests to assess behavioral changes. Additionally, the levels of MAO-B in the PFC were evaluated. Results revealed that in the F1, anxiety increased only in the bi-parental ethanol-exposed male offspring in the elevated plus maze test (p < 0.05), while depressive-like behavior rose only in maternal and bi-parental ethanol-exposed offspring (p < 0.01). However, compulsive-like behavior increased in all ethanol-exposed offspring (p < 0.01). No significant phenotypic changes were observed in the F2. The levels of MAO-B in the PFC increased in the maternal (p < 0.05) and bi-parental ethanol-exposed offspring (p < 0.01). Our study demonstrates that parental ethanol exposure, even in the days preceding mating, adversely affects behaviors and induces molecular changes in the brain. Given these findings, it becomes imperative to monitor children exposed to parental (especially maternal) ethanol for the prevention of mental disorders.
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Affiliation(s)
- Mohammad Basir Asefi
- Faculty of Pharmacy and Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amirhossein Heidari
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | | | - Zahra Mousavi
- Department of Pharmacology-Toxicology, Faculty of Pharmacy and Pharmaceutical Sciences, Tehran Medical Sciences, Islamic Azad University, Iran
| | - Ghorbangol Ashabi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad-Reza Zarrindast
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Ranjan M, Mahoney JJ, Rezai AR. Neurosurgical neuromodulation therapy for psychiatric disorders. Neurotherapeutics 2024; 21:e00366. [PMID: 38688105 PMCID: PMC11070709 DOI: 10.1016/j.neurot.2024.e00366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 04/09/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024] Open
Abstract
Psychiatric disorders are among the leading contributors to global disease burden and disability. A significant portion of patients with psychiatric disorders remain treatment-refractory to best available therapy. With insights from the neurocircuitry of psychiatric disorders and extensive experience of neuromodulation with deep brain stimulation (DBS) in movement disorders, DBS is increasingly being considered to modulate the neural network in psychiatric disorders. Currently, obsessive-compulsive disorder (OCD) is the only U.S. FDA (United States Food and Drug Administration) approved DBS indication for psychiatric disorders. Medically refractory depression, addiction, and other psychiatric disorders are being explored for DBS neuromodulation. Studies evaluating DBS for psychiatric disorders are promising but lack larger, controlled studies. This paper presents a brief review and the current state of DBS and other neurosurgical neuromodulation therapies for OCD and other psychiatric disorders. We also present a brief review of MR-guided Focused Ultrasound (MRgFUS), a novel form of neurosurgical neuromodulation, which can target deep subcortical structures similar to DBS, but in a noninvasive fashion. Early experiences of neurosurgical neuromodulation therapies, including MRgFUS neuromodulation are encouraging in psychiatric disorders; however, they remain investigational. Currently, DBS and VNS are the only FDA approved neurosurgical neuromodulation options in properly selected cases of OCD and depression, respectively.
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Affiliation(s)
- Manish Ranjan
- Department of Neurosurgery, WVU Rockefeller Neuroscience Institute, Morgantown, WV, USA.
| | - James J Mahoney
- Department of Behavioral Medicine and Psychiatry, WVU Rockefeller Neuroscience Institute, Morgantown, WV, USA; Department of Neuroscience, WVU Rockefeller Neuroscience Institute, Morgantown, WV, USA
| | - Ali R Rezai
- Department of Neurosurgery, WVU Rockefeller Neuroscience Institute, Morgantown, WV, USA; Department of Neuroscience, WVU Rockefeller Neuroscience Institute, Morgantown, WV, USA
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Shobeiri P, Hosseini Shabanan S, Haghshomar M, Khanmohammadi S, Fazeli S, Sotoudeh H, Kamali A. Cerebellar Microstructural Abnormalities in Obsessive-Compulsive Disorder (OCD): a Systematic Review of Diffusion Tensor Imaging Studies. CEREBELLUM (LONDON, ENGLAND) 2024; 23:778-801. [PMID: 37291229 DOI: 10.1007/s12311-023-01573-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/10/2023]
Abstract
Previous neuroimaging studies have suggested that obsessive-compulsive disorder (OCD) is associated with altered resting-state functional connectivity of the cerebellum. In this study, we aimed to describe the most significant and reproducible microstructural abnormalities and cerebellar changes associated with obsessive-compulsive disorder (OCD) using diffusion tensor imaging (DTI) investigations. PubMed and EMBASE were searched for relevant studies using the PRISMA 2020 protocol. A total of 17 publications were chosen for data synthesis after screening titles and abstracts, full-text examination, and executing the inclusion criteria. The patterns of cerebellar white matter (WM) integrity loss, determined by fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) metrics, varied across studies and symptoms. Changes in fractional anisotropy (FA) values were described in six publications, which were decreased in four and increased in two studies. An increase in diffusivity parameters of the cerebellum (i.e., MD, RD, and AD) in OCD patients was reported in four studies. Alterations of the cerebellar connectivity with other brain areas were also detected in three studies. Heterogenous results were found in studies that investigated cerebellar microstructural abnormalities in correlation with symptom dimension or severity. OCD's complex phenomenology may be characterized by changes in cerebellar WM connectivity across wide networks, as shown by DTI studies on OCD patients in both children and adults. Classification features in machine learning and clinical tools for diagnosing OCD and determining the prognosis of the disorder might both benefit from using cerebellar DTI data.
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Affiliation(s)
- Parnian Shobeiri
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Maryam Haghshomar
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Shaghayegh Khanmohammadi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soudabeh Fazeli
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Houman Sotoudeh
- Department of Radiology and Neurology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Arash Kamali
- Department of Diagnostic and Interventional Radiology, University of Texas McGovern Medical School, Houston, TX, USA
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Irak M, Topçuoğlu V, Duman TN, Akyurt S, Yılmaz İ, Pala İY. Investigating Retrospective and Prospective Metamemory Judgments During Episodic Memory in Patients With Obsessive-Compulsive Disorders. Behav Ther 2024; 55:277-291. [PMID: 38418040 DOI: 10.1016/j.beth.2023.07.002] [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: 12/21/2022] [Revised: 06/25/2023] [Accepted: 07/03/2023] [Indexed: 03/01/2024]
Abstract
It is clear evidence that individuals diagnosed with obsessive-compulsive disorder (OCD) lack confidence in their memory and have low metamemory performance (judgment and accuracy). However, it is still unclear whether low metamemory performance is specific to first, domain general or domain specific, and second, to stimulus domain. To address these issues, we compared individuals diagnosed with OCD and healthy controls (HCs) on recognition, retrospective (judgments of learning [JOL]) and prospective (feeling of knowing [FOK]) metamemory judgments and under three different episodic memory tasks, which consisted of symptom-free, familiar and unfamiliar stimuli (word, scene, and face photo). OCD patients showed lower recognition performance, JOL and FOK judgments, and accuracy in all tasks than HCs. Also, OCD patients were slower than HCs during all cognitive performances. In both groups, metamemory performances were lower in familiar items than unfamiliar items. However, recognition performances were not affected by stimulus type. Our results support the idea of general episodic memory and a metamemory deficit in OCD. Moreover, metamemory deficits in OCD are domain general.
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Pérez-Vigil A, Ilzarbe D, Garcia-Delgar B, Morer A, Pomares M, Puig O, Lera-Miguel S, Rosa M, Romero M, Calvo Escalona R, Lázaro L. Theory of mind in neurodevelopmental disorders: beyond autistic spectrum disorder. Neurologia 2024; 39:117-126. [PMID: 38272257 DOI: 10.1016/j.nrleng.2024.01.005] [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: 11/16/2020] [Accepted: 04/06/2021] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Theory of mind (ToM) is the human ability to perceive, interpret, and attribute the mental states of other people, and the alteration of this cognitive function is a core symptom of autistic spectrum disorder (ASD). In such other neurodevelopmental disorders as childhood-onset obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) that can present with cognitive dysfunctions, ToM has been less extensively studied, especially in the young population. The aim of the study was to compare advanced ToM between groups of young people diagnosed with OCD, TS, or ASD and a control group. METHODS Clinical interviews were conducted with male patients aged between 11 and 17 years with a main diagnosis of OCD (n = 19), TS (n = 14), or ASD (n = 18), and a control group (n = 20). We administered instruments for estimating intelligence quotient and severity of psychiatric symptoms, and tasks to evaluate ToM (the "Stories from everyday life" task and the "Reading the mind in the eyes" test). RESULTS Young people with TS and with ASD present similar difficulties in solving advanced ToM tasks, whereas patients with childhood-onset OCD present similar results to controls. CONCLUSIONS ToM is altered in other neurodevelopmental disorders beyond ASD, such as TS.
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Affiliation(s)
- A Pérez-Vigil
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - D Ilzarbe
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
| | - B Garcia-Delgar
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Morer
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain
| | - M Pomares
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - O Puig
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - S Lera-Miguel
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Rosa
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Romero
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain
| | - R Calvo Escalona
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - L Lázaro
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Medicina, Universidad de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Caykoylu A, Ugurlu M, Sahin EK, Akan S, Ugurlu GK, Erdogan EC, Alkan EU. Is Every Thyroid Antibody a Bad Sign?: The Complex Relationship of Antithyroid Antibodies and Obsessive-compulsive Symptoms. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:45-52. [PMID: 38247411 PMCID: PMC10811394 DOI: 10.9758/cpn.22.1032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/07/2023] [Accepted: 01/12/2023] [Indexed: 01/23/2024]
Abstract
Objective : Several immunological factors are emphasized in the etiology of autoimmune thyroid diseases and obsessivecompulsive disorder. Obsessive-compulsive symptoms (OCS) are commonly seen in patients with autoimmune thyroid diseases. This study aims to evaluate the relationship between OCS and antithyroid antibodies. Methods : The study included 145 patients with Hashimoto thyroiditis or Graves' disease and 42 healthy controls. Thyroid function tests and serum thyroid autobody levels (anti-thyroglobulin [TG], anti-thyroid peroxidase [TPO], and anti-thyroid stimulating hormone [TSH]) of the patients were measured. The socio-demographic data and OCS of the participants were evaluated with Dimensional OCS (DOCS). Results : DOCS scores were higher in patients than in the control group. There was not found a significant relationship between free T3, free T4, and TSH levels and DOCS scores. Anti-TG positivity in females was associated with lower DOCS scores. Anti-TPO positivity in males had a positive correlation with DOCS scores. There was no correlation between sex and the presence of anti-TSH in terms of OCS severity. Univariate analysis found the highest OCS scores in anti-TPO positive, anti-TG, and anti-TSH negative patients. The group with the lowest OCS scores was found to be anti-TG positive, anti-TPO, and anti-TSH negative patients. Conclusion : OCS severity could be affected by different thyroid autoantibody profiles in patients with autoimmune thyroid diseases. While anti-TG serves a protective role against OCS in females, the presence of anti-TPO may worsen the OCS in men. Additionally, the co-existence of different antithyroid antibodies may affect the severity of OCS differently according to sex.
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Affiliation(s)
- Ali Caykoylu
- Department of Psychiatry, Ankara Yıldırım Beyazit University, Ankara, Turkiye
| | - Mustafa Ugurlu
- Department of Psychiatry, Ankara Yıldırım Beyazit University, Ankara, Turkiye
| | - Esra Kabadayi Sahin
- Department of Psychiatry, Ankara Yıldırım Beyazit University, Ankara, Turkiye
| | - Selcuk Akan
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkiye
| | | | | | - Emine Ulku Alkan
- Department of Translational Medicine, Ankara Yıldırım Beyazit University, Ankara, Turkiye
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Karch S, Maywald M, Schwartz C, Heil C, Neumüller J, Keeser D, Garcia S, Tschentscher N, Pogarell O, Paolini M, Voderholzer U. Neuronal correlates of intensification and acceptance of symptoms during exposure therapy in patients with obsessive-compulsive disorder. Front Psychol 2024; 15:1256046. [PMID: 38375106 PMCID: PMC10875107 DOI: 10.3389/fpsyg.2024.1256046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/15/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Cognitive behaviour therapy with exposure and response prevention is efficient in treating patients with obsessive-compulsive disorder (OCD). Nevertheless, it would be helpful for many patients to complement the therapeutic treatment with acceptance strategies to further increase the therapeutic benefit. The aim of the present study was to examine neurobiological responses to acceptance and intensification strategies during symptom provocation alongside the psychotherapeutic process. Method A total of 23 patients diagnosed with OCD (subtype: washing/contamination fear) was instructed to utilise either an acceptance strategy (ACS) or an intensification strategy (INS) to cope with their emotional and cognitive reactions to personalised symptom-triggering and neutral pictures. Fourteen patients participated twice: at the beginning [T1] and at the end [T2] of an inpatient multimodal treatment including cognitive behaviour therapy with response prevention to assess functional variations. Results For the contrast of T1 and T2, ACS showed increased brain activity in the left inferior frontal gyrus (IFG), left caudate body, and posterior cingulate gyrus (PCC). They also showed decreased activity in the left anterior insula. INS showed decreased activation in right lingual gyrus and right caudate body. At T2, ACS showed increased activation compared to INS in the left cerebrum: IFG, caudate nucleus, middle and superior temporal gyrus, and PCC/cuneus. For the comparison of T1 and T2, the ACS revealed increased brain activity in the left IFG, left caudate body, and right inferior parietal lobe. It showed decreased activity in the left anterior insula. The INS revealed decreased activity in right lingual gyrus and right caudate body.The psychometric questionnaires suggested that patients were able to reduce obsession, compulsion, and depression symptoms. Furthermore, patients rated the ACS as more useful for themselves compared with the INS. Conclusion The increased left IFG activity using ACS (T1 vs. T2) could be interpreted as a better inhibitory top-down process, while the increased PCC response might be due to a better reappraisal strategy after therapy. ACS seems to mobilise neuronal activations under therapy, especially in the left hemisphere. Both strategies showed reductions in emotional networks as a neuronal correlate of therapy success. Overall, ACS may be more efficient than INS, as rated by the patients and as in accordance with neurobiological findings.
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Affiliation(s)
- Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | | | - Clara Heil
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | | | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Sarah Garcia
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Nadja Tschentscher
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Marco Paolini
- Department of Radiology, University Hospital LMU, Munich, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
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Verkhratsky A, Butt A, Li B, Illes P, Zorec R, Semyanov A, Tang Y, Sofroniew MV. Astrocytes in human central nervous system diseases: a frontier for new therapies. Signal Transduct Target Ther 2023; 8:396. [PMID: 37828019 PMCID: PMC10570367 DOI: 10.1038/s41392-023-01628-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 10/14/2023] Open
Abstract
Astroglia are a broad class of neural parenchymal cells primarily dedicated to homoeostasis and defence of the central nervous system (CNS). Astroglia contribute to the pathophysiology of all neurological and neuropsychiatric disorders in ways that can be either beneficial or detrimental to disorder outcome. Pathophysiological changes in astroglia can be primary or secondary and can result in gain or loss of functions. Astroglia respond to external, non-cell autonomous signals associated with any form of CNS pathology by undergoing complex and variable changes in their structure, molecular expression, and function. In addition, internally driven, cell autonomous changes of astroglial innate properties can lead to CNS pathologies. Astroglial pathophysiology is complex, with different pathophysiological cell states and cell phenotypes that are context-specific and vary with disorder, disorder-stage, comorbidities, age, and sex. Here, we classify astroglial pathophysiology into (i) reactive astrogliosis, (ii) astroglial atrophy with loss of function, (iii) astroglial degeneration and death, and (iv) astrocytopathies characterised by aberrant forms that drive disease. We review astroglial pathophysiology across the spectrum of human CNS diseases and disorders, including neurotrauma, stroke, neuroinfection, autoimmune attack and epilepsy, as well as neurodevelopmental, neurodegenerative, metabolic and neuropsychiatric disorders. Characterising cellular and molecular mechanisms of astroglial pathophysiology represents a new frontier to identify novel therapeutic strategies.
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Affiliation(s)
- Alexei Verkhratsky
- International Joint Research Centre on Purinergic Signalling/School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China.
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
- Achucarro Centre for Neuroscience, IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.
- Department of Stem Cell Biology, State Research Institute Centre for Innovative Medicine, LT-01102, Vilnius, Lithuania.
| | - Arthur Butt
- Institute of Biomedical and Biomolecular Sciences, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Baoman Li
- Department of Forensic Analytical Toxicology, School of Forensic Medicine, China Medical University, Shenyang, China
| | - Peter Illes
- International Joint Research Centre on Purinergic Signalling/School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Rudolf Boehm Institute for Pharmacology and Toxicology, University of Leipzig, 04109, Leipzig, Germany
| | - Robert Zorec
- Celica Biomedical, Lab Cell Engineering, Technology Park, 1000, Ljubljana, Slovenia
- Laboratory of Neuroendocrinology-Molecular Cell Physiology, Institute of Pathophysiology, University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - Alexey Semyanov
- Department of Physiology, Jiaxing University College of Medicine, 314033, Jiaxing, China
| | - Yong Tang
- International Joint Research Centre on Purinergic Signalling/School of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
- Key Laboratory of Acupuncture for Senile Disease (Chengdu University of TCM), Ministry of Education/Acupuncture and Chronobiology Key Laboratory of Sichuan Province, Chengdu, China.
| | - Michael V Sofroniew
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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Shivakumar AB, Kumari S, Mehak SF, Gangadharan G. Compulsive-like Behaviors in Amyloid-β 1-42-Induced Alzheimer's Disease in Mice Are Associated With Hippocampo-cortical Neural Circuit Dysfunction. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:773-784. [PMID: 37881551 PMCID: PMC10593884 DOI: 10.1016/j.bpsgos.2023.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
Background In addition to memory deficits, patients with Alzheimer's disease (AD) experience neuropsychiatric disturbances. Recent studies have suggested the association of obsessive-compulsive disorder with the early stages of AD. However, there is a lack of understanding of the neurobiological underpinnings of compulsive-like behaviors at the neuronal circuit level and their relationship with AD. Methods We have addressed this issue in an amyloid-β 1-42-induced mouse model of AD by studying compulsive-like behaviors. Next, we compared the hippocampal and medial prefrontal cortex (mPFC) local field potential pattern and coherence between these regions of control and AD mice. We also assessed the expression pattern of acetylcholine and glutamatergic signaling in these regions, using quantitative polymerase chain reaction. Results Our findings show that AD mice exhibit compulsive-like behaviors, as evidenced by enhanced marble burying, nest building, and burrowing. Furthermore, AD mice exhibited hippocampo-cortical circuit dysfunction demonstrated by decreased power of rhythmic oscillations at the theta (4-12 Hz) and gamma (25-50 Hz) frequencies in the hippocampus and mPFC, two functionally interconnected brain regions involved both in AD and compulsive behaviors. Importantly, coherence between the hippocampus and mPFC in the theta band of AD animals was significantly reduced. Furthermore, we found reduced cholinergic and glutamatergic neurotransmission in the hippocampus and mPFC of AD mice. Conclusions We conclude that the hippocampo-cortical functional alterations may play a significant role in mediating the compulsive-like behaviors observed in AD mice. These findings may help in understanding the underlying circuit mechanisms of obsessive-compulsive disorder-like phenotypes associated with AD.
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Affiliation(s)
- Apoorva Bettagere Shivakumar
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sparsha Kumari
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sonam Fathima Mehak
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Gireesh Gangadharan
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
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van den Boom BJG, Elhazaz-Fernandez A, Rasmussen PA, van Beest EH, Parthasarathy A, Denys D, Willuhn I. Unraveling the mechanisms of deep-brain stimulation of the internal capsule in a mouse model. Nat Commun 2023; 14:5385. [PMID: 37666830 PMCID: PMC10477328 DOI: 10.1038/s41467-023-41026-x] [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: 01/04/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023] Open
Abstract
Deep-brain stimulation (DBS) is an effective treatment for patients suffering from otherwise therapy-resistant psychiatric disorders, including obsessive-compulsive disorder. Modulation of cortico-striatal circuits has been suggested as a mechanism of action. To gain mechanistic insight, we monitored neuronal activity in cortico-striatal regions in a mouse model for compulsive behavior, while systematically varying clinically-relevant parameters of internal-capsule DBS. DBS showed dose-dependent effects on both brain and behavior: An increasing, yet balanced, number of excited and inhibited neurons was recruited, scattered throughout cortico-striatal regions, while excessive grooming decreased. Such neuronal recruitment did not alter basic brain function such as resting-state activity, and only occurred in awake animals, indicating a dependency on network activity. In addition to these widespread effects, we observed specific involvement of the medial orbitofrontal cortex in therapeutic outcomes, which was corroborated by optogenetic stimulation. Together, our findings provide mechanistic insight into how DBS exerts its therapeutic effects on compulsive behaviors.
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Affiliation(s)
- Bastijn J G van den Boom
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Alfredo Elhazaz-Fernandez
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Peter A Rasmussen
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Enny H van Beest
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Aishwarya Parthasarathy
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ingo Willuhn
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
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11
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Lamanna J, Ferro M, Spadini S, Racchetti G, Malgaroli A. The Dysfunctional Mechanisms Throwing Tics: Structural and Functional Changes in Tourette Syndrome. Behav Sci (Basel) 2023; 13:668. [PMID: 37622808 PMCID: PMC10451670 DOI: 10.3390/bs13080668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Tourette Syndrome (TS) is a high-incidence multifactorial neuropsychiatric disorder characterized by motor and vocal tics co-occurring with several diverse comorbidities, including obsessive-compulsive disorder and attention-deficit hyperactivity disorder. The origin of TS is multifactorial, with strong genetic, perinatal, and immunological influences. Although almost all neurotransmettitorial systems have been implicated in TS pathophysiology, a comprehensive neurophysiological model explaining the dynamics of expression and inhibition of tics is still lacking. The genesis and maintenance of motor and non-motor aspects of TS are thought to arise from functional and/or structural modifications of the basal ganglia and related circuitry. This complex wiring involves several cortical and subcortical structures whose concerted activity controls the selection of the most appropriate reflexive and habitual motor, cognitive and emotional actions. Importantly, striatal circuits exhibit bidirectional forms of synaptic plasticity that differ in many respects from hippocampal and neocortical plasticity, including sensitivity to metaplastic molecules such as dopamine. Here, we review the available evidence about structural and functional anomalies in neural circuits which have been found in TS patients. Finally, considering what is known in the field of striatal plasticity, we discuss the role of exuberant plasticity in TS, including the prospect of future pharmacological and neuromodulation avenues.
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Affiliation(s)
- Jacopo Lamanna
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, 20132 Milan, Italy
- Faculty of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Mattia Ferro
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Psychology, Sigmund Freud University, 20143 Milan, Italy
| | - Sara Spadini
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, 20132 Milan, Italy
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, 20132 Milan, Italy
| | - Gabriella Racchetti
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, 20132 Milan, Italy
| | - Antonio Malgaroli
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, 20132 Milan, Italy
- Faculty of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
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12
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Pirone A, Ciregia F, Lazzarini G, Miragliotta V, Ronci M, Zuccarini M, Zallocco L, Beghelli D, Mazzoni MR, Lucacchini A, Giusti L. Proteomic Profiling Reveals Specific Molecular Hallmarks of the Pig Claustrum. Mol Neurobiol 2023; 60:4336-4358. [PMID: 37095366 PMCID: PMC10293365 DOI: 10.1007/s12035-023-03347-2] [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: 07/29/2022] [Accepted: 04/13/2023] [Indexed: 04/26/2023]
Abstract
The present study, employing a comparative proteomic approach, analyzes the protein profile of pig claustrum (CLA), putamen (PU), and insula (IN). Pig brain is an interesting model whose key translational features are its similarities with cortical and subcortical structures of human brain. A greater difference in protein spot expression was observed in CLA vs PU as compared to CLA vs IN. The deregulated proteins identified in CLA resulted to be deeply implicated in neurodegenerative (i.e., sirtuin 2, protein disulfide-isomerase 3, transketolase) and psychiatric (i.e., copine 3 and myelin basic protein) disorders in humans. Metascape analysis of differentially expressed proteins in CLA vs PU comparison suggested activation of the α-synuclein pathway and L1 recycling pathway corroborating the involvement of these anatomical structures in neurodegenerative diseases. The expression of calcium/calmodulin-dependent protein kinase and dihydropyrimidinase like 2, which are linked to these pathways, was validated using western blot analysis. Moreover, the protein data set of CLA vs PU comparison was analyzed by Ingenuity Pathways Analysis to obtain a prediction of most significant canonical pathways, upstream regulators, human diseases, and biological functions. Interestingly, inhibition of presenilin 1 (PSEN1) upstream regulator and activation of endocannabinoid neuronal synapse pathway were observed. In conclusion, this is the first study presenting an extensive proteomic analysis of pig CLA in comparison with adjacent areas, IN and PUT. These results reinforce the common origin of CLA and IN and suggest an interesting involvement of CLA in endocannabinoid circuitry, neurodegenerative, and psychiatric disorders in humans.
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Affiliation(s)
- Andrea Pirone
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy.
| | - Federica Ciregia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulia Lazzarini
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | | | - Maurizio Ronci
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
- Interuniversitary Consortium for Engineering and Medicine, COIIM, Campobasso, Italy
| | - Mariachiara Zuccarini
- Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Lorenzo Zallocco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Daniela Beghelli
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | | | - Antonio Lucacchini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Laura Giusti
- School of Pharmacy, University of Camerino, Camerino, Italy
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13
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Soffer-Dudek N. Obsessive-compulsive symptoms and dissociative experiences: Suggested underlying mechanisms and implications for science and practice. Front Psychol 2023; 14:1132800. [PMID: 37051604 PMCID: PMC10084853 DOI: 10.3389/fpsyg.2023.1132800] [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: 12/27/2022] [Accepted: 03/03/2023] [Indexed: 03/29/2023] Open
Abstract
A strong and specific link between obsessive-compulsive disorder or symptoms (OCD/S) and a tendency for dissociative experiences (e.g., depersonalization-derealization, absorption and imaginative involvement) cannot be explained by trauma and is poorly understood. The present theoretical formulation proposes five different models conceptualizing the relationship. According to Model 1, dissociative experiences result from OCD/S through inward-focused attention and repetition. According to Model 2, dissociative absorption causally brings about both OCD/S and associated cognitive risk factors, such as thought-action fusion, partly through impoverished sense of agency. The remaining models highlight common underlying causal mechanisms: temporo-parietal abnormalities impairing embodiment and sensory integration (Model 3); sleep alterations causing sleepiness and dreamlike thought or mixed sleep-wake states (Model 4); and a hyperactive, intrusive imagery system with a tendency for pictorial thinking (Model 5). The latter model relates to Maladaptive Daydreaming, a suggested dissociative syndrome with strong ties to the obsessive-compulsive spectrum. These five models point to potential directions for future research, as these theoretical accounts may aid the two fields in interacting with each other, to the benefit of both. Finally, several dissociation-informed paths for further developing clinical intervention in OCD are identified.
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Affiliation(s)
- Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva, Israel
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14
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Masharipov R, Korotkov A, Knyazeva I, Cherednichenko D, Kireev M. Impaired Non-Selective Response Inhibition in Obsessive-Compulsive Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1171. [PMID: 36673927 PMCID: PMC9859350 DOI: 10.3390/ijerph20021171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/17/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Two prominent features of obsessive-compulsive disorder (OCD) are the inability to inhibit intrusive thoughts and behaviors and pathological doubt or intolerance of uncertainty. Previous study showed that uncertain context modeled by equiprobable presentation of excitatory (Go) and inhibitory (NoGo) stimuli requires non-selective response inhibition in healthy subjects. In other words, it requires transient global inhibition triggered not only by excitatory stimuli but also by inhibitory stimuli. Meanwhile, it is unknown whether OCD patients show abnormal brain activity of the non-selective response inhibition system. In order to test this assumption, we performed an fMRI study with an equiprobable Go/NoGo task involving fourteen patients with OCD and compared them with 34 healthy controls. Patients with OCD showed pathological slowness in the Go/NoGo task. The non-selective response inhibition system in OCD included all brain areas seen in healthy controls and, in addition, involved the right anterior cingulate cortex (ACC) and the anterior insula/frontal operculum (AIFO). Moreover, a between-group comparison revealed hypoactivation of brain regions within cingulo-opercular and cortico-striato-thalamo-cortical (CSTC) circuits in OCD. Among hypoactivated areas, the right ACC and the right dorsolateral prefrontal cortex (DLPFC) were associated with non-selective inhibition. Furthermore, regression analysis showed that OCD slowness was associated with decreased activation in cingulate regions and two brain areas related to non-selective inhibition: the right DLPFC and the right inferior parietal lobule (IPL). These results suggest that non-selective response inhibition is impaired in OCD, which could be a potential explanation for a relationship between inhibitory deficits and the other remarkable characteristic of OCD known as intolerance of uncertainty.
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Affiliation(s)
- Ruslan Masharipov
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
| | - Alexander Korotkov
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
| | - Irina Knyazeva
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
| | - Denis Cherednichenko
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
| | - Maxim Kireev
- N.P. Bechtereva Institute of the Human Brain, Russian Academy of Sciences, Academika Pavlova Street 9, Saint Petersburg 197376, Russia
- Institute for Cognitive Studies, Saint Petersburg State University, Saint Petersburg 197376, Russia
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15
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Zhang S, Li B, Jiang J, Hu X, Li H, Cao L, Zhou Z, Liang K, Zhou H, Zhang L, Gong Q, Huang X. Abnormal focal segments in left uncinate fasciculus in adults with obsessive-compulsive disorder. Front Psychiatry 2023; 14:1128808. [PMID: 37065900 PMCID: PMC10098161 DOI: 10.3389/fpsyt.2023.1128808] [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: 12/21/2022] [Accepted: 03/06/2023] [Indexed: 04/18/2023] Open
Abstract
Background Although the specific role of the uncinate fasciculus (UF) in emotional processing in patients with obsessive-compulsive disorder (OCD) has been investigated, the exact focal abnormalities in the UF have not been identified. The aim of the current study was to identify focal abnormalities in the white matter (WM) microstructure of the UF and to determine the associations between clinical features and structural neural substrates. Methods In total, 71 drug-naïve patients with OCD and 81 age- and sex-matched healthy controls (HCs) were included. Automated fiber quantification (AFQ), a tract-based quantitative approach, was adopted to measure alterations in diffusion parameters, including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD), along the trajectory of the UF. Additionally, we utilized partial correlation analyses to explore the relationship between the altered diffusion parameters and clinical characteristics. Results OCD patients showed significantly higher FA and lower RD at the level of the temporal and insular portions in the left UF than HCs. In the insular segments of the left UF, increased FA was positively correlated with the Hamilton Anxiety Scale (HAMA) score, while decreased RD was negatively correlated with the duration of illness. Conclusion We observed specific focal abnormalities in the left UF in adult patients with OCD. Correlations with measures of anxiety and duration of illness underscore the functional importance of the insular portion of left UF disturbance in OCD patients.
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Affiliation(s)
- Suming Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Bin Li
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiaxin Jiang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lingxiao Cao
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Zilin Zhou
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Kaili Liang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Huan Zhou
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China
- *Correspondence: Qiyong Gong,
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Psychoradiology Research Unit of the Chinese Academy of Medical Sciences, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Xiaoqi Huang,
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16
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Khan I, Jaura TA, Tukruna A, Arif A, Tebha SS, Nasir S, Mukherjee D, Masroor N, Yosufi A. Use of Selective Alternative Therapies for Treatment of OCD. Neuropsychiatr Dis Treat 2023; 19:721-732. [PMID: 37041856 PMCID: PMC10083036 DOI: 10.2147/ndt.s403997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 03/30/2023] [Indexed: 04/13/2023] Open
Abstract
About 40% of the people with the obsessive-compulsive-disorder do not experience the desired outcome after the existing treatment, and its several side effects were reported. This systematic review was conducted to evaluate the efficacy and tolerability of alternative drugs and assess the possibility of their use as treatment options for obsessive-compulsive-disorder. The Scientific databases PubMed, Science Direct, Google Scholar, Cochrane, Directory of Open Access Journals, MedRxiv and BioRxiv, were searched from inception to March 2022, using appropriate search strategies for each drug and following the Prisma guidelines 2020. Studies were selected according to the already set criteria and assessed for bias. Data were extracted, and descriptive and continuous data were analyzed and presented as frequency/percentage and mean. A total of 16 observational and interventional studies were included for data extraction. The studies focused on four drugs, Psilocybin (n=4), Cannabis (n=7), Nicotine (n=3), and Morphine (n=2), that were used to test out their effect on OCD symptoms. Overall, the majority of the studies showed promising results by documenting a reduction in Y-BOCS scores. However, few subjects, specifically those using nicotine or Cannabis, did not affect their condition or self-reported worsening symptoms. Few side effects were also noticed. This systematic review found that the drugs mostly showed a positive response. All Psilocybin and morphine users, 88.2% and 74.1% of the nicotine and Cannabis users, respectively, reported experiencing the positive effect of these drugs, indicating that these drugs have the potential to be used in the management of OCD. However, further research is required in this arena to thoroughly understand the mechanism of action by which these drugs produce their therapeutic effect. Policies to destigmatize and encourage clinical trials with these drugs are crucial for exploring the use of these drugs as a treatment option for OCD.
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Affiliation(s)
- Iman Khan
- Department of Medicine, Ziauddin Medical University, Karachi, Sindh, Pakistan
| | - Taimoor Asif Jaura
- General Adult Psychiatry, Southwest London and Saint George’s Mental Health Nhs Trust, London, UK
| | - Alaa Tukruna
- Department of Medicine, Batterjee medical college, Jeddah, Kingdom of Saudi Arabia
| | - Aabiya Arif
- Department of Medicine, Ziauddin Medical University, Karachi, Sindh, Pakistan
| | - Sameer Saleem Tebha
- Department of Neurosurgery and Neurology, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Sameen Nasir
- Medical College, Aga Khan University Hospital, Karachi, Pakistan
| | - Dattatreya Mukherjee
- Department of Medicine, International School, Jinan University, Jinan, People’s Republic of China
| | - Nadia Masroor
- Department of Medicine, Liaquat University of medical and health Sciences, Jamshoro, Sindh, Pakistan
| | - Abubakr Yosufi
- Medical School, Kabul University of Medical Sciences, Kabul, Afghanistan
- Correspondence: Abubakr Yosufi, Kabul University of Medical Sciences, Kabul, Afghanistan, Tel +93 747236767, Email
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17
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Yamamuro K. Near-infrared spectroscopy in child and adolescent neurodevelopmental disorders. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2022; 1:e59. [PMID: 38868653 PMCID: PMC11114441 DOI: 10.1002/pcn5.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/17/2022] [Accepted: 10/19/2022] [Indexed: 06/14/2024]
Abstract
Near-infrared spectroscopy (NIRS) is a noninvasive optical technique that uses the near-infrared spectrum for functional neuroimaging by measuring oxygenation and hemodynamic changes in the cerebral cortex. The advantages of NIRS include its portability and ease of application, which allows for testing with the subject in natural positions, such as sitting or standing. Since 1994, NIRS has been increasingly used to conduct functional activation studies on different psychiatric disorders, most prominently schizophrenia, depression, bipolar disorder, and neurodevelopmental disorders. However, limited information on its use among child and adolescent patients is available. We herein review recent findings obtained using NIRS measurements of the brain during cognitive tasks in neurodevelopmental disorders, such as autism spectrum disorder, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, and Tourette's disorder. This will facilitate evaluations of the causation and treatment of prefrontal cortex dysfunctions.
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Affiliation(s)
- Kazuhiko Yamamuro
- Department of PsychiatryNara Medical University School of MedicineKashiharaJapan
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18
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Porwal MH, Karra H, Sharma U, Bhatti D. Deep brain stimulation for refractory obsessive-compulsive disorder: A review and analysis of the FDA MAUDE database. Surg Neurol Int 2022; 13:399. [PMID: 36128133 PMCID: PMC9479641 DOI: 10.25259/sni_613_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Deep brain stimulation (DBS) is used as a treatment option for patients diagnosed with a form of obsessive-compulsive disorder (OCD) that is highly resistant to conventional treatment methods. In 2009, DBS was granted a humanitarian device exemption-approval by the Food and Drug Administration after promising preliminary data. Monitoring of long-term safety data through post market surveillance of adverse events has not yet been conducted for DBS in OCD patients. This study aims to address this critical knowledge gap. Methods: All patient- and device-related (PR; DR) reports from January 1, 2012, to December 31, 2021, were downloaded and compiled from the manufacturer and user facility device experience (MAUDE) database pertaining to DBS for OCD using the product class name “Deep Brain Stimulator For OCD.” Data in this study were examined using descriptive statistics to evaluate for frequency of reporting. Results: The most frequently reported PR adverse event categories included psychiatric (40%), neurological (19%), other (14%), decreased therapeutic response (10%), and infections (10%). The most frequent DR reports were high impedance (14%), energy output problem (7%), battery problem (7%), malposition of device (7%), and improper/incorrect procedure or method (7%). Conclusion: The PR and DR adverse events in our study align with the previous findings of adverse events. They also further solidify that DBS for refractory OCD may be a viable option for the right patient population. However, further studies are essential given the limitations of the MAUDE database.
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Affiliation(s)
- Mokshal H. Porwal
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin,
| | - Hamsitha Karra
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin,
| | - Umesh Sharma
- Department of Neurology, Orlando Regional Medical Center,
| | - Danish Bhatti
- Department of Neurology, University of Central Florida College of Medicine, Orlando, Florida, United States
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19
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Sun J, Yuan Y, Wu X, Liu A, Wang J, Yang S, Liu B, Kong Y, Wang L, Zhang K, Li Q, Zhang S, Yuan T, Xu TL, Huang J. Excitatory SST neurons in the medial paralemniscal nucleus control repetitive self-grooming and encode reward. Neuron 2022; 110:3356-3373.e8. [PMID: 36070748 DOI: 10.1016/j.neuron.2022.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/27/2022] [Accepted: 08/05/2022] [Indexed: 01/13/2023]
Abstract
The use of body-focused repetitive behaviors (BFRBs) is conceptualized as a means of coping with stress. However, the neurological mechanism by which repetitive behaviors affect anxiety regulation is unclear. Here, we identify that the excitatory somatostatin-positive neurons in the medial paralemniscal nucleus (MPLSST neurons) in mice promote self-grooming and encode reward. MPLSST neurons display prominent grooming-related neuronal activity. Loss of function of MPLSST neurons impairs both self-grooming and post-stress anxiety alleviation. Activation of MPLSST neurons is rewarding and sufficient to drive reinforcement by activating dopamine (DA) neurons in the ventral tegmental area (VTA) and eliciting dopamine release. The neuropeptide SST facilitates the rewarding impact of MPLSST neurons. MPLSST neuron-mediated self-grooming is triggered by the input from the central amygdala (CeA). Our study reveals a dual role of CeA-MPLSST-VTADA circuit in self-grooming and post-stress anxiety regulation and conceptualizes MPLSST neurons as an interface linking the stress and reward systems in mice.
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Affiliation(s)
- Jingjing Sun
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yuan Yuan
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaohua Wu
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Anqi Liu
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jingjie Wang
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Shuo Yang
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Bing Liu
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yalei Kong
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Lizhao Wang
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Kai Zhang
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qian Li
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Siyu Zhang
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Tifei Yuan
- Shanghai Mental Health Center, Shanghai 200030, China
| | - Tian-Le Xu
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ju Huang
- Center for Brain Science of Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Department of Anatomy and Physiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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20
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Lebenheim L, Booker SA, Derst C, Weiss T, Wagner F, Gruber C, Vida I, Zahm DS, Veh RW. A novel giant non-cholinergic striatal interneuron restricted to the ventrolateral striatum coexpresses Kv3.3 potassium channel, parvalbumin, and the vesicular GABA transporter. Mol Psychiatry 2022; 27:2315-2328. [PMID: 33190145 PMCID: PMC9126804 DOI: 10.1038/s41380-020-00948-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The striatum is the main input structure of the basal ganglia. Distinct striatal subfields are involved in voluntary movement generation and cognitive and emotional tasks, but little is known about the morphological and molecular differences of striatal subregions. The ventrolateral subfield of the striatum (VLS) is the orofacial projection field of the sensorimotor cortex and is involved in the development of orofacial dyskinesias, involuntary chewing-like movements that often accompany long-term neuroleptic treatment. The biological basis for this particular vulnerability of the VLS is not known. Potassium channels are known to be strategically localized within the striatum. In search of possible molecular correlates of the specific vulnerability of the VLS, we analyzed the expression of voltage-gated potassium channels in rodent and primate brains using qPCR, in situ hybridization, and immunocytochemical single and double staining. Here we describe a novel, giant, non-cholinergic interneuron within the VLS. This neuron coexpresses the vesicular GABA transporter, the calcium-binding protein parvalbumin (PV), and the Kv3.3 potassium channel subunit. This novel neuron is much larger than PV neurons in other striatal regions, displays characteristic electrophysiological properties, and, most importantly, is restricted to the VLS. Consequently, the giant striatal Kv3.3-expressing PV neuron may link compromised Kv3 channel function and VLS-based orofacial dyskinesias.
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Affiliation(s)
- Lydia Lebenheim
- Institut für Integrative Neuroanatomie, Charité-Universitätsmedizin Berlin, Philippstraße 12, D-10115, Berlin, Germany
| | - Sam A Booker
- Institut für Integrative Neuroanatomie, Charité-Universitätsmedizin Berlin, Philippstraße 12, D-10115, Berlin, Germany.,Centre for Discovery Brain Sciences, University of Edinburgh, Edinburgh, EH8 9XD, UK
| | - Christian Derst
- Institut für Integrative Neuroanatomie, Charité-Universitätsmedizin Berlin, Philippstraße 12, D-10115, Berlin, Germany
| | - Torsten Weiss
- Institut für Integrative Neuroanatomie, Charité-Universitätsmedizin Berlin, Philippstraße 12, D-10115, Berlin, Germany
| | - Franziska Wagner
- Institut für Integrative Neuroanatomie, Charité-Universitätsmedizin Berlin, Philippstraße 12, D-10115, Berlin, Germany.,Hans Berger Klinik für Neurologie, Universitätsklinikum Jena, An der Klinik 1, D-07747, Jena, Germany
| | - Clemens Gruber
- Institut für Integrative Neuroanatomie, Charité-Universitätsmedizin Berlin, Philippstraße 12, D-10115, Berlin, Germany
| | - Imre Vida
- Institut für Integrative Neuroanatomie, Charité-Universitätsmedizin Berlin, Philippstraße 12, D-10115, Berlin, Germany
| | - Daniel S Zahm
- Department of Pharmacology and Physiology, Saint Louis University School of Medicine, 1402 S. Grand Blvd, Saint Louis, MO, 63104, USA.
| | - Rüdiger W Veh
- Institut für Zell- und Neurobiologie, Charité -Universitätsmedizin Berlin, Philippstraße 12, D-10115, Berlin, Germany.
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Gupta R, Mehan S, Sethi P, Prajapati A, Alshammari A, Alharbi M, Al-Mazroua HA, Narula AS. Smo-Shh Agonist Purmorphamine Prevents Neurobehavioral and Neurochemical Defects in 8-OH-DPAT-Induced Experimental Model of Obsessive-Compulsive Disorder. Brain Sci 2022; 12:brainsci12030342. [PMID: 35326298 PMCID: PMC8946713 DOI: 10.3390/brainsci12030342] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 02/01/2023] Open
Abstract
Obsessive-compulsive disorder is a mental disorder characterized by repetitive, unwanted thoughts and behavior due to abnormal neuronal corticostriatal-thalamocortical pathway and other neurochemical changes. Purmorphamine is a smoothened-sonic-hedgehog agonist that has a protective effect against many neurological diseases due to its role in maintaining functional connectivity during CNS development and its anti-inflammatory and antioxidant properties. As part of our current research, we investigated the neuroprotective effects of PUR against behavioral and neurochemical changes in 8-hydroxy-2-(di-n-propylamino)-tetralin-induced obsessive-compulsive disorder in rats. Additionally, the effect of PUR was compared with the standard drug for OCD, i.e., fluvoxamine. The intra-dorsal raphe-nucleus injection of 8-OH-DPAT in rats for seven days significantly showed OCD-like repetitive and compulsive behavior along with increased oxidative stress, inflammation, apoptosis, as well as neurotransmitter imbalance. These alterations were dose-dependently attenuated by long-term purmorphamine treatment at 5 mg/kg and 10 mg/kg i.p. In this study, we assessed the level of various neurochemical parameters in different biological samples, including brain homogenate, blood plasma, and CSF, to check the drug’s effect centrally and peripherally. These effects were comparable to the standard oral treatment withfluvoxamine at 10 mg/kg. However, when fluvoxamine was given in combination with purmorphamine, there was a more significant restoration of these alterations than the individualtreatmentswithfluvoxamine and purmorphamine. All the above findings demonstrate that the neuroprotective effect of purmorphamine in OCD can be strong evidence for developing a new therapeutic target for treating and managing OCD.
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Affiliation(s)
- Ria Gupta
- Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga 142001, Punjab, India; (R.G.); (P.S.); (A.P.)
| | - Sidharth Mehan
- Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga 142001, Punjab, India; (R.G.); (P.S.); (A.P.)
- Correspondence:
| | - Pranshul Sethi
- Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga 142001, Punjab, India; (R.G.); (P.S.); (A.P.)
| | - Aradhana Prajapati
- Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga 142001, Punjab, India; (R.G.); (P.S.); (A.P.)
| | - Abdulrahman Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.); (H.A.A.-M.)
| | - Metab Alharbi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.); (H.A.A.-M.)
| | - Haneen A. Al-Mazroua
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (A.A.); (M.A.); (H.A.A.-M.)
| | - Acharan S. Narula
- Narula Research, LLC, 107 Boulder Bluff, Chapel Hill, NC 27516, USA;
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Diarjani AA, Javadi SAHS. The effect of low-frequency repetitive transcranial magnetic stimulation on left dorsolateral prefrontal cortex in patients with the obsessive-compulsive disorder: a double-blinded, sham-controlled clinical trial. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00172-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract
Background
Obsessive-compulsive disorder (OCD) is a complicated neuropsychiatric disorder, which its prevalence ranges from 2 to 4%. In 30–60% of patients due to intolerance of side effects or partial response to treat symptoms of the disease remain or relapse. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive therapeutic option to treat this condition. Transcranial magnetic stimulation can be applied for treating with no anesthesia. The current study intended to evaluate the effectiveness of low-frequency rTMS on the left dorsolateral prefrontal cortex as an adjunct treatment in combination with standard medication in patients with OCD.
Results
In both groups of intervention and sham, the Y-BOCS scale was decreased. There was no significant difference between the two groups (P=0.82). Also after 15 sessions, the symptoms of OCD patients were improved. Although the treatment process was the same in the control group, none of the patients showed any serious complications, such as seizures, severe headache, neurological complication, or cognitive impairment during treatment.
Conclusions
It seems that treatment with 1 Hz rTMS on the left dorsolateral prefrontal cortex does not play an effective role in the recovery of OCD patients.
Trial registration
Name of the registry: Therapeutic effect comparison of the Repetitive Transcranial MagneticMagnetic Stimulation (RTMS) combination therapy with drug versus medication monotherapy in obsessive-compulsive disorder (OCD). Trial registration number: IRCT ID: IRCT20200728048240N1. Date of registration: 2020/8/8.
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23
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Yacou MA, Chowdury A, Easter P, Hanna GL, Rosenberg DR, Diwadkar VA. Sustained attention induces altered effective connectivity of the ascending thalamo-cortical relay in obsessive-compulsive disorder. Front Psychiatry 2022; 13:869106. [PMID: 36032258 PMCID: PMC9402224 DOI: 10.3389/fpsyt.2022.869106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Abnormal function of the thalamo-cortical relay is considered a hallmark of obsessive-compulsive disorder (OCD) and aberrant network interactions may underpin many of the clinical and cognitive symptoms that characterize the disorder. Several statistical approaches have been applied to in vivo fMRI data to support the general loss of thalamo-cortical connectivity in OCD. However, (a) few studies have assessed the contextual constraints under which abnormal network interactions arise or (b) have used methods of effective connectivity to understand abnormal network interactions. Effective connectivity is a particularly valuable method as it describes the putative causal influences that brain regions exert over each other, as opposed to the largely statistical consistencies captured in functional connectivity techniques. Here, using dynamic causal modeling (DCM), we evaluated how attention demand induced inter-group differences (HC ≠ OCD) in effective connectivity within a motivated thalamo-cortical network. Of interest was whether these effects were observed on the ascending thalamo-cortical relay, essential for the sensory innervation of the cortex. fMRI time series data from sixty-two participants (OCD, 30; HC, 32) collected using an established sustained attention task were submitted to a space of 162 competing models. Across the space, models distinguished between competing hypotheses of thalamo-cortical interactions. Bayesian model selection (BMS) identified marginally differing likely generative model architectures in OCD and HC groups. Bayesian model averaging (BMA), was used to weight connectivity parameter estimates across all models, with each parameter weighted by each model's posterior probability, thus providing more stable estimates of effective connectivity. Inferential statistical analyses of estimated parameters revealed two principal results: (1) Significantly reduced intrinsic connectivity of the V1 → SPC pathway in OCD, suggested connective weakness in the early constituents of the dorsal visual pathway; (2) More pertinent with the discovery possibilities afforded by DCM, sustained attention in OCD patients induced significantly reduced contextual modulation of the ascending relay from the thalamus to the prefrontal cortex. These results form an important complement to our understanding of the contextual bases of thalamo-cortical network deficits in OCD, emphasizing vulnerability of the ascending relay.
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Affiliation(s)
- Mario A Yacou
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Asadur Chowdury
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Philip Easter
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - David R Rosenberg
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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24
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The Role of Expectation and Beliefs on the Effects of Non-Invasive Brain Stimulation. Brain Sci 2021; 11:brainsci11111526. [PMID: 34827526 PMCID: PMC8615662 DOI: 10.3390/brainsci11111526] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022] Open
Abstract
Non-invasive brain stimulation (NIBS) techniques are used in clinical and cognitive neuroscience to induce a mild magnetic or electric field in the brain to modulate behavior and cortical activation. Despite the great body of literature demonstrating promising results, unexpected or even paradoxical outcomes are sometimes observed. This might be due either to technical and methodological issues (e.g., stimulation parameters, stimulated brain area), or to participants’ expectations and beliefs before and during the stimulation sessions. In this narrative review, we present some studies showing that placebo and nocebo effects, associated with positive and negative expectations, respectively, could be present in NIBS trials, both in experimental and in clinical settings. The lack of systematic evaluation of subjective expectations and beliefs before and after stimulation could represent a caveat that overshadows the potential contribution of placebo and nocebo effects in the outcome of NIBS trials.
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25
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Guillén-Font MA, Cervera M, Puigoriol E, FOGUET-BOREU QUINTÍ, Arrufat FX, Serra-Millàs M. Insight in Obsessive-Compulsive Disorder: Relationship With Sociodemographic and Clinical Characteristics. J Psychiatr Pract 2021; 27:427-438. [PMID: 34768265 PMCID: PMC8575164 DOI: 10.1097/pra.0000000000000580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Insight is considered a multidimensional concept and, in the context of obsessive-compulsive disorder (OCD), impairment in insight has been widely reported to be associated with severity and other clinical and sociodemographic variables. However, the studies concerning insight in OCD have produced heterogenous data as a result of the scales used to measure insight. To overcome this heterogeneity, the study presented here used 4 different widely used and validated insight scales. The objective was to evaluate various aspects of insight using these scales to identify the relationships between different aspects of insight and clinical and sociodemographic variables to assess which scale or scales might possess greater efficiency in clinical practice. For this purpose, a descriptive, observational, and cross-sectional study of 81 patients in treatment in a mental health center was conducted. Patients were evaluated using the Brown Assessment of Beliefs Scale, the Overvalued Ideas Scale, the Scale of Unawareness of Mental Disorders, the Yale-Brown Obsessive Compulsive Scale, the Clinical Global Impressions Scale, the Global Assessment of Functioning Scale, and the Rey-Osterrieth Complex Figure Test. The results reported significant relationships between insight and scores on the Yale-Brown Obsessive Compulsive Scale (Thoughts, Compulsions, and Total scales), Clinical Global Impressions Scale, and the Global Assessment of Functioning Scale, and significant differences with regard to sex, level of education, working status, and course of the disorder. A correlation analysis was conducted to assess the relationships among the 4 insight scales. The results of this analysis suggest that the scales that measure insight in a multidimensional way (Brown Assessment of Beliefs Scale and Overvalued Ideas Scale) provide more information about the severity of the disorder in patients with OCD.
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26
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Pérez-Vigil A, Ilzarbe D, Garcia-Delgar B, Morer A, Pomares M, Puig O, Lera-Miguel S, Rosa M, Romero M, Calvo Escalona R, Lázaro L. Theory of mind in neurodevelopmental disorders: Beyond autistic spectrum disorder. Neurologia 2021; 39:S0213-4853(21)00086-4. [PMID: 34090719 DOI: 10.1016/j.nrl.2021.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/21/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Theory of mind (ToM) is the human ability to perceive, interpret, and attribute the mental states of other people, and the alteration of this cognitive function is a core symptom of autistic spectrum disorder (ASD). In such other neurodevelopmental disorders as childhood-onset obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) that can present with cognitive dysfunctions, ToM has been less extensively studied, especially in the young population. The aim of the study was to compare advanced ToM between groups of young people diagnosed with OCD, TS, or ASD and a control group. METHODS Clinical interviews were conducted with male patients aged between 11 and 17 years with a main diagnosis of OCD (n=19), TS (n=14), or ASD (n=18), and a control group (n=20). We administered instruments for estimating intelligence quotient and severity of psychiatric symptoms, and tasks to evaluate ToM (the "Stories from everyday life" task and the "Reading the mind in the eyes" test). RESULTS Young people with TS and with ASD present similar difficulties in solving advanced ToM tasks, whereas patients with childhood-onset OCD present similar results to controls. CONCLUSIONS ToM is altered in other neurodevelopmental disorders beyond ASD, such as TS.
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Affiliation(s)
- A Pérez-Vigil
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España.
| | - D Ilzarbe
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España
| | - B Garcia-Delgar
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España
| | - A Morer
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España
| | - M Pomares
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
| | - O Puig
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
| | - S Lera-Miguel
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España
| | - M Rosa
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - M Romero
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España
| | - R Calvo Escalona
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
| | - L Lázaro
- Departamento de Psiquiatría Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínic de Barcelona, Barcelona, España; Departamento de Medicina, Universidad de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
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27
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Abstract
Learning to respond appropriately to one's surrounding environment is fundamental to survival. Importantly, however, individuals vary in how they respond to cues in the environment and this variation may be a key determinant of psychopathology. The ability of seemingly neutral cues to promote maladaptive behavior is a hallmark of several psychiatric disorders including, substance use disorder, post-traumatic stress disorder, eating disorders and obsessive-compulsive disorder. Thus, it is important to uncover the neural mechanisms by which such cues are able to attain inordinate control and promote psychopathological behavior. Here, we suggest that glucocorticoids play a critical role in this process. Glucocorticoids are primarily recognized as the main hormone secreted in response to stress but are known to exert their effects across the body and the brain, and to affect learning and memory, cognition and reward-related behaviors, among other things. Here we speculate that glucocorticoids act to facilitate a dopamine-dependent form of cue-reward learning that appears to be relevant to a number of psychiatric conditions. Specifically, we propose to utilize the sign-tracker/goal-tracker animal model as a means to capture individual variation in stimulus-reward learning and to isolate the role of glucocorticoid-dopamine interactions in mediating these individual differences. It is hoped that this framework will lead to the discovery of novel mechanisms that contribute to complex neuropsychiatric disorders and their comorbidity.
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Affiliation(s)
- Sofia A. Lopez
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA
| | - Shelly B. Flagel
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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28
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Li Q, Zhao Y, Huang Z, Guo Y, Long J, Luo L, You W, Sweeney JA, Li F, Gong Q. Microstructural white matter abnormalities in pediatric and adult obsessive-compulsive disorder: A systematic review and meta-analysis. Brain Behav 2021; 11:e01975. [PMID: 33270358 PMCID: PMC7882176 DOI: 10.1002/brb3.1975] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/09/2020] [Accepted: 11/15/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To identify the most prominent and replicable fractional anisotropy (FA) alterations of white matter associated with obsessive-compulsive disorder (OCD) in tract-based spatial statistics (TBSS) studies. METHODS We reviewed previous TBSS studies (n = 20) in OCD and performed a meta-analysis (n = 16) of FA differences. RESULTS No between-group differences in FA were detected in the pooled meta-analysis. However, reduced FA was identified in the genu and anterior body of corpus callosum (CC) in adult OCD. FA reductions in the anterior body of CC were associated with a later age of onset in adult patients with OCD. For pediatric OCD, decreased FA in earlier adolescence and increased FA in later adolescence were seemingly related to an altered trajectory of brain maturation. CONCLUSIONS Absent in the pooled sample but robust in adults, disrupted microstructural organization in the anterior part of CC indicates a bias of deficits toward connections in interhemispheric connections of rostral neocortical regions, which could lead to deficits of interhemispheric communication and thus contribute to cognitive and emotional deficits in adult OCD. The correlation between FA in the anterior body of CC and older illness onset suggests that patients with later adult onset of illness may represent a biologically distinct subgroup. For pediatric OCD, alterations in neurodevelopmental maturation may contribute to inconsistent patterns of FA alteration relative to controls during adolescence. While most studies of OCD have emphasized alterations of within hemisphere fronto-striatal circuits, these results indicate that between hemisphere connectivity of this circuitry may also represent important pathophysiology of the illness.
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Affiliation(s)
- Qian Li
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan UniversityChengduChina
| | - Youjin Zhao
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan UniversityChengduChina
| | - Zixuan Huang
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Medical Imaging Technology Department, West China School of MedicineSichuan UniversityChengduChina
| | - Yi Guo
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan UniversityChengduChina
| | - Jingyi Long
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan UniversityChengduChina
| | - Lekai Luo
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan UniversityChengduChina
| | - Wanfang You
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan UniversityChengduChina
| | - John A. Sweeney
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Department of PsychiatryUniversity of CincinnatiCincinnatiOHUSA
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan UniversityChengduChina
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan UniversityChengduChina
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Hatchondo L, Vallée A, Vallée R, Jaafari N, Maillochaud S, Naudin M, Vallée JN, Guillevin R, Guillevin C. Altered phospholipid and high-energy phosphate metabolism in the basal ganglia and thalamus of severe obsessive compulsive patients with treatment resistance: A phosphorus 31 nuclear magnetic resonance spectroscopy study. Psychiatry Res Neuroimaging 2021; 307:111217. [PMID: 33199172 DOI: 10.1016/j.pscychresns.2020.111217] [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: 01/16/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Cerebral metabolism in obsessive-compulsive-disorder(OCD) has been the subject of numerous studies using proton magnetic resonance spectroscopy(MRS). Despite heterogeneous results, some studies have unraveled membrane turnover and energy metabolism abnormalities in different brain regions, suggesting that alterations in these processes may contribute to the pathophysiology. So far, no authors have explored phospholipids and high-energy phosphate metabolism using 31P-MRS, which allows in vivo quantification of phosphorus metabolites that are considered to be related to membrane turnover and energy metabolism. MATERIALS AND METHODS The aim of our study was to describe and compare brain metabolic changes using 31P-MRS in the striatum and the thalamus, between 23 severe OCD patients and 22 healthy controls. All subject underwent a clinical examination and a same 31P-MRS protocol. RESULTS Significantly, increased concentrations of PC, PDE,PME,GPC,PME/PCr,PDE/PCr were found in patients compared to controls in the striatum and the thalamus. PCr and tATP were decreased in the striatum. Finally, significant correlations were found in the striatum and the thalamus between illness duration and some specific measured parameters. CONCLUSION Our results showed significant modifications of the membrane and energy metabolism in the basal ganglia of severe OCD patients and suggests a link between energetic buffer and serotonin metabolism disorder.
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Affiliation(s)
- Laura Hatchondo
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France
| | - Alexandre Vallée
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; University Hospital of Poitiers, 2 rue de la milétrie, 86021 Poitiers, France
| | - Rodolphe Vallée
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; Avicenne University hospital, Paris 13 University, AP-HP, 93009 Bobigny, France
| | - Nemat Jaafari
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France; Poitiers University, France.
| | - Sylvie Maillochaud
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Mathieu Naudin
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; University Hospital of Poitiers, 2 rue de la milétrie, 86021 Poitiers, France.
| | - Jean-Noël Vallée
- Amiens-Picardie University Hospital, Picardie Jules Verne (UPJV) University, Amiens, France
| | - Rémy Guillevin
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; University Hospital of Poitiers, 2 rue de la milétrie, 86021 Poitiers, France.
| | - Carole Guillevin
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; University Hospital of Poitiers, 2 rue de la milétrie, 86021 Poitiers, France.
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Chabardes S, Krack P, Piallat B, Bougerol T, Seigneuret E, Yelnik J, Fernandez Vidal S, David O, Mallet L, Benabid AL, Polosan M. Deep brain stimulation of the subthalamic nucleus in obsessive-compulsives disorders: long-term follow-up of an open, prospective, observational cohort. J Neurol Neurosurg Psychiatry 2020; 91:1349-1356. [PMID: 33033168 PMCID: PMC7677463 DOI: 10.1136/jnnp-2020-323421] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/01/2020] [Accepted: 08/31/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a major cause of disability in western country and responsible for severe impairment of quality of life. About 10% of patients present with severe OCD symptoms and require innovative treatment such as deep brain stimulation (DBS). Among possible targets, the non-motor subthalamic nucleus (STN) is a key node of the basal ganglia circuitry, strongly connected to limbic cortical areas known to be involved in OCD. METHOD We analysed, in a prospective, observational, monocentric, open label cohort, the effect of chronic non-motor STN-DBS in 19 patients with treatment-resistant OCD consecutively operated in a single centre. Severity of OCD was evaluated using the Yale and Brown Obsessive-Compulsive Scale (YBOCS). YBOCS scores at 6, 12 and 24 months postoperatively were compared with baseline. Responders were defined by >35% improvement of YBOCS scores. Global Assessment Functioning (GAF) scale was used to evaluate the impact of improvement. RESULTS At a 24-month follow-up, the mean YBOCS score improved by 53.4% from 33.3±3.5 to 15.8±9.1 (95% CI 11.2-20.4; p<0.0001). Fourteen out of 19 patients were considered as responders, 5 out of 19 being improved over 75% and 10 out of 19 over 50%. GAF scale improved by 92% from 34.1±3.9 to 66.4±18.8 (95% CI 56.7-76.1; p=0.0003). The most frequent adverse events consisted of transient DBS-induced hypomania and anxiety. CONCLUSION Chronic DBS of the non-motor STN is an effective and relatively safe procedure to treat severe OCD resistant to conventional management.
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Affiliation(s)
- Stephan Chabardes
- CLINATEC, CEA Clinatec-Minatec, Grenoble, France .,Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.,Grenoble Institut neurosciences, University Grenoble Alpes-INSERM U1216, 38000 Grenoble, France
| | - Paul Krack
- Division of Neurology, Department of Neurology, Bern University Hospital, Bern, Switzerland, Bern, Switzerland.,Department of Neurology, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Brigitte Piallat
- Grenoble Institut neurosciences, University Grenoble Alpes-INSERM U1216, 38000 Grenoble, France
| | - Thierry Bougerol
- Department of Psychiatry, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Eric Seigneuret
- Department of Neurosurgery, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Jerome Yelnik
- Institut du Cerveau, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | - Sara Fernandez Vidal
- Institut du Cerveau, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France
| | - Olivier David
- Grenoble Institut neurosciences, University Grenoble Alpes-INSERM U1216, 38000 Grenoble, France
| | - Luc Mallet
- Institut du Cerveau, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France.,Département Médical-Universitaire de Psychiatrie et d'Addictologie, Univ Paris-Est Créteil, DMU IMPACT, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Créteil, France.,Department of Mental Health and Psychiatry, Global Health Institute, University of Geneva, Geneva, Switzerland
| | | | - Mircea Polosan
- Grenoble Institut neurosciences, University Grenoble Alpes-INSERM U1216, 38000 Grenoble, France.,Department of Psychiatry, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
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Szechtman H, Harvey BH, Woody EZ, Hoffman KL. The Psychopharmacology of Obsessive-Compulsive Disorder: A Preclinical Roadmap. Pharmacol Rev 2020; 72:80-151. [PMID: 31826934 DOI: 10.1124/pr.119.017772] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This review evaluates current knowledge about obsessive-compulsive disorder (OCD), with the goal of providing a roadmap for future directions in research on the psychopharmacology of the disorder. It first addresses issues in the description and diagnosis of OCD, including the structure, measurement, and appropriate description of the disorder and issues of differential diagnosis. Current pharmacotherapies for OCD are then reviewed, including monotherapy with serotonin reuptake inhibitors and augmentation with antipsychotic medication and with psychologic treatment. Neuromodulatory therapies for OCD are also described, including psychosurgery, deep brain stimulation, and noninvasive brain stimulation. Psychotherapies for OCD are then reviewed, focusing on behavior therapy, including exposure and response prevention and cognitive therapy, and the efficacy of these interventions is discussed, touching on issues such as the timing of sessions, the adjunctive role of pharmacotherapy, and the underlying mechanisms. Next, current research on the neurobiology of OCD is examined, including work probing the role of various neurotransmitters and other endogenous processes and etiology as clues to the neurobiological fault that may underlie OCD. A new perspective on preclinical research is advanced, using the Research Domain Criteria to propose an adaptationist viewpoint that regards OCD as the dysfunction of a normal motivational system. A systems-design approach introduces the security motivation system (SMS) theory of OCD as a framework for research. Finally, a new perspective on psychopharmacological research for OCD is advanced, exploring three approaches: boosting infrastructure facilities of the brain, facilitating psychotherapeutic relearning, and targeting specific pathways of the SMS network to fix deficient SMS shut-down processes. SIGNIFICANCE STATEMENT: A significant proportion of patients with obsessive-compulsive disorder (OCD) do not achieve remission with current treatments, indicating the need for innovations in psychopharmacology for the disorder. OCD may be conceptualized as the dysfunction of a normal, special motivation system that evolved to manage the prospect of potential danger. This perspective, together with a wide-ranging review of the literature, suggests novel directions for psychopharmacological research, including boosting support systems of the brain, facilitating relearning that occurs in psychotherapy, and targeting specific pathways in the brain that provide deficient stopping processes in OCD.
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Affiliation(s)
- Henry Szechtman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada (H.S.); SAMRC Unit on Risk Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University (Potchefstroom Campus), Potchefstroom, South Africa (B.H.H.); Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada (E.Z.W.); and Centro de Investigación en Reproducción Animal, CINVESTAV-Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico (K.L.H.)
| | - Brian H Harvey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada (H.S.); SAMRC Unit on Risk Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University (Potchefstroom Campus), Potchefstroom, South Africa (B.H.H.); Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada (E.Z.W.); and Centro de Investigación en Reproducción Animal, CINVESTAV-Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico (K.L.H.)
| | - Erik Z Woody
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada (H.S.); SAMRC Unit on Risk Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University (Potchefstroom Campus), Potchefstroom, South Africa (B.H.H.); Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada (E.Z.W.); and Centro de Investigación en Reproducción Animal, CINVESTAV-Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico (K.L.H.)
| | - Kurt Leroy Hoffman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada (H.S.); SAMRC Unit on Risk Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University (Potchefstroom Campus), Potchefstroom, South Africa (B.H.H.); Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada (E.Z.W.); and Centro de Investigación en Reproducción Animal, CINVESTAV-Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico (K.L.H.)
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Koorenhof LJ, Dommett EJ. An Investigation Into Response Inhibition in Distinct Clinical Groups Within Obsessive-Compulsive Disorder. J Neuropsychiatry Clin Neurosci 2020; 31:228-238. [PMID: 30888920 DOI: 10.1176/appi.neuropsych.18070166] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Response inhibition has been frequently studied in obsessive-compulsive disorder (OCD) with mixed results. The inconsistent findings may stem in part from failure to consider the heterogeneity of the disorder. METHODS The authors examined behavioral and event-related potential (ERP) components (N2 and P3) during a simple response inhibition go/nogo task in a sample of patients with OCD (N=48) and control subjects (N=53). Comparisons in behavioral and electrophysiological measures were made between groups (OCD compared with control) and within the OCD group in terms of symptom clusters (symmetry, forbidden thoughts, and cleaning) and comorbidity status (OCD only and OCD with depression). RESULTS In the OCD group, the N2 component appeared more frontally localized compared with the control group. Participants with OCD demonstrated longer N2 latency and a larger difference in N2 between the nogo and go conditions, suggesting slower but greater conflict monitoring. P3 had a larger amplitude in the OCD group compared with the control group, indicative of greater response inhibition, but was also reduced in the nogo compared with go condition, suggesting suppressed response inhibition. No significant differences were found between symptom clusters, but patients with OCD only made more omission errors compared with patients with OCD and comorbid depression. The latter cohort also had faster P3 latencies, which, combined with the behavioral data, indicates slightly improved response inhibition when comorbid depression is found. CONCLUSIONS On the basis of these results, it would seem unlikely that symptom clusters have contributed to previous inconsistencies in the literature. Comorbid depression, which may have affected previous results, should be considered in future research.
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Affiliation(s)
- Loes J Koorenhof
- The School of Life, Health and Chemical Sciences, Open University, Milton Keynes, United Kingdom (Koorenhof); and the Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London (Dommett)
| | - Eleanor J Dommett
- The School of Life, Health and Chemical Sciences, Open University, Milton Keynes, United Kingdom (Koorenhof); and the Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London (Dommett)
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33
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Pekrul M, Seer C, Lange F, Dressler D, Kopp B. Flanker Task Performance in Isolated Dystonia (Blepharospasm): A Focus on Sequential Effects. Brain Sci 2020; 10:brainsci10020076. [PMID: 32024200 PMCID: PMC7071414 DOI: 10.3390/brainsci10020076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 01/29/2020] [Accepted: 01/30/2020] [Indexed: 11/16/2022] Open
Abstract
Isolated dystonia manifests with involuntary muscle hyperactivity, but the extent of cognitive impairment remains controversial. We examined the executive functions in blepharospasm while accounting for motor symptom-related distractions as a factor often limiting the interpretability of neuropsychological studies in dystonia. Our control group comprised of patients with hemifacial spasm, which is a condition producing similar motor symptoms without any central nervous system pathology. Nineteen patients with blepharospasm and 22 patients with hemifacial spasm completed a flanker task. Stimulus congruency on the current trial, on the preceding trial, and a response sequence served as independent variables. We analyzed the response time and accuracy. Gross overall group differences were not discernible. While congruency, congruency sequence, and response sequence exerted the expected effects, no group differences emerged with regard to these variables. A difference between patients with blepharospasm and those with hemifacial spasm consisted in longer reaction times when responses had to be repeated following stimulus incongruency on the preceding trial. We conclude that patients with blepharospasm seem to have difficulties in repeating their responses when incongruency on preceding trials interferes with habit formation or other forms of fast routes to action. Our specific finding may provide an opportunity to study altered basal ganglia plasticity in focal dystonia.
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Affiliation(s)
- Max Pekrul
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany; (C.S.); (F.L.); (D.D.); (B.K.)
- Correspondence:
| | - Caroline Seer
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany; (C.S.); (F.L.); (D.D.); (B.K.)
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Tervuursevest 101, 3001 Leuven, Belgium
- LBI—KU Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Florian Lange
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany; (C.S.); (F.L.); (D.D.); (B.K.)
- Behavioral Engineering Research Group, KU Leuven, Naamsestraat 69, 3000 Leuven, Belgium
| | - Dirk Dressler
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany; (C.S.); (F.L.); (D.D.); (B.K.)
- Movement Disorders Section, Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Bruno Kopp
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany; (C.S.); (F.L.); (D.D.); (B.K.)
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Leppanen J, Cardi V, Sedgewick F, Treasure J, Tchanturia K. Basal ganglia volume and shape in anorexia nervosa. Appetite 2020; 144:104480. [PMID: 31586464 PMCID: PMC6891247 DOI: 10.1016/j.appet.2019.104480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 09/07/2019] [Accepted: 10/01/2019] [Indexed: 12/04/2022]
Abstract
Background Reward-centred models have proposed that anomalies in the basal ganglia circuitry that underlies reward learning and habit formation perpetuate anorexia nervosa (AN). The present study aimed to investigate the volume and shape of key basal ganglia regions, including the bilateral caudate, putamen, nucleus accumbens (NAcc), and globus pallidus in AN. Methods The present study combined data from two existing studies resulting in a sample size of 46 women with AN and 56 age-matched healthy comparison (HC) women. Group differences in volume and shape of the regions of interest were examined. Within the AN group, the impact of eating disorder characteristics on volume and shape of the basal ganglia regions were also explored. Results The shape analyses revealed inward deformations in the left caudate, right NAcc, and bilateral ventral and internus globus pallidus, and outward deformations in the right middle and posterior globus pallidus in the AN group. Conclusions The present findings appear to fit with the theoretical models suggesting that there are alterations in the basal ganglia regions associated with habit formation and reward processing in AN. Further investigation of structural and functional connectivity of these regions in AN as well as their role in recovery would be of interest.
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Affiliation(s)
- Jenni Leppanen
- Kings' College London, Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine, London, United Kingdom.
| | - Valentina Cardi
- Kings' College London, Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine, London, United Kingdom
| | - Felicity Sedgewick
- University of Bristol, 35 Berkeley Square, Clifton, Bristol, United Kingdom
| | - Janet Treasure
- Kings' College London, Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Kate Tchanturia
- Kings' College London, Institute of Psychiatry, Psychology, and Neuroscience, Psychological Medicine, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom; Illia State University, Department of Psychology, Tbilisi, Georgia
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Szejko N, Fremer C, Müller-Vahl KR. Cannabis Improves Obsessive-Compulsive Disorder-Case Report and Review of the Literature. Front Psychiatry 2020; 11:681. [PMID: 32848902 PMCID: PMC7396551 DOI: 10.3389/fpsyt.2020.00681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/29/2020] [Indexed: 12/18/2022] Open
Abstract
Although several lines of evidence support the hypothesis of a dysregulation of serotoninergic neurotransmission in the pathophysiology of obsessive-compulsive disorder (OCD), there is also evidence for an involvement of other pathways such as the GABAergic, glutamatergic, and dopaminergic systems. Only recently, data obtained from a small number of animal studies alternatively suggested an involvement of the endocannabinoid system in the pathophysiology of OCD reporting beneficial effects in OCD-like behavior after use of substances that stimulate the endocannabinoid system. In humans, until today, only two case reports are available reporting successful treatment with dronabinol (tetrahydrocannabinol, THC), an agonist at central cannabinoid CB1 receptors, in patients with otherwise treatment refractory OCD. In addition, data obtained from a small open uncontrolled trial using the THC analogue nabilone suggest that the combination of nabilone plus exposure-based psychotherapy is more effective than each treatment alone. These reports are in line with data from a limited number of case studies and small controlled trials in patients with Tourette syndrome (TS), a chronic motor and vocal tic disorder often associated with comorbid obsessive compulsive behavior (OCB), reporting not only an improvement of tics, but also of comorbid OCB after use of different kinds of cannabis-based medicines including THC, cannabis extracts, and flowers. Here we present the case of a 22-year-old male patient, who suffered from severe OCD since childhood and significantly improved after treatment with medicinal cannabis with markedly reduced OCD and depression resulting in a considerable improvement of quality of life. In addition, we give a review of current literature on the effects of cannabinoids in animal models and patients with OCD and suggest a cannabinoid hypothesis of OCD.
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Affiliation(s)
- Natalia Szejko
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.,Division of Neurocritical Care & Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT, United States.,Department of Bioethics, Medical University of Warsaw, Warsaw, Poland.,Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Carolin Fremer
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kirsten R Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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Modarresi A, Chaibakhsh S, Koulaeinejad N, Koupaei SR. A systematic review and meta-analysis: Memantine augmentation in moderate to severe obsessive-compulsive disorder. Psychiatry Res 2019; 282:112602. [PMID: 31630042 DOI: 10.1016/j.psychres.2019.112602] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
Abstract
A considerable proportion of obsessive-compulsive disorder (OCD) patients receiving first-line pharmacological therapy, fail to fully respond to treatment and continue to exhibit significant symptoms. In this systematic review, we evaluate the efficacy of memantine, as a glutamate-modulating agent, in moderate to severe OCD. Single and double blinded as well as open-label trials of memantine augmentation in adults with OCD were considered. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores were the primary outcome measure. The electronic databases of PubMed, Scopus, Embase and Google Scholar were searched for relevant trials using keywords 'obsessive-compulsive disorder OR OCD' AND 'memantine'. The meta-analysis of eight studies involving 125 OCD subjects receiving memantine augmentation exhibited a significant overall mean reduction of 11.73 points in Y-BOCS scores. The categorical analysis of treatment response (a minimum of 35% reduction in Y-BOCS) in four double-blind placebo-controlled studies indicated that OCD patients receiving memantine augmentation were 3.61 times more likely to respond to treatment than those receiving placebo. We found that 20 mg/day memantine augmentation to first-line pharmacological treatment for a period of at least 8 weeks is a safe and effective intervention for moderate to severe OCD.
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Affiliation(s)
- Atieh Modarresi
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Chaibakhsh
- Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran; Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Neda Koulaeinejad
- Department of Clinicl Pharmacy, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Shahram Rafieian Koupaei
- Core trainee in psychiatry, Cambridge and Peterborough Foundation Trust, Cambridge, United Kingdom
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Wang YM, Cai XL, Zhang RT, Wang Y, Madsen KH, Sørensen TA, Møller A, Cheung EFC, Chan RCK. Searchlight classification based on Amplitude of Low Frequency Fluctuation and functional connectivity in individuals with obsessive-compulsive symptoms. Cogn Neuropsychiatry 2019; 24:322-334. [PMID: 31451062 DOI: 10.1080/13546805.2019.1658575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Investigating obsessive-compulsive symptoms in subclinical populations provides a useful framework for understanding the early development of obsessive-compulsive spectrum disorders. The present study aimed to apply searchlight classification analysis on resting-state functional magnetic resonance imaging data to identify potential brain markers in subclinical individuals with obsessive-compulsive symptoms. METHODS In this observational study, 40 college students with high obsessive-compulsive symptom scores and 40 with low obsessive-compulsive symptom scores were recruited from universities in China. We conducted searchlight classification and comparison analysis between the two groups based on Amplitude of Low Frequency Fluctuation (ALFF), fraction ALFF (fALFF) and resting-state functional connectivity using searchlight classification. RESULTS We found that the highest accuracy rate in differentiating between the two groups was 85.00%. Significant discriminating features included the ALFF of the left medial superior frontal gyrus and the functional connectivity between the right thalamus and the bilateral medial superior frontal gyrus, and the right putamen, as well as the functional connectivity between the left caudate and the right insula. CONCLUSIONS These findings highlight the specific and distinguishing brain functional abnormalities associated with obsessive-compulsive symptoms.
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Affiliation(s)
- Yong-Ming Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Sino-Danish College, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China.,Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
| | - Xin-Lu Cai
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Sino-Danish College, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China.,Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
| | - Rui-Ting Zhang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
| | - Kristoffer Hougaard Madsen
- Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre , Hvidovre , Denmark.,Department of Applied Mathematics and Computer Science, Technical University of Denmark , Kongens Lyngby , Denmark
| | - Thomas Alrik Sørensen
- Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Centre for Cognitive Neuroscience, Department of Communication and Psychology, Aalborg University , Aalborg , Denmark
| | - Arne Møller
- Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Department of Nuclear Medicine and PET Centre, Aarhus University Hospital , Aarhus , Denmark
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region , Hong Kong , PR People's Republic of China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology , Beijing , PR People's Republic of China.,Sino-Danish College, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China.,Sino-Danish Center for Education and Research , Beijing , PR People's Republic of China.,Department of Psychology, University of Chinese Academy of Sciences , Beijing , PR People's Republic of China
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38
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Abstract
Neurosurgical interventions have been used for decades to treat severe, refractory obsessive-compulsive disorder (OCD). Deep brain stimulation (DBS) is a neurosurgical procedure that is used routinely to treat movement disorders such as Parkinson's disease and essential tremor. Over the past two decades, DBS has been applied to OCD, building on earlier experience with lesional procedures. Promising results led to Humanitarian Device Exemption (HDE) approval of the therapy from the United States Food and Drug Administration in 2009. In this review, the authors describe the development of DBS for OCD, the most recent outcome data, and areas for future research.
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Affiliation(s)
- Sruja Arya
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Megan M Filkowski
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | | | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
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Ray A, Subramanian A, Chhabra H, Kommu JVS, Venkatsubramanian G, Srinath S, Girimaji S, Sheshadri SP, Philip M. Eye movement tracking in pediatric obsessive compulsive disorder. Asian J Psychiatr 2019; 43:9-16. [PMID: 31075652 DOI: 10.1016/j.ajp.2019.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 04/04/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022]
Abstract
Till date researchers have elucidated the neurobiological substrates in OCD using methods like neuroimaging. However, a potential biomarker is still elusive. The present study is an attempt to identify a potential biomarker in pediatric OCD using eye tracking. The present study measured pro-saccade and anti-saccade parameters in 36 cases of pediatric OCD and 31 healthy controls. There was no significant difference between cases and controls in the error rate, peak velocity, position gain and latency measures in both pro-saccade and anti-saccade eye tracking tasks. With age, anti-saccades become slower in velocity, faster in response and more accurate irrespective of disorder status of the child. Pro-saccades also show a similar effect that is less prominent than anti-saccades. Gain measures more significantly vary with age in children with OCD than the controls, whereas latency measures positively correlated with age in children with OCD as opposed to being negatively correlated in the controls. Findings of this study do not support any of the eye tracking measures as putative diagnostic bio-markers in OCD. However, latency and gain parameters across different age groups in anti-saccade tasks need to be explored in future studies.
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Affiliation(s)
- Anirban Ray
- Dept. of Child & Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore Hosur Road, Bangalore, Pin: 560029; Department of Psychiatry, Institute of Post Graduate Medical Education & Research, 7 D. L. Khan Road, Kolkata, West Bengal.
| | - Aditi Subramanian
- Translational Psychiatry Lab, Department of Psychiartry, National Institute of Mental Health and Neurosciences, Bangalore Hosur Road, Bangalore, Pin: 560029
| | - Harleen Chhabra
- Translational Psychiatry Lab, Department of Psychiartry, National Institute of Mental Health and Neurosciences, Bangalore Hosur Road, Bangalore, Pin: 560029
| | - John Vijay Sagar Kommu
- Dept. of Child & Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore Hosur Road, Bangalore, Pin: 560029
| | - Ganesan Venkatsubramanian
- Translational Psychiatry Lab, Department of Psychiartry, National Institute of Mental Health and Neurosciences, Bangalore Hosur Road, Bangalore, Pin: 560029
| | - Shoba Srinath
- Dept. of Child & Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore Hosur Road, Bangalore, Pin: 560029
| | - Satish Girimaji
- Dept. of Child & Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore Hosur Road, Bangalore, Pin: 560029
| | - Shekhar P Sheshadri
- Dept. of Child & Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore Hosur Road, Bangalore, Pin: 560029
| | - Mariamma Philip
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore Hosur Road, Bangalore, Pin: 560029
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40
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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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41
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Esawy MM, Shabana MA, Ali EF. Role of IL-6/IL-10 ratio in the diagnosis and in the assessment of the severity of obsessive-compulsive disorder. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s00580-018-2803-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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42
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Brain serotonin synthesis capacity in obsessive-compulsive disorder: effects of cognitive behavioral therapy and sertraline. Transl Psychiatry 2018; 8:82. [PMID: 29666372 PMCID: PMC5904107 DOI: 10.1038/s41398-018-0128-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 01/06/2018] [Accepted: 01/31/2018] [Indexed: 02/01/2023] Open
Abstract
Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are both effective treatments for some patients with obsessive-compulsive disorder (OCD), yet little is known about the neurochemical changes related to these treatment modalities. Here, we used positron emission tomography and the α-[11C]methyl-L-tryptophan tracer to examine the changes in brain regional serotonin synthesis capacity in OCD patients following treatment with CBT or SSRI treatment. Sixteen medication-free OCD patients were randomly assigned to 12 weeks of either CBT or sertraline treatment. Pre-to-post treatment changes in the α-[11C]methyl-L-tryptophan brain trapping constant, K* (ml/g/min), were assessed as a function of symptom response, and correlations with symptom improvement were examined. Responders/partial responders to treatment did not show significant changes in relative regional tracer uptake; rather, in responders/partial responders, 12 weeks of treatment led to serotonin synthesis capacity increases that were brain-wide. Irrespective of treatment modality, baseline serotonin synthesis capacity in the raphe nuclei correlated positively with clinical improvement. These observations suggest that, for some patients, successful remediation of OCD symptoms might be associated with greater serotonergic tone.
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43
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OCD-like behavior is caused by dysfunction of thalamo-amygdala circuits and upregulated TrkB/ERK-MAPK signaling as a result of SPRED2 deficiency. Mol Psychiatry 2018; 23:444-458. [PMID: 28070119 PMCID: PMC5794898 DOI: 10.1038/mp.2016.232] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/20/2016] [Accepted: 11/01/2016] [Indexed: 01/02/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disease affecting about 2% of the general population. It is characterized by persistent intrusive thoughts and repetitive ritualized behaviors. While gene variations, malfunction of cortico-striato-thalamo-cortical (CSTC) circuits, and dysregulated synaptic transmission have been implicated in the pathogenesis of OCD, the underlying mechanisms remain largely unknown. Here we show that OCD-like behavior in mice is caused by deficiency of SPRED2, a protein expressed in various brain regions and a potent inhibitor of Ras/ERK-MAPK signaling. Excessive self-grooming, reflecting OCD-like behavior in rodents, resulted in facial skin lesions in SPRED2 knockout (KO) mice. This was alleviated by treatment with the selective serotonin reuptake inhibitor fluoxetine. In addition to the previously suggested involvement of cortico-striatal circuits, electrophysiological measurements revealed altered transmission at thalamo-amygdala synapses and morphological differences in lateral amygdala neurons of SPRED2 KO mice. Changes in synaptic function were accompanied by dysregulated expression of various pre- and postsynaptic proteins in the amygdala. This was a result of altered gene transcription and triggered upstream by upregulated tropomyosin receptor kinase B (TrkB)/ERK-MAPK signaling in the amygdala of SPRED2 KO mice. Pathway overactivation was mediated by increased activity of TrkB, Ras, and ERK as a specific result of SPRED2 deficiency and not elicited by elevated brain-derived neurotrophic factor levels. Using the MEK inhibitor selumetinib, we suppressed TrkB/ERK-MAPK pathway activity in vivo and reduced OCD-like grooming in SPRED2 KO mice. Altogether, this study identifies SPRED2 as a promising new regulator, TrkB/ERK-MAPK signaling as a novel mediating mechanism, and thalamo-amygdala synapses as critical circuitry involved in the pathogenesis of OCD.
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45
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Kamaradova D, Brunovsky M, Prasko J, Horacek J, Hajda M, Grambal A, Latalova K. EEG correlates of induced anxiety in obsessive-compulsive patients: comparison of autobiographical and general anxiety scenarios. Neuropsychiatr Dis Treat 2018; 14:2165-2174. [PMID: 30214206 PMCID: PMC6120576 DOI: 10.2147/ndt.s169172] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The underlying symptomatology of obsessive-compulsive disorder (OCD) can be viewed as an impairment in both cognitive and behavioral inhibition, regarding difficult inhibition of obsessions and behavioral compulsions. Converging results from neuroimaging and electroencephalographic (EEG) studies have identified changes in activities throughout the medial frontal and orbital cortex and subcortical structures supporting the cortico-striato-thalamo-cortical circuit model of OCD. This study aimed to elucidate the electrophysiological changes induced by autobiographical and general anxiety scenarios in patients with OCD. METHODS Resting-state eyes-closed EEG data were recorded in 19 OCD patients and 15 healthy controls. Cortical EEG sources were estimated by standardized low-resolution electromagnetic tomography (sLORETA). The changes in the emotional state were induced by two different scenarios: the autobiographical script related to patient's OCD symptoms and the script triggering general anxiety. RESULTS During the resting state, we proved increased delta activity in the frontal, limbic and temporal lobe and the sub-lobar area in OCD patients. In a comparison of neural activities during general anxiety in OCD patients and the control group, we proved an increase in delta (parietal, temporal, occipital, frontal and limbic lobes, and sub-lobal area), theta (temporal, parietal and occipital lobes) and alpha-1 activities (parietal lobe). Finally, we explored the neural activity of OCD patients during exposure to the autobiographic scenario. We proved an increase in beta-3 activity (left frontal lobe). CONCLUSION Our study proved differences in neural activation in OCD patients and healthy controls during imagination of general anxiety. Exposure to the autobiographic OCD scenario leads to activation of left frontal brain areas. The results show the possibility of using specific scenarios in OCD therapy.
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Affiliation(s)
- Dana Kamaradova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
| | | | - Jan Prasko
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
| | - Jiri Horacek
- National Institute of Mental Health, Klecany, Czech Republic
| | - Miroslav Hajda
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
| | - Ales Grambal
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
| | - Klara Latalova
- Department of Psychiatry, University Hospital Olomouc, Olomouc, Czech Republic,
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46
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Berlin GS, Lee HJ. Response inhibition and error-monitoring processes in individuals with obsessive-compulsive disorder. J Obsessive Compuls Relat Disord 2018; 16:21-27. [PMID: 29607292 PMCID: PMC5875186 DOI: 10.1016/j.jocrd.2017.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Response inhibition (RI) has been putatively linked to the symptoms of OCD. Despite the enticing link between RI and OCD, there are points in the relationship that require clarification. We examined the RI-OCD relationship taking into account a) the potentially differential pattern of RI-OCD relationship between obsessions and compulsions, and b) the potentially confounding effect of negative affect, particularly in regards to depression. Additionally, we investigated how error-monitoring processes in the inhibitory context account for OCD symptoms. Results showed that the RI-OCD relationship is robust in regards to compulsion symptoms, but not for obsessions, even when controlling for negative affect. Additionally, while individuals with OCD display behavioral slow-down following commission errors on the stop-signal task, slow-down following successful inhibition is significantly related to compulsion symptoms. Findings suggest that future studies investigating RI in OCD should take into account heterogeneous clinical presentations in OCD, as well as incorporate error-monitoring variables to better understand RI processes in OCD.
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Affiliation(s)
- Gregory S. Berlin
- University of Wisconsin-Milwaukee, 2441 E Hartford Avenue, Milwaukee, WI 53211
| | - Han-Joo Lee
- University of Wisconsin-Milwaukee, 2441 E Hartford Avenue, Milwaukee, WI 53211
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47
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van der Straten AL, Denys D, van Wingen GA. Impact of treatment on resting cerebral blood flow and metabolism in obsessive compulsive disorder: a meta-analysis. Sci Rep 2017; 7:17464. [PMID: 29234089 PMCID: PMC5727319 DOI: 10.1038/s41598-017-17593-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 11/28/2017] [Indexed: 12/23/2022] Open
Abstract
Neurobiological models of obsessive-compulsive disorder (OCD) posit that its clinical symptoms such as repetitive thoughts and behaviors are related to hyperactivity in the cortico-striato-thalamo-cortical (CSTC) circuit. Small scale neuroimaging studies have shown that treatment of OCD is associated with reduced activity across different brain structures within this circuitry. We performed the first meta-analysis of positron emission tomography (PET) and single photon emission computed tomography (SPECT) studies that investigated cerebral blood flow or glucose metabolism in patients with OCD before and after pharmacological or psychological treatment. We calculated standardized mean differences for the regions-of-interest most often reported. The meta-analysis revealed small reductions in activity in the caudate nucleus and orbitofrontal cortex after treatment with a serotonin reuptake inhibitor or cognitive behavioral therapy. Small reductions were also observed in the thalamus when one SPECT study with a large opposite effect was excluded from the analysis. Meta-regression analyses for the caudate nucleus showed no significant effect of the type of treatment, decrease in symptom severity, mean duration until the follow-up scan, or year of publication. These results show that pharmacological and psychological treatments reduce resting CSTC circuit activity, and provide further support for the CSTC circuit model in OCD.
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Affiliation(s)
- A L van der Straten
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
- Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands.
| | - D Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - G A van Wingen
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
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48
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Şair A, Şair YB, Canazlar E, Sevinçok L. Remission of obsessive-compulsive symptoms following temporoparietal haemorrhage: a case report. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1410336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Ahmet Şair
- Department of Neurology, Adnan Menderes University, Aydin, Turkey
| | - Yaşan Bilge Şair
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Elif Canazlar
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Levent Sevinçok
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
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49
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Hatchondo L, Jaafari N, Langbour N, Maillochaud S, Herpe G, Guillevin R, Guillevin C. 1H magnetic resonance spectroscopy suggests neural membrane alteration in specific regions involved in obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2017; 269:48-53. [PMID: 28938221 DOI: 10.1016/j.pscychresns.2017.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 11/23/2022]
Affiliation(s)
- Laura Hatchondo
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
| | - Nematollah Jaafari
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Nicolas Langbour
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Sylvie Maillochaud
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Guillaume Herpe
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Department of Medical Imaging - University Hospital of Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
| | - Rémy Guillevin
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Department of Medical Imaging - University Hospital of Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
| | - Carole Guillevin
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Department of Medical Imaging - University Hospital of Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
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50
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Zhang CY, Chen Y, Chen S, Kong XC, Liu Y, You CQ, Wan C, Bondzie PA, Su H, Zhang C, He FF. Evaluation of Mental Disorders Using Proton Magnetic Resonance Spectroscopy in Dialysis and Predialysis Patients. Kidney Blood Press Res 2017; 42:686-696. [PMID: 29145203 DOI: 10.1159/000484023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/25/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Psychological complications are prevalent in patients with chronic kidney disease (CKD). This study aimed to investigate mental disorders in stage 4-5 CKD patients, to detect metabolite concentrations in the brain by proton magnetic resonance spectroscopy (1H-MRS) and to compare the effects of different dialysis therapies on mental disorders in end-stage renal disease (ESRD). METHODS The sample population was made up of predialysis (13), hemodialysis (HD) (13), and peritoneal dialysis (PD) patients (12). We collected the baseline data of patients' age, sex, hemoglobin (Hb) and parathyroid hormone(PTH) levels. The predialysis patients served as the control group. The psychological status of the three groups was assessed using three psychological scales. 1H-MRS was used to evaluate the relative metabolite concentrations in the bilateral amygdala, hippocampus and unilateral anterior cingulated cortex (ACC). RESULTS The psychological status was better in HD patients than in predialysis and PD patients. 1H-MRS alterations were predominantly found in the ACC. Choline-containing compounds relative to creatine (Cho/Cr), myo-inositol relative to creatine (MI/Cr) and glutamate and glutamine relative to creatine (Glx/Cr) in the ACC were higher in HD patients. 1H-MRS results were correlated with the baseline data and the scores of psychological scales. CONCLUSIONS CKD patients showed different types of mental disorders as well as metabolite disturbances in the brain. The metabolite concentrations correlated with the psychological status which was better in HD than in predialytic and PD patients.
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Affiliation(s)
- Chun-Yun Zhang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Chen
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shan Chen
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang-Chuang Kong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao-Qun You
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cheng Wan
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Philip A Bondzie
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Hua Su
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chun Zhang
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang-Fang He
- Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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