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Zhou XC, Chen LH, Wu S, Wang KZ, Wei ZC, Li T, Huang YS, Hua ZH, Xia Q, Lv ZZ, Lv LJ. Brain effect mechanism of lever positioning manipulation on LDH analgesia based on multimodal MRI: a study protocol. BMC Complement Med Ther 2024; 24:246. [PMID: 38915038 PMCID: PMC11194935 DOI: 10.1186/s12906-024-04549-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024] Open
Abstract
INTRODUCTION The clinical symptoms of Lumbar Disc Herniation (LDH) can be effectively ameliorated through Lever Positioning Manipulation (LPM), which is closely linked to the brain's pain-regulating mechanisms. Magnetic Resonance Imaging (MRI) offers an objective and visual means to study how the brain orchestrates the characteristics of analgesic effects. From the perspective of multimodal MRI, we applied functional MRI (fMRI) and Magnetic Resonance Spectrum (MRS) techniques to comprehensively evaluate the characteristics of the effects of LPM on the brain region of LDH from the aspects of brain structure, brain function and brain metabolism. This multimodal MRI technique provides a biological basis for the clinical application of LPM in LDH. METHODS AND ANALYSIS A total of 60 LDH patients and 30 healthy controls, matched by gender, age, and years of education, will be enrolled in this study. The LDH patients will be divided into two groups (Group 1, n = 30; Group 2, n = 30) using a random number table method. Group 1 will receive LPM treatment once every two days, for a total of 12 times over 4 weeks. Group 2 will receive sham LPM treatment during the same period as Group 1. All 30 healthy controls will be divided into Group 3. Multimodal MRI will be performed on Group 1 and Group 2 at three time points (TPs): before LPM (TP1), after one LPM session (TP2), and after a full course of LPM treatment. The healthy controls (Group 3) will not undergo LPM and will be subject to only a single multimodal MRI scan. Participants in both Group 1 and Group 2 will be required to complete clinical questionnaires. These assessments will focus on pain intensity and functional disorders, using the Visual Analog Scale (VAS) and the Japanese Orthopaedic Association (JOA) scoring systems, respectively. DISCUSSION The purpose of this study is to investigate the multimodal brain response characteristics of LDH patients after treatment with LPM, with the goal of providing a biological basis for clinical applications. TRIAL REGISTRATION NUMBER https://clinicaltrials.gov/ct2/show/NCT05613179 , identifier: NCT05613179.
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Affiliation(s)
- Xing-Chen Zhou
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Research Institute of Tuina (Spinal Disease), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Long-Hao Chen
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Research Institute of Tuina (Spinal Disease), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shuang Wu
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Kai-Zheng Wang
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Research Institute of Tuina (Spinal Disease), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zi-Cheng Wei
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Tao Li
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yuan-Shen Huang
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- Research Institute of Tuina (Spinal Disease), Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zi-Han Hua
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Qiong Xia
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhi-Zhen Lv
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
| | - Li-Jiang Lv
- The Third Affiliated Hospital of Zhejiang, University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
- The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
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Wang Z, Zhao Z, Song Z, Xu J, Wang Y, Zhao Z, Li Y. Functional alterations of the brain default mode network and somatosensory system in trigeminal neuralgia. Sci Rep 2024; 14:10205. [PMID: 38702383 PMCID: PMC11068897 DOI: 10.1038/s41598-024-60273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024] Open
Abstract
Mapping the localization of the functional brain regions in trigeminal neuralgia (TN) patients is still lacking. The study aimed to explore the functional brain alterations and influencing factors in TN patients using functional brain imaging techniques. All participants underwent functional brain imaging to collect resting-state brain activity. The significant differences in regional homogeneity (ReHo) and amplitude of low frequency (ALFF) between the TN and control groups were calculated. After familywise error (FWE) correction, the differential brain regions in ReHo values between the two groups were mainly located in bilateral middle frontal gyrus, bilateral inferior cerebellum, right superior orbital frontal gyrus, right postcentral gyrus, left inferior temporal gyrus, left middle temporal gyrus, and left gyrus rectus. The differential brain regions in ALFF values between the two groups were mainly located in the left triangular inferior frontal gyrus, left supplementary motor area, right supramarginal gyrus, and right middle frontal gyrus. With the functional impairment of the central pain area, the active areas controlling memory and emotion also change during the progression of TN. There may be different central mechanisms in TN patients of different sexes, affected sides, and degrees of nerve damage. The exact central mechanisms remain to be elucidated.
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Affiliation(s)
- Zairan Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, China
| | - Zijun Zhao
- Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Zihan Song
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jiayi Xu
- Medical Records Room, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yizheng Wang
- Department of Pain Rehabilitation, The Forth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Zongmao Zhao
- Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
| | - Yongning Li
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, China.
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Desfossés-Vallée S, Leclerc JB, Blanchet P, O’Connor KP, Lavoie ME. Comparing the 'When' and the 'Where' of Electrocortical Activity in Patients with Tourette Syndrome, Body-Focused Repetitive Behaviors, and Obsessive Compulsive Disorder. J Clin Med 2024; 13:2489. [PMID: 38731020 PMCID: PMC11084402 DOI: 10.3390/jcm13092489] [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: 03/21/2024] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
Background/Objectives: Tourette Syndrome (TS), Obsessive Compulsive Disorder (OCD), and Body-Focused Repetitive Behaviors (BFRB) are three disorders that share many similarities in terms of phenomenology, neuroanatomy, and functionality. However, despite the literature pointing toward a plausible spectrum of these disorders, only a few studies have compared them. Studying the neurocognitive processes using Event-Related Potentials (ERPs) offers the advantage of assessing brain activity with excellent temporal resolution. The ERP components can then reflect specific processes known to be potentially affected by these disorders. Our first goal is to characterize 'when' in the processing stream group differences are the most prominent. The second goal is to identify 'where' in the brain the group discrepancies could be. Methods: Participants with TS (n = 24), OCD (n = 18), and BFRB (n = 16) were matched to a control group (n = 59) and were recorded with 58 EEG electrodes during a visual counting oddball task. Three ERP components were extracted (i.e., P200, N200, and P300), and generating sources were modelized with Standardized Low-Resolution Electromagnetic Tomography. Results: We showed no group differences for the P200 and N200 when controlling for anxiety and depressive symptoms, suggesting that the early cognitive processes reflected by these components are relatively intact in these populations. Our results also showed a decrease in the later anterior P300 oddball effect for the TS and OCD groups, whereas an intact oddball effect was observed for the BFRB group. Source localization analyses with sLORETA revealed activations in the lingual and middle occipital gyrus for the OCD group, distinguishing it from the other two clinical groups and the controls. Conclusions: It seems that both TS and OCD groups share deficits in anterior P300 activation but reflect distinct brain-generating source activations.
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Affiliation(s)
- Sarah Desfossés-Vallée
- Laboratoire de Psychophysiologie Cognitive et Sociale, Montréal, QC H1N 3J4, Canada;
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada; (J.B.L.); (P.B.); (K.P.O.)
- Département de Psychologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Julie B. Leclerc
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada; (J.B.L.); (P.B.); (K.P.O.)
- Département de Psychologie, Université du Québec à Montréal, Montréal, QC H2X 3P2, Canada
- Centre de Recherche CIUSSS du Nord-de-l’île-de-Montréal, Montréal, QC H4J 1C5, Canada
| | - Pierre Blanchet
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada; (J.B.L.); (P.B.); (K.P.O.)
- Faculté de Médecine Dentaire, Département de Stomatologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Kieron P. O’Connor
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada; (J.B.L.); (P.B.); (K.P.O.)
- Département de Psychiatrie et Addictologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Marc E. Lavoie
- Laboratoire de Psychophysiologie Cognitive et Sociale, Montréal, QC H1N 3J4, Canada;
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3J4, Canada; (J.B.L.); (P.B.); (K.P.O.)
- Département de Sciences Humaines, Lettres et Communication, Université TÉLUQ, Quebec City, QC G1K 9H6, Canada
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Yuan X, Zhu Y, Xiao L, Chuan Liu Z, Zou J, Hu Z, Wu Y, Li P, Hu M, Zhou F. Regional homogeneity in patients with obsessive-compulsive disorder and depression: A resting state functional magnetic resonance imaging study. Neurosci Lett 2023; 817:137528. [PMID: 37865188 DOI: 10.1016/j.neulet.2023.137528] [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: 05/29/2023] [Revised: 09/20/2023] [Accepted: 10/16/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To explore the brain functional impairment of patients with obsessive-compulsive disorder (OCD) with and without depressive symptoms and analyze the correlation between the degree of impairment and the severity of symptoms. METHOD Fourteen patients with OCD who met the ICD-10 diagnostic criteria for OCD were included. The group having OCD with depression (OCDd) consisted of 15 patients, and 17 healthy controls (HC) matched for age and education were also included. The Yale-Brown OCD Scale (Y-BOCS) and the 24-item Hamilton Assessment of Depression Scale (HAMD) were administered to the OCD and OCDd groups. Resting-state functional brain magnetic resonance imaging was performed in the three groups of participants. RESULT The OCDd group had lower scores on the HAMD, Y-BOCS, and obsessive-compulsive thinking subscales compared with the OCD group (P < 0.05). The scores on the OCDd subscale were negatively correlated with the HAMD scores (R = - 0.568, P = 0.027). The OCDd group had higher regional homogeneity (ReHo) values in the lingual gyrus than the OCD group. The OCDd group had higher ReHo values in the lingual gyrus than the HC group, and the OCDd group had higher ReHo values than the HC group. These differences were statistically significant (P < 0.05). After correction for multiple comparisons, significant difference was observed between the OCDd and HC groups (P<0.05). In the OCD group, the ReHo value of the lingual gyrus was negatively correlated with the Y-BOCS total score and the compulsive behavior subscale score (R = - 0.609, -0.552; P = 0.016, 0.033). CONCLUSION Abnormal ReHo values in the lingual gyrus and right medial superior frontal gyrus were found in the patients with OCDd. In the OCDd group, the ReHo values of the lingual gyrus were negatively correlated with the scores on the Y-BOCS total and obsessive-compulsive subscales, suggesting that abnormal local coherence of the lingual gyrus may be related to the severity of OCD.
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Affiliation(s)
- Xin Yuan
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province 330006, China
| | - Yanyan Zhu
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province 330006, China
| | - Li Xiao
- Department of Infection, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province 330006, China
| | - Zi Chuan Liu
- Gao 'an People's Hospital, Yichun, Jiangxi Province, 330800, China
| | - Jingzhi Zou
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province 330006, China
| | - Zhizhong Hu
- Mental Health Education Center, Nanchang University, Nanchang, Jiangxi Province 330036, China
| | - Yunhong Wu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province 330006, China
| | - Pan Li
- School of Public Policy and Administration, Nanchang University, Nanchang, Jiangxi Province, 330036, China
| | - Maorong Hu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province 330006, China.
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Neuroradiology Lab, Jiangxi Province Medical Imaging Research Institute, Nanchang, Jiangxi Province 330006, China.
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Liu Y, Sun J, Jiang J, Wan K, Tang Y, Zhang M, Chen L, Hua Q, Fang W, Zhu C, Wang K. Brain functional specialization in obsessive-compulsive disorder associated with neurotransmitter profiles. J Affect Disord 2023; 329:477-482. [PMID: 36871908 DOI: 10.1016/j.jad.2023.02.146] [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: 10/14/2022] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND Cerebral specialization is an important functional architecture of the human brain. Abnormal cerebral specialization may be the underlying pathogenesis of obsessive-compulsive disorder (OCD). Resting-state functional magnetic resonance imaging (rs-fMRI) was used to show that the specialization pattern of OCD was of great significance for early warning and precise intervention of the disease. METHOD The autonomy index (AI) based on the rs-fMRI was calculated to compare brain specializations between 80 OCD patients and 81 matched healthy controls (HCs). In addition, we also correlated the AI alteration patterns with neurotransmitter receptor/transporter densities. RESULTS OCD patients showed increased AI in the right insula and right superior temporal gyrus when compared with HCs. In addition, AI differences were associated with serotonin receptors (5-HT1AR and 5HT4R), dopamine D2 receptors, norepinephrine transporters, and metabotropic glutamate receptor densities. LIMITATIONS Drug effect; cross-sectional study design; the selection of positron emission tomography template. CONCLUSIONS This study showed abnormal specialization patterns in OCD patients, which may lead to the elucidation of the underlying pathological mechanism of the disease.
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Affiliation(s)
- Yueling Liu
- Department of Psychology, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Jinmei Sun
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Jin Jiang
- Department of Psychology, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Ke Wan
- Department of Psychology, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Yan Tang
- Department of Psychology, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Mengzhu Zhang
- Department of Psychology, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Lu Chen
- Department of Psychology, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Qiang Hua
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Wenmei Fang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Anhui Clinical Center for Mental and Psychological Diseases, Hefei Fourth People's Hospital, Hefei, China; Anhui Mental Health Center, Hefei, China.
| | - Chunyan Zhu
- Department of Psychology, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Psychology, The Second Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China.
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
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Luo G, Wang S, Yao S, Quan D, Guo G, Gao J, Zheng H. Direct changes of neurometabolic concentrations in the pregenual anterior cingulate cortex among obsessive-compulsive patients after repetitive transcranial magnetic stimulation treatment. J Affect Disord 2023; 333:79-85. [PMID: 37080494 DOI: 10.1016/j.jad.2023.04.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/01/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND AND AIM Although Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising new noninvasive brain stimulation therapy, its underlying mechanisms of action remain unknown. OCD patients exhibit impaired response control and attention shifting, which is linked to some brain areas such as anterior cingulate cortex and basal ganglia. OCD patients also display altered neurometabolic concentrations in cortical cortical-striatal-thalamic-cortical (CSTC). In this study, we aimed to elucidate efficacy of rTMS treatment in alleviating related symptoms and pregenual anterior cingulate cortex (pACC) neurometabolites. METHODS OCD patients were randomly divided into either drug (n = 23) or drug + rTMS (n = 29) groups, and those in the latter group subjected to 4-week rTMS treatment. All participants were visited twice, at baseline and follow-up after four weeks. During both visits, all patients were subjected to 1H-MRS, then Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Global Assessment Function (GAF) used to assess severity of obsessive-compulsive symptoms. We also evaluated synchronous anxiety and depression by Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Hamilton Anxiety Scale (HAM-A) and Hamilton Depression Scale (HAM-D). RESULTS After 4 weeks of treatment, patients in the Drug + rTMS group displayed significantly lower Y-BOCS (p = 0.038), BDI (p = 0.009), HAM-D (p = 0.013), HAM-A (p = 0.012) scores than their counterparts in the Drug group. Conversely, patients in the Drug + rTMS group had significantly higher tNAA concentrations (p = 0.030) than those in the Drug group. Notably, the Drug + rTMS group exhibited higher, but insignificant Glu (p = 0.055) and Glx (p = 0.068) concentrations compared to the Drug group. Partial correlation analysis revealed a significant negative correlation between post HAM-A scores and 4-week change of pACC glutamate levels in the Drug + rTMS group (r = -0.434, p = 0.02). CONCLUSION rTMS treatment is an efficacious treatment therapy for OCD, mainly by inducing changes in neurometabolites.
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Affiliation(s)
- Guowei Luo
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Shantou University Medical College, Shantou, China
| | - Shibin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Siyu Yao
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Dongming Quan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Guangquan Guo
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Junling Gao
- Department of Medicine, University of Hong Kong, Hong Kong, China
| | - Huirong Zheng
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China; South China University of Technology School of Medicine, Guangzhou, China; Shantou University Medical College, Shantou, China.
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Qi CX, Wen Z, Huang X. Reduction of Interhemispheric Homotopic Connectivity in Cognitive and Visual Information Processing Pathways in Patients With Thyroid-Associated Ophthalmopathy. Front Hum Neurosci 2022; 16:882114. [PMID: 35865354 PMCID: PMC9295451 DOI: 10.3389/fnhum.2022.882114] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Thyroid-associated ophthalmopathy (TAO) is a vision threatening autoimmune and inflammatory orbital disease, and has been reported to be associated with a wide range of structural and functional abnormalities of bilateral hemispheres. However, whether the interhemisphere functional connectivity (FC) of TAO patients is altered still remain unclear. A new technique called voxel-mirrored homotopic connectivity (VMHC) combined with support vector machine (SVM) method was used in the present study to explore interhemispheric homotopic functional connectivity alterations in patients with TAO. Methods A total of 21 TAO patients (14 males and 7 females) and 21 wellmatched healthy controls (HCs, 14 males and 7 females), respectively, underwent functional magnetic resonance imaging (fMRI) scanning in the resting state. We evaluated alterations in the resting state functional connectivity between hemispheres by applying VMHC method and then selected these abnormal brain regions as seed areas for subsequent study using FC method. Furthermore, the observed changes of regions in the VMHC analysis were chosen as classification features to differentiate patients with TAO from HCs through support vector machine (SVM) method. Results The results showed that compared with HCs, TAO patients showed significantly lower VMHC values in the bilateral postcentral gyrus, lingual gyrus, calcarine, middle temporal gyrus, middle occipital gyrus and angular. Moreover, significantly decreased FC values were found between the right postcentral gyrus/lingual gyrus/calcarine and left lingual gyrus/cuneus/superior occipital gyrus, left postcentral gyrus/lingual gyrus/calcarine and right lingual gyrus/ middle temporal gyrus, right middle temporal gyrus and left cerebellum-8/lingual gyrus/middle occipital gyrus/supplementary motor area, left middle temporal gyrus and right middle occipital gyrus, right middle occipital gyrus/angular and left middle temporal pole (voxel-level p < 0.01, Gaussian random field correction, cluster-level p < 0.05). The SVM classification model achieved good performance in differentiating TAO patients from HCs (total accuracy: 73.81%; area under the curve: 0.79). Conclusion The present study revealed that the altered interhemisphere interaction and integration of information involved in cognitive and visual information processing pathways including the postcentral gyrus, cuneus, cerebellum, angular, widespread visual cortex and temporal cortex in patients with TAO relative to HC group. VMHC variability had potential value for accurately and specifically distinguishing patients with TAO from HCs. The new findings may provide novel insights into the neurological mechanisms underlying visual and cognitive disorders in patients with TAO.
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Affiliation(s)
- Chen-Xing Qi
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhi Wen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang University, Nanchang, China
- *Correspondence: Xin Huang
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Li X, Li H, Jiang X, Li J, Cao L, Liu J, Xing H, Huang X, Gong Q. Characterizing multiscale modular structures in medication-free obsessive-compulsive disorder patients with no comorbidity. Hum Brain Mapp 2022; 43:2391-2399. [PMID: 35170143 PMCID: PMC8996347 DOI: 10.1002/hbm.25794] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/03/2022] [Accepted: 01/21/2022] [Indexed: 02/05/2023] Open
Abstract
Brain networks exhibit signatures of modular structure, which maintains a fine trade‐off between wiring cost and efficiency of information transmission. Alterations in modular structure have been found in patients with obsessive–compulsive disorder (OCD). However, previous studies were focused on a single scale (i.e., modularity or intra/intermodular connectivity) for investigation. Here, we recruited 92 OCD patients and 90 healthy controls. A comprehensive analysis was performed on modular architecture alterations in the voxelwise functional connectome at the “global” (modularity), “meso” (modular segregation and within‐ and between‐module connections), and “local” (participation coefficients, PC) scales. We also examined the correlation between modular structure metrics and clinical symptoms. The findings revealed that (1) there was no significant group difference in global modularity; (2) both primary modules (visual network, sensorimotor network) and high‐order modules (dorsal attention network, frontoparietal network) exhibited lower modular segregation in OCD patients, which was mainly driven by increased numbers of between‐module connections; and (3) OCD patients showed higher PC in several connectors including the bilateral middle occipital gyri, left medial orbital frontal gyrus, left superior frontal gyrus, left posterior cingulate gyrus, right superior temporal gyrus and right middle frontal gyrus, and lower PC in the right lingual gyrus. Moreover, these alterations in modular structure were associated with clinical symptoms in patients. Our findings provide further insights into the involvement of different modules in functional network dysfunction in OCD from a connectomic perspective and suggest a synergetic mechanism of module interactions that may be related to the pathophysiology of OCD.
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Affiliation(s)
- Xue Li
- College of Physics, Sichuan University, Chengdu, China.,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xi Jiang
- College of Physics, Sichuan University, Chengdu, China
| | - Jing Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lingxiao Cao
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Jing Liu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Haoyang Xing
- College of Physics, Sichuan University, Chengdu, China.,Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China
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9
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Liu J, Cao L, Li H, Gao Y, Bu X, Liang K, Bao W, Zhang S, Qiu H, Li X, Hu X, Lu L, Zhang L, Hu X, Huang X, Gong Q. Abnormal resting-state functional connectivity in patients with obsessive-compulsive disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 135:104574. [DOI: 10.1016/j.neubiorev.2022.104574] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/12/2021] [Accepted: 02/07/2022] [Indexed: 12/31/2022]
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10
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Li K, Long J, Deng W, Cheng B, Wang J. Electroconvulsive therapy for obsessive-compulsive disorder: A retrospective study. Front Psychiatry 2022; 13:1040443. [PMID: 36440390 PMCID: PMC9682229 DOI: 10.3389/fpsyt.2022.1040443] [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: 09/09/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Chronic mental diseases such as obsessive-compulsive disorder (OCD) are associated with a high disability rate. Some patients still do not improve their symptoms even with adequate cognitive-behavioral therapy and drug treatment. In the treatment of OCD, electroconvulsive therapy (ECT) is not considered a neuromodulation modality with sufficient evidence. OBJECTIVE This retrospective study aimed to determine the efficacy and associated risk factors of ECT in OCD patients. MATERIALS AND METHODS The study included 21 OCD patients who underwent ECT at a high-volume center in China between January 2009 and December 2020. The demographics and clinical characteristics of the patients were assessed using descriptive statistics. Based on Clinical Global Impressions-Improvement scale, patients were categorized into response and non-response groups. Clinical and demographic characteristics of two groups of patients were compared. RESULTS An analysis of 21 patients was conducted. In total, 12 patients (57.1%) responded to ECT, 11 patients (52.4%) reported side effects, and an average of 7 ECT sessions were administered. In terms of demographic, there was no statistically significant difference between the two groups. It is noteworthy that the non-response group reported more depression and schizophrenia related disorders comorbidities than the response group (χ2 = 6.252, P = 0.041). CONCLUSION The effectiveness of ECT in treating OCD is limited, especially in patients with refractory symptoms. Comorbidity with other mental disorders may affect the efficacy of ECT.
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Affiliation(s)
- Kun Li
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jiang Long
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wei Deng
- Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Affiliated Mental Health Center & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Jiaojian Wang
- State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
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11
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Association between gray/white matter contrast and white matter microstructural alterations in medication-naïve obsessive–compulsive disorder. NEUROIMAGE: CLINICAL 2022; 35:103122. [PMID: 35872436 PMCID: PMC9421450 DOI: 10.1016/j.nicl.2022.103122] [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: 05/05/2022] [Revised: 06/12/2022] [Accepted: 07/16/2022] [Indexed: 11/21/2022] Open
Abstract
Increased gray/white matter contrast (GWC) was found in patients with OCD. Decreased fractional anisotropy (FA) was found in patients with OCD. GWC and white matter FA were coupled in patients with OCD and healthy controls.
Intracortical myelin is involved in speeding and synchronizing neural activity of the cerebral cortex and has been found to be disrupted in various psychiatric disorders. However, its role in obsessive–compulsive disorder (OCD) has remained unknown. In this study, we investigated the alterations in intracortical myelin and their association with white matter (WM) microstructural abnormalities in OCD. T1-weighted and diffusion-weighted brain images were obtained for 51 medication-naïve patients with OCD and 26 healthy controls (HCs). The grey/white matter contrast (GWC) was calculated from T1-weighted signal intensities to characterize the intracortical myelin profile in OCD. Diffusion parameters, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD), were extracted from diffusion-weighted images to examine the WM microstructure in OCD. Compared with HCs, patients with OCD showed increased GWC in the bilateral orbitofrontal, cuneus, lingual and fusiform gyrus, left anterior cingulate, left superior parietal, right inferior parietal, and right middle frontal cortices, suggesting reduced intracortical myelin. Patients with OCD also showed decreased FA in several WM regions, with a topology corresponding to the GWC alterations. In both groups, the mean GWC of the significant clusters in between-group GWC analysis was correlated negatively with the mean FA of the significant clusters in between-group FA analysis. In patients with OCD, the FA of a cluster in the right cerebellum correlated negatively with the Yale-Brown obsessive–compulsive scale scores. Our results suggest that abnormal intracortical and WM myelination could be the microstructural basis for the brain connectivity alterations and disrupted inhibitory control in OCD.
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12
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Altered Functional Connectivity Strength at Rest in Medication-Free Obsessive-Compulsive Disorder. Neural Plast 2021; 2021:3741104. [PMID: 34539777 PMCID: PMC8443365 DOI: 10.1155/2021/3741104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/25/2021] [Accepted: 08/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies explored the whole-brain functional connectome using the degree approach in patients with obsessive-compulsive disorder (OCD). However, whether the altered degree values can be used to discriminate OCD from healthy controls (HCs) remains unclear. Methods A total of 40 medication-free patients with OCD and 38 HCs underwent a resting-state functional magnetic resonance imaging (rs-fMRI) scan. Data were analyzed with the degree approach and a support vector machine (SVM) classifier. Results Patients with OCD showed increased degree values in the left thalamus and left cerebellum Crus I and decreased degree values in the left dorsolateral prefrontal cortex, right precuneus, and left postcentral gyrus. SVM classification analysis indicated that the increased degree value in the left thalamus is a marker of OCD, with an acceptable accuracy of 88.46%, sensitivity of 87.50%, and specificity of 89.47%. Conclusion Altered degree values within and outside the cortical-striatal-thalamic-cortical (CSTC) circuit may cocontribute to the pathophysiology of OCD. Increased degree values of the left thalamus can be used as a future marker for OCD understanding-classification.
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Cao J, Chai-Zhang TC, Huang Y, Eshel MN, Kong J. Potential scalp stimulation targets for mental disorders: evidence from neuroimaging studies. J Transl Med 2021; 19:343. [PMID: 34376209 PMCID: PMC8353731 DOI: 10.1186/s12967-021-02993-1] [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: 05/28/2021] [Accepted: 07/17/2021] [Indexed: 11/16/2022] Open
Abstract
Mental disorders widely contribute to the modern global disease burden, creating a significant need for improvement of treatments. Scalp stimulation methods (such as scalp acupuncture and transcranial electrical stimulation) have shown promising results in relieving psychiatric symptoms. However, neuroimaging findings haven’t been well-integrated into scalp stimulation treatments. Identifying surface brain regions associated with mental disorders would expand target selection and the potential for these interventions as treatments for mental disorders. In this study, we performed large-scale meta-analyses separately on eight common mental disorders: attention deficit hyperactivity disorder, anxiety disorder, autism spectrum disorder, bipolar disorder, compulsive disorder, major depression, post-traumatic stress disorder and schizophrenia; utilizing modern neuroimaging literature to summarize disorder-associated surface brain regions, and proposed neuroimaging-based target protocols. We found that the medial frontal gyrus, the supplementary motor area, and the dorsal lateral prefrontal cortex are commonly involved in the pathophysiology of mental disorders. The target protocols we proposed may provide new brain targets for scalp stimulation in the treatment of mental disorders, and facilitate its clinical application.
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Affiliation(s)
- Jin Cao
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Thalia Celeste Chai-Zhang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Yiting Huang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Maya Nicole Eshel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA.
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14
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Liu X, Xu X, Mao C, Zhang P, Zhang Q, Jiang L, Yang Y, Ma J, Ye L, Lee KO, Wu J, Yao Z. Increased thalamo-cortical functional connectivity in patients with diabetic painful neuropathy: A resting-state functional MRI study. Exp Ther Med 2021; 21:509. [PMID: 33791018 PMCID: PMC8005696 DOI: 10.3892/etm.2021.9940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 02/10/2021] [Indexed: 11/20/2022] Open
Abstract
Functional changes in the brain of patients with painful diabetic neuropathy (PDN) have remained largely elusive. The aim of the present study was to explore changes in thalamo-cortical functional connectivity (FC) of patients with PDN using resting-state functional MRI. A total of 20 patients with type 2 diabetes mellitus (T2DM) with non-painful diabetic neuropathy (Group NDN), 19 patients with T2DM with PDN (Group-PDN) and 13 age-, sex- and education-matched healthy controls were recruited. The differences in thalamo-cortical FC among the three groups were compared. Patients in Group PDN had increased FC in the left thalamus, the right angular gyrus and the occipital gyrus as compared to those in Group NDN. Furthermore, patients in Group PDN had increased FC in the right thalamus and angular gyrus as compared to those in Group NDN. In conclusion, the present results suggested that the thalamo-cortical FC is increased in patients with T2DM and PDN. Furthermore, the increased FC in the thalamic-parietal-occipital connectivity may be a central pathophysiological mechanism for PDN. The study was retrospectively registered at ClinicalTrials.gov on 3 October 2018 (identifier no. NCT03700502).
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Affiliation(s)
- Xiaomei Liu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210010, P.R. China
| | - Xianghong Xu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210010, P.R. China
| | - Cunnan Mao
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210010, P.R. China
| | - Peng Zhang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210010, P.R. China
| | - Qing Zhang
- Department of Endocrinology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China
| | - Lanlan Jiang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210010, P.R. China
| | - Yuyin Yang
- Department of Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Jianhua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210010, P.R. China
| | - Lei Ye
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore 169609, Singapore
| | - Kok-Onn Lee
- Department of Medicine, National University of Singapore, Singapore 119074, Singapore
| | - Jindan Wu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210010, P.R. China
| | - Zhijian Yao
- Department of Psychiatry, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
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15
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Dikmeer N, Besiroglu L, Di Biase MA, Zalesky A, Kasal MI, Bilge A, Durmaz E, Polat S, Gelal F, Zorlu N. White matter microstructure and connectivity in patients with obsessive-compulsive disorder and their unaffected siblings. Acta Psychiatr Scand 2021; 143:72-81. [PMID: 33029781 DOI: 10.1111/acps.13241] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We aimed to examine white matter microstructure and connectivity in individuals with obsessive-compulsive disorder (OCD) and their unaffected siblings, relative to healthy controls. METHODS Diffusion-weighted magnetic resonance imaging (dMRI) scans were acquired in 30 patients with OCD, 21 unaffected siblings, and 31 controls. We examined white matter microstructure using measures of fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD). Structural networks were examined using network-based statistic (NBS). RESULTS Compared to controls, OCD patients showed significantly reduced FA and increased RD in clusters traversing the left forceps minor, inferior fronto-occipital fasciculus, anterior thalamic radiation, and cingulum. Furthermore, the OCD group displayed significantly weaker connectivity (quantified by the streamline count) compared to controls in the right hemisphere, most notably in edges connecting subcortical structures to temporo-occipital cortical regions. The sibling group showed intermediate streamline counts, FA and RD values between OCD and healthy control groups in connections found to be abnormal in patients with OCD. However, these reductions did not significantly differ compared to controls. CONCLUSION Therefore, siblings of OCD patients display intermediate levels in dMRI measures of microstructure and connectivity, suggesting white matter abnormalities might be related to the familial predisposition for OCD.
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Affiliation(s)
- Nur Dikmeer
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Lutfullah Besiroglu
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Maria A Di Biase
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Andrew Zalesky
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Department of Biomedical Engineering, The University of Melbourne, Melbourne, VIC, Australia
| | - Meltem I Kasal
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Aslıhan Bilge
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Ercan Durmaz
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Serap Polat
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Fazil Gelal
- Department of Radiodiagnostics, Katip Celebi University, Ataturk Education and Research Hospital, Ankara, Turkey
| | - Nabi Zorlu
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
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Pregabalin augmentation for resistant obsessive-compulsive disorder: a double-blind placebo-controlled clinical trial. CNS Spectr 2020; 25:552-556. [PMID: 31648655 DOI: 10.1017/s1092852919001500] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Glutamate dysfunction has been shown to be associated with pathophysiology of obsessive-compulsive disorder (OCD). Our objective is to survey the effects of pregabalin (a glutamate-modulating agent) as an augmenting treatment for resistant OCD. PATIENTS AND METHODS In this 12-week double-blind placebo-controlled clinical trial, 56 patients with resistant OCD were randomly allocated to receive either pregabalin or placebo plus their current medication (sertraline). Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to evaluate the outcomes. Adverse effects were also registered. RESULTS Of the 56 patients with resistant OCD who were randomly allocated in 2 groups of pregabalin (n = 28) and placebo group (n = 28), 42 patients (22 in pregabalin group and 20 in placebo group) completed the trial. Throughout the trial, the mean score decreased from 26.13± 7.03 to 8.81 ± 3.47 in the pregabalin group (p < 0) and from 26.85 ± 4.34 to 17.63 ± 4.22 in the placebo group (p < 0). At the end of trial, 16 (57.14%) patients in the pregabalin group and 2 (7.14%) patients in the placebo group showed more than 35% decline in YBOCS (p < .01). The pregabalin group showed good tolerability and safety. CONCLUSIONS Our study revealed that pregabalin, as an augmenting medication, is more effective than placebo in the treatment of patients with resistant OCD.
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