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Kwon H, Ha M, Choi S, Park S, Jang M, Kim M, Kwon JS. Resting-state functional connectivity of amygdala subregions across different symptom subtypes of obsessive-compulsive disorder patients. Neuroimage Clin 2024; 43:103644. [PMID: 39042954 DOI: 10.1016/j.nicl.2024.103644] [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: 02/19/2024] [Revised: 05/30/2024] [Accepted: 07/16/2024] [Indexed: 07/25/2024]
Abstract
AIM Obsessive-compulsive disorder (OCD) is a heterogeneous condition characterized by distinct symptom subtypes, each with varying pathophysiologies and treatment responses. Recent research has highlighted the role of the amygdala, a brain region that is central to emotion processing, in these variations. However, the role of amygdala subregions with distinct functions has not yet been fully elucidated. In this study, we aimed to clarify the biological mechanisms underlying OCD subtype heterogeneity by investigating the functional connectivity (FC) of amygdala subregions across distinct OCD symptom subtypes. METHODS Resting-state functional magnetic resonance images were obtained from 107 medication-free OCD patients and 110 healthy controls (HCs). Using centromedial, basolateral, and superficial subregions of the bilateral amygdala as seed regions, whole-brain FC was compared between OCD patients and HCs and among patients with different OCD symptom subtypes, which included contamination fear and washing, obsessive (i.e., harm due to injury, aggression, sexual, and religious), and compulsive (i.e., symmetry, ordering, counting, and checking) subtypes. RESULTS Compared to HCs, compulsive-type OCD patients exhibited hypoconnectivity between the left centromedial amygdala (CMA) and bilateral superior frontal gyri. Compared with patients with contamination fear and washing OCD subtypes, patients with compulsive-type OCD showed hypoconnectivity between the left CMA and left frontal cortex. CONCLUSIONS CMA-frontal cortex hypoconnectivity may contribute to the compulsive presentation of OCD through impaired control of behavioral responses to negative emotions. Our findings underscored the potential significance of the distinct neural underpinnings of different OCD manifestations, which could pave the way for more targeted treatment strategies in the future.
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Affiliation(s)
- Harah Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Clinical Medical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Minji Ha
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Sunah Choi
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Sunghyun Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Moonyoung Jang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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Li W, Xie M, Chen H, Zhang X, Zhang H, Xu Z, Song S, Wang Z, Jiang W, Jiang Y, Liu N, Zhang N. Resting-state functional connectivity of amygdala subregions predicts treatment outcome for cognitive behavioral therapy in obsessive-compulsive disorder at a 4-month follow-up. Psychiatry Res 2024; 335:115876. [PMID: 38564923 DOI: 10.1016/j.psychres.2024.115876] [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: 09/23/2023] [Revised: 03/10/2024] [Accepted: 03/24/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Cognitive behavioral therapy (CBT) is considered as the first-line treatment for obsessive-compulsive disorder (OCD). However, the underlying neural mechanisms through which CBT exerts its effects in OCD remain unclear. This study aims to investigate whether the improvement of clinical symptoms in OCD patients after CBT treatment is associated with changes in resting-state functional connectivity (FC) of the amygdala subregion, and whether these changes can be served as potential predictors of four-months treatment efficacy. METHODS We collected resting-state functional magnetic resonance imaging (rs-fMRI) data from 57 OCD patients and 50 healthy subjects at baseline. In the patient group, rs-fMRI was also obtained after completion of an 8-week CBT treatment and 4 months post-treatment. A whole-brain rsFC analysis was conducted using the amygdala subregion as the seed point. We analyzed the FC patterns in relation to 4 months clinical outcomes to elucidate the long-term efficacy of CBT in OCD patients. RESULTS Treatment responseat at pre-treatment was found to be associated with reduced rsFC between the left basolateral amygdala(BLA)and left superior temporal gyrus(STG) at baseline. Lower pre-treatment FC were negatively correlated with the severity of OCD symptoms as measured by the Yale-Brown Obsessive Compulsive Severity Scale (Y-BOCS). Moreover, the area under the receiver operating characteristic (ROC) curve for the FC between the left BLA and STG at the end of treatment was 73.0% and 70.4% for the effective-ineffective and remitted or unremitted groups, respectively. At the 4-month follow-up, the area under the ROC curve for the effective-ineffective and remitted or unremitted groups was 83.9% and 76.5%, respectively. CONCLUSION These findings suggest that brain functional activity in patients with OCD can predict treatment response to CBT, and longitudinal changes in relevant brain functional activity following CBT treatment are associated with treatment response in OCD.
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Affiliation(s)
- Wangyue Li
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Minyao Xie
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Haocheng Chen
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Xuedi Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Huan Zhang
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Zhihan Xu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Shasha Song
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Zhongqi Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Wenjing Jiang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Yicheng Jiang
- School of Psychology, Nanjing Normal University, Nanjing, PR China
| | - Na Liu
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China.
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, PR China
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Ferrão JVB, do Rosário MC, Fontenelle LF, Ferrão YA. Prevalence and psychopathology features of mental rituals in patients with obsessive-compulsive disorder: A descriptive exploratory study of 1001 patients. Clin Psychol Psychother 2023; 30:1520-1533. [PMID: 37554049 DOI: 10.1002/cpp.2890] [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: 03/19/2023] [Revised: 07/04/2023] [Accepted: 07/17/2023] [Indexed: 08/10/2023]
Abstract
INTRODUCTION Mental rituals (MR) are compulsions with no overt behavioural or motoric signs. It is presently unclear whether MR found in obsessive-compulsive disorder are associated with a distinctive clinical profile. OBJECTIVES The main objectives of this paper were to assess the prevalence and psychopathological correlates of mental rituals in a large sample of OCD patients. METHODS This exploratory case-control study compared 519 patients with versus 447 without MR in terms of sociodemographics, presence and severity of obsessive-compulsive symptoms, psychiatric comorbidities, sensory phenomena, suicidality, and insight. RESULTS Current MR were found in 51.8%, while lifetime MR were found in 55.4% of the sample. The multiple logistic regression model determined that the most relevant clinical factors independently associated with current MR in OCD patients were the absence of any sensory phenomena and the presence of lifetime suicide ideation. CONCLUSION Due to its relation to OCD clinical aspects, MR are a frequent feature among OCD patients. It also seems to be associated with a range of features that are probably relevant for treatment, especially sensory phenomena and suicidality.
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Affiliation(s)
- João Vítor Bueno Ferrão
- Medical School, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Maria Conceição do Rosário
- Brazilian Consortium for Research on Obsessive-Compulsive Spectrum Disorders (C-TOC), Unidade de Psiquiatria da Infância e Adolescência (UPIA), Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Leonardo F Fontenelle
- Brazilian Consortium for Research on Obsessive-Compulsive Spectrum Disorders (C-TOC), Departamento de Psiquiatria e Medicina Legal da Faculdade de Medicina da Universidade Federal do Rio de Janeiro (UFRJ) e da Faculdade de Medicina da Universidade Federal Fluminense (UFF), Instituto DOr de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil
| | - Ygor Arzeno Ferrão
- Brazilian Consortium for Research on Obsessive-Compulsive Spectrum Disorders (C-TOC), Clinical Neurosciences, Medical School, Programa de Pós- Graduação em Ciências da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
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Khayrullina G, Panfilova E, Martynova O. Increased error rate and delayed response to negative emotional stimuli in antisaccade task in obsessive-compulsive disorder. Int J Psychophysiol 2023; 192:62-71. [PMID: 37604280 DOI: 10.1016/j.ijpsycho.2023.08.009] [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: 05/21/2023] [Revised: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 08/23/2023]
Abstract
Ample evidence links impaired inhibitory control, attentional distortions, emotional dysregulation, and obsessive-compulsive disorder (OCD). However, it remains unclear what underlies the deficit that triggers the OCD cycle. The present study used an antisaccade paradigm with emotional valences to compare eye movement patterns reflecting inhibitory control and attention switching in OCD and healthy control groups. Thirty-two patients with OCD and thirty healthy controls performed the antisaccade task with neutral, positive, and negative visual images served as fixation stimuli. Presentation of the fixation stimulus overlapped with target stimuli appearance for 200 ms. The OCD group showed more errors to negative stimuli than the control group and they also performed antisaccades more slowly to negative and neutral stimuli than positive ones. Other patterns, including mean gaze velocity of correct antisaccades did not differ between groups. The mean gaze velocity of correct antisaccades was higher for negative and positive stimuli than for neutral stimuli in both groups. The peak velocity parameter did not show any differences either between groups or between valences. The findings support a hypothesis that an attentional bias toward negative stimuli interferes with inhibitory control in OCD.
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Affiliation(s)
- Guzal Khayrullina
- Institute of Higher Nervous Activity and Neurophysiology RAS, Butlerova 5A, Moscow 117484, Russia; Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Myasnitskaya 20, Moscow 101000, Russia.
| | - Elizaveta Panfilova
- Institute of Higher Nervous Activity and Neurophysiology RAS, Butlerova 5A, Moscow 117484, Russia
| | - Olga Martynova
- Institute of Higher Nervous Activity and Neurophysiology RAS, Butlerova 5A, Moscow 117484, Russia; Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Myasnitskaya 20, Moscow 101000, Russia
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Vellucci L, Ciccarelli M, Buonaguro EF, Fornaro M, D’Urso G, De Simone G, Iasevoli F, Barone A, de Bartolomeis A. The Neurobiological Underpinnings of Obsessive-Compulsive Symptoms in Psychosis, Translational Issues for Treatment-Resistant Schizophrenia. Biomolecules 2023; 13:1220. [PMID: 37627285 PMCID: PMC10452784 DOI: 10.3390/biom13081220] [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: 02/28/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Almost 25% of schizophrenia patients suffer from obsessive-compulsive symptoms (OCS) considered a transdiagnostic clinical continuum. The presence of symptoms pertaining to both schizophrenia and obsessive-compulsive disorder (OCD) may complicate pharmacological treatment and could contribute to lack or poor response to the therapy. Despite the clinical relevance, no reviews have been recently published on the possible neurobiological underpinnings of this comorbidity, which is still unclear. An integrative view exploring this topic should take into account the following aspects: (i) the implication for glutamate, dopamine, and serotonin neurotransmission as demonstrated by genetic findings; (ii) the growing neuroimaging evidence of the common brain regions and dysfunctional circuits involved in both diseases; (iii) the pharmacological modulation of dopaminergic, serotoninergic, and glutamatergic systems as current therapeutic strategies in schizophrenia OCS; (iv) the recent discovery of midbrain dopamine neurons and dopamine D1- and D2-like receptors as orchestrating hubs in repetitive and psychotic behaviors; (v) the contribution of N-methyl-D-aspartate receptor subunits to both psychosis and OCD neurobiology. Finally, we discuss the potential role of the postsynaptic density as a structural and functional hub for multiple molecular signaling both in schizophrenia and OCD pathophysiology.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Andrea de Bartolomeis
- Section of Psychiatry, Laboratory of Translational and Molecular Psychiatry and Unit of Treatment-Resistant Psychosis, Department of Neuroscience, Reproductive Sciences and Dentistry University Medical School of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy
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Saaiman D, Brand L, de Brouwe G, Janse van Rensburg H, Terre'Blanche G, Legoabe L, Krahe T, Wolmarans D. Striatal adenosine A 2A receptor involvement in normal and large nest building deer mice: perspectives on compulsivity and anxiety. Behav Brain Res 2023; 449:114492. [PMID: 37172739 DOI: 10.1016/j.bbr.2023.114492] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023]
Abstract
Obsessive-compulsive disorder (OCD) is characterized by recurring obsessive thoughts and repetitive behaviors that are often associated with anxiety and perturbations in cortico-striatal signaling. Given the suboptimal response of OCD to current serotonergic interventions, there is a need to better understand the psychobiological mechanisms that may underlie the disorder. In this regard, investigations into adenosinergic processes might be fruitful. Indeed, adenosine modulates both anxiety- and motor behavioral output. Thus, we aimed to explore the potential associations between compulsive-like large nest building (LNB) behavior in deer mice, anxiety and adenosinergic processes. From an initial pool of 120 adult deer mice, 34 normal nest building (NNB)- and 32 LNB-expressing mice of both sexes were selected and exposed to either a normal water (wCTRL) or vehicle control (vCTRL), lorazepam (LOR) or istradefylline (ISTRA) for 7- (LOR) or 28 days after which nesting assessment was repeated and animals screened for anxiety-like behavior in an anxiogenic open field. Mice were then euthanized, the striatal tissue removed on ice and the adenosine A2A receptor expression quantified. Our findings indicate that NNB and LNB behavior are not distinctly associated with measures of generalized anxiety and that ISTRA-induced changes in nesting expression are dissociated from changes in anxiety scores. Further, data from this investigation show that nesting in deer mice is directly related to striatal adenosine signaling, and that LNB is founded upon a lower degree of adenosinergic A2A stimulation.
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Affiliation(s)
- D Saaiman
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, North-West University, Potchefstroom, South Africa
| | - L Brand
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, North-West University, Potchefstroom, South Africa
| | - G de Brouwe
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, North-West University, Potchefstroom, South Africa
| | - H Janse van Rensburg
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmaceutical Chemistry, North-West University, Potchefstroom, South Africa
| | - G Terre'Blanche
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmaceutical Chemistry, North-West University, Potchefstroom, South Africa
| | - L Legoabe
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmaceutical Chemistry, North-West University, Potchefstroom, South Africa
| | - T Krahe
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - D Wolmarans
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, North-West University, Potchefstroom, South Africa.
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7
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Safar K, Pang EW, Vandewouw MM, de Villa K, Arnold PD, Iaboni A, Ayub M, Kelley E, Lerch JP, Anagnostou E, Taylor MJ. Atypical oscillatory dynamics during emotional face processing in paediatric obsessive-compulsive disorder with MEG. Neuroimage Clin 2023; 38:103408. [PMID: 37087819 PMCID: PMC10149418 DOI: 10.1016/j.nicl.2023.103408] [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: 11/30/2022] [Revised: 02/21/2023] [Accepted: 04/14/2023] [Indexed: 04/25/2023]
Abstract
Children and youth with obsessive-compulsive disorder (OCD) demonstrate difficulties with social, emotional and cognitive functions in addition to the core diagnosis of obsessions and compulsions. This is the first magnetoencephalography (MEG) study to examine whole-brain neurophysiological functional connectivity of emotional face processing networks in paediatric OCD. Seventy-two participants (OCD: n = 36; age 8-17 yrs; typically developing controls: n = 36, age 8-17 yrs) completed an implicit emotional face processing task in the MEG. Functional connectivity networks in canonical frequency bands were compared between groups, and within OCD and control groups between emotions (angry vs. happy). Between groups, participants with OCD showed increased functional connectivity in the gamma band to angry faces, suggesting atypical perception of angry faces in OCD. Within groups, the OCD group showed greater engagement of the beta band, suggesting the over-use of top-down processing when perceiving happy versus angry emotions, while controls engaged in bottom-up gamma processing, also greater to happy faces. Over-activation of top-down processing has been linked to difficulties modifying one's cognitive set. Findings establish altered patterns of neurophysiological connectivity in children with OCD, and are striking in their oscillatory specificity. Our results contribute to a greater understanding of the neurobiology of the disorder, and are foundational for the possibility of alternative targets for intervention.
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Affiliation(s)
- Kristina Safar
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada.
| | - Elizabeth W Pang
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Marlee M Vandewouw
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada; Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Institute of Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Kathrina de Villa
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Alana Iaboni
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Muhammed Ayub
- Department of Psychology, Queen's University, Kingston, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, Canada; Department of Psychiatry, Queen's University, Kingston, Canada
| | - Jason P Lerch
- Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Canada
| | - Evdokia Anagnostou
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Margot J Taylor
- Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada; Program in Neurosciences & Mental Health, Hospital for Sick Children, Toronto, Canada; Department of Medical Imaging, University of Toronto, Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada
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Yu J, Xie M, Song S, Zhou P, Yuan F, Ouyang M, Wang C, Liu N, Zhang N. Functional Connectivity within the Frontal–Striatal Network Differentiates Checkers from Washers of Obsessive-Compulsive Disorder. Brain Sci 2022; 12:brainsci12080998. [PMID: 36009061 PMCID: PMC9406102 DOI: 10.3390/brainsci12080998] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Obsessive-compulsive disorder (OCD) is a psychiatric disorder with high clinical heterogeneity manifested by the presence of obsessions and/or compulsions. The classification of the symptom dimensional subtypes is helpful for further exploration of the pathophysiological mechanisms underlying the clinical heterogeneity of OCD. Washing and checking symptoms are the two major symptom subtypes in OCD, but the neural mechanisms of the different types of symptoms are not yet clearly understood. The purpose of this study was to compare regional and network functional alterations between washing and checking OCD based on resting-state functional magnetic resonance imaging (rs-fMRI). Methods: In total, 90 subjects were included, including 15 patients in the washing group, 30 patients in the checking group, and 45 healthy controls (HCs). Regional homogeneity (ReHo) was used to compare the differences in regional spontaneous neural activity among the three groups, and local indicators were analyzed by receiver operating characteristic (ROC) curves as imaging markers for the prediction of the clinical subtypes of OCD. Furthermore, differently activated local brain areas, as regions of interest (ROIs), were used to explore differences in altered brain functioning between washing and checking OCD symptoms based on a functional connectivity (FC) analysis. Results: Extensive abnormalities in spontaneous brain activity involving frontal, temporal, and occipital regions were observed in the patients compared to the HCs. The differences in local brain functioning between checking and washing OCD were mainly concentrated in the bilateral middle frontal gyrus, right supramarginal gyrus, right angular gyrus, and right inferior occipital gyrus. The ROC curve analysis revealed that the hyperactivation right middle frontal gyrus had a better discriminatory value for checking and washing OCD. Furthermore, the seed-based FC analysis revealed higher FC between the left medial superior frontal gyrus and right caudate nucleus compared to that in the healthy controls. Conclusions: These findings suggest that extensive local differences exist in intrinsic spontaneous activity among the checking group, washing group, and HCs. The neural basis of checking OCD may be related to dysfunction in the frontal–striatal network, which distinguishes OCD from washing OCD.
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Affiliation(s)
- Jianping Yu
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; (J.Y.); (M.X.); (S.S.); (M.O.); (C.W.); (N.Z.)
| | - Minyao Xie
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; (J.Y.); (M.X.); (S.S.); (M.O.); (C.W.); (N.Z.)
| | - Shasha Song
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; (J.Y.); (M.X.); (S.S.); (M.O.); (C.W.); (N.Z.)
| | - Ping Zhou
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China;
| | - Fangzheng Yuan
- School of Psychology, Nanjing Normal University, 122 Ninghai Road, Nanjing 210024, China;
| | - Mengyuan Ouyang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; (J.Y.); (M.X.); (S.S.); (M.O.); (C.W.); (N.Z.)
| | - Chun Wang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; (J.Y.); (M.X.); (S.S.); (M.O.); (C.W.); (N.Z.)
| | - Na Liu
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China;
- Correspondence:
| | - Ning Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; (J.Y.); (M.X.); (S.S.); (M.O.); (C.W.); (N.Z.)
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9
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Ruan H, Wang Y, Li Z, Tong G, Wang Z. A Systematic Review of Treatment Outcome Predictors in Deep Brain Stimulation for Refractory Obsessive-Compulsive Disorder. Brain Sci 2022; 12:brainsci12070936. [PMID: 35884742 PMCID: PMC9316868 DOI: 10.3390/brainsci12070936] [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: 05/24/2022] [Revised: 07/06/2022] [Accepted: 07/15/2022] [Indexed: 12/04/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a chronic and debilitating mental disorder. Deep brain stimulation (DBS) is a promising approach for refractory OCD patients. Research aiming at treatment outcome prediction is vital to provide optimized treatments for different patients. The primary purpose of this systematic review was to collect and synthesize studies on outcome prediction of OCD patients with DBS implantations in recent years. This systematic review (PROSPERO registration number: CRD42022335585) followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis) guidelines. The search was conducted using three different databases with the following search terms related to OCD and DBS. We identified a total of 3814 articles, and 17 studies were included in our review. A specific tract confirmed by magnetic resonance imaging (MRI) was predictable for DBS outcome regardless of implant targets, but inconsistencies still exist. Current studies showed various ways of successful treatment prediction. However, considering the heterogeneous results, we hope that future studies will use larger cohorts and more precise approaches for predictors and establish more personalized ways of DBS surgeries.
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Affiliation(s)
- Hanyang Ruan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; (H.R.); (Y.W.); (Z.L.); (G.T.)
| | - Yang Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; (H.R.); (Y.W.); (Z.L.); (G.T.)
| | - Zheqin Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; (H.R.); (Y.W.); (Z.L.); (G.T.)
| | - Geya Tong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; (H.R.); (Y.W.); (Z.L.); (G.T.)
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; (H.R.); (Y.W.); (Z.L.); (G.T.)
- Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, China
- Shanghai Key Laboratory of Psychotic Disorders (No. 13dz2260500), Shanghai 200030, China
- Correspondence: ; Tel.: +86-180-1731-1286
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10
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Seguin D, Pac S, Wang J, Nicolson R, Martinez-Trujillo J, Anagnostou E, Lerch JP, Hammill C, Schachar R, Crosbie J, Kelley E, Ayub M, Brian J, Liu X, Arnold PD, Georgiades S, Duerden EG. Amygdala subnuclei volumes and anxiety behaviors in children and adolescents with autism spectrum disorder, attention deficit hyperactivity disorder, and obsessive-compulsive disorder. Hum Brain Mapp 2022; 43:4805-4816. [PMID: 35819018 PMCID: PMC9582362 DOI: 10.1002/hbm.26005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/11/2022] [Accepted: 06/26/2022] [Indexed: 12/14/2022] Open
Abstract
Alterations in the structural maturation of the amygdala subnuclei volumes are associated with anxiety behaviors in adults and children with neurodevelopmental and associated disorders. This study investigated the relationship between amygdala subnuclei volumes and anxiety in 233 children and adolescents (mean age = 11.02 years; standard deviation = 3.17) with autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and children with obsessive compulsive disorder (OCD), as well as typically developing (TD) children. Parents completed the Child Behavior Checklist (CBCL), and the children underwent structural MRI at 3 T. FreeSurfer software was used to automatically segment the amygdala subnuclei. A general linear model revealed that children and adolescents with ASD, ADHD, and OCD had higher anxiety scores compared to TD children (p < .001). A subsequent interaction analysis revealed that children with ASD (B = 0.09, p < .0001) and children with OCD (B = 0.1, p < .0001) who had high anxiety had larger right central nuclei volumes compared with TD children. Similar results were obtained for the right anterior amygdaloid area. Amygdala subnuclei volumes may be key to identifying children with neurodevelopmental disorders or those with OCD who are at high risk for anxiety. Findings may inform the development of targeted behavioral interventions to address anxiety behaviors and to assess the downstream effects of such interventions.
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Affiliation(s)
- Diane Seguin
- Physiology & Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Sara Pac
- Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Jianan Wang
- Biomedical Engineering, Faculty of Engineering, Western University, London, Canada
| | - Rob Nicolson
- Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
| | - Julio Martinez-Trujillo
- Physiology & Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Canada
| | - Jason P Lerch
- The Hospital for Sick Children, Toronto, Canada.,Wellcome Centre for Integrative Neuroimaging, University of Oxford, FMRIB, Nuffield Department of Clinical Neurosciences, Oxford, UK.,Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | | | | | | | | | - Muhammad Ayub
- Department of Psychiatry, Queen's University, Kingston, Canada
| | - Jessica Brian
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, Canada
| | - Xudong Liu
- Department of Psychiatry, Queen's University, Kingston, Canada.,Queen's Genomics Lab at Ongwanada (QGLO), Ongwanada Resource Center, Kingston, Canada
| | - Paul D Arnold
- Department of Psychiatry Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Emma G Duerden
- Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.,Applied Psychology, Faculty of Education, Western University, London, Canada
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11
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Yu J, Zhou P, Yuan S, Wu Y, Wang C, Zhang N, Li CSR, Liu N. Symptom provocation in obsessive-compulsive disorder: A voxel-based meta-analysis and meta-analytic connectivity modeling. J Psychiatr Res 2022; 146:125-134. [PMID: 34971910 DOI: 10.1016/j.jpsychires.2021.12.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/04/2021] [Accepted: 12/11/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a heterogeneous psychiatric illness with a complex array of symptoms and potentially distinct neural underpinnings. We employed meta-analysis and connectivity modeling of symptom dimensions to delineate the circuit mechanisms of OCD. METHODS With the activation likelihood estimation (ALE) algorithm we performed meta-analysis of whole-brain functional magnetic resonance imaging (fMRI) studies of symptom provocation. We contrasted all OCD patients and controls in a primary analysis and divided the studies according to clinical symptoms in secondary meta-analyses. Finally, we employed meta-analytic connectivity modeling analyses (MACMs) to examine co-activation patterns of the brain regions revealed in the primary meta-analysis. RESULTS A total of 14 experiments from 12 eligible studies with a total of 238 OCD patients (124 men) and 219 healthy controls (120 men) were included in the primary analysis. OCD patients showed higher activation in the right caudate body/putamen/insula and lower activation in the left orbitofrontal cortex (OFC), left inferior frontal gyrus (IFG), left caudate body/middle cingulate cortex (MCC), right middle temporal gyrus (MTG), middle occipital gyrus (MOG) and right lateral occipital gyrus (LOG). MACMs revealed significant co-activation between left IFG and left caudate body/MCC, left MOG and right LOG, right LOG and MTG. In the secondary meta-analyses, the washing subgroup showed higher activation in the right OFC, bilateral ACC, left MOG and right caudate body. CONCLUSION OCD patients showed elevated dorsal striatal activation during symptom provocation. In contrast, the washing subgroup engaged higher activation in frontal, temporal and posterior cortical structures as well as right caudate body. Broadly consistent with the proposition of cortico-striatal-thalamic-cortical circuit dysfunction, these findings highlight potentially distinct neural circuits that may underlie the symptoms and potentially etiological subtypes of OCD.
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Affiliation(s)
- Jianping Yu
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
| | - Ping Zhou
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
| | - Shiting Yuan
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
| | - Yun Wu
- Functional Brain Imaging Institute of Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
| | - Chun Wang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
| | - Ning Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
| | - Chiang-Shan R Li
- Department of Psychiatry, Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA.
| | - Na Liu
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
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12
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De la Peña-Arteaga V, Morgado P, Couto B, Ferreira S, Castro I, Sousa N, Soriano-Mas C, Picó-Pérez M. A functional magnetic resonance imaging study of frontal networks in obsessive-compulsive disorder during cognitive reappraisal. Eur Psychiatry 2022; 65:e62. [DOI: 10.1192/j.eurpsy.2022.2322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Patients with obsessive-compulsive disorder (OCD) present difficulties in the cognitive regulation of emotions, possibly because of inefficient recruitment of distributed patterns of frontal cortex regions. The aim of the present study is to characterize the brain networks, and their dysfunctions, related to emotion regulation alterations observed during cognitive reappraisal in OCD.
Methods
Adult patients with OCD (n = 31) and healthy controls (HC; n = 30) were compared during performance of a functional magnetic resonance imaging cognitive reappraisal protocol. We used a free independent component analysis approach to analyze network-level alterations during emotional experience and regulation. Correlations with behavioral scores were also explored.
Results
Analyses were focused on six networks encompassing the frontal cortex. OCD patients showed decreased activation of the frontotemporal network in comparison with HC (F(1,58) = 7.81, p = 0.007) during cognitive reappraisal. A similar trend was observed in the left frontoparietal network.
Conclusions
The present study demonstrates that patients with OCD show decreased activation of specific networks implicating the frontal cortex during cognitive reappraisal. These outcomes should help to better characterize the psychological processes modulating fear, anxiety, and other core symptoms of patients with OCD, as well as the associated neurobiological alterations, from a system-level perspective.
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13
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Gao J, Yang X, Chen X, Liu R, Wang P, Meng F, Li Z, Zhou Y. Resting-state functional connectivity of the amygdala subregions in unmedicated patients with obsessive-compulsive disorder before and after cognitive behavioural therapy. J Psychiatry Neurosci 2021; 46:E628-E638. [PMID: 34785511 PMCID: PMC8598242 DOI: 10.1503/jpn.210084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/03/2021] [Accepted: 08/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cognitive behavioural therapy (CBT) is considered an effective first-line treatment for obsessive-compulsive disorder (OCD). However, the neural basis of CBT for OCD has not yet been elucidated. The role of the amygdala in OCD and its functional coupling with the cerebral cortex have received increasing attention, and may provide new understanding of the neural basis of CBT for OCD. METHODS We acquired baseline resting-state functional MRI (fMRI) scans from 45 unmedicated patients with OCD and 40 healthy controls; we then acquired another wave of resting-state fMRI scans from the patients with OCD after 12 weeks of CBT. We performed seed-based resting-state functional connectivity analyses of the amygdala subregions to examine changes in patients with OCD as a result of CBT. RESULTS Compared to healthy controls, patients with OCD showed significantly increased resting-state functional connectivity at baseline between the left basolateral amygdala and the right middle frontal gyrus, and between the superficial amygdala and the right cuneus. In patients with OCD who responded to CBT, we found decreased resting-state functional connectivity after CBT between the amygdala subregions and the visual association cortices and increased resting-state functional connectivity between the amygdala subregions and the right inferior parietal lobe. Furthermore, these changes in resting-state functional connectivity were positively associated with changes in scores on the compulsion or obsession subscales of the Yale-Brown Obsessive-Compulsive Scale. LIMITATIONS Because of the lack of a second scan for healthy controls after 12 weeks, our results may have been confounded by other variables. CONCLUSION Our findings yield insights into the pathophysiology of OCD; they also reveal the potential neural changes elicited by CBT, and thus have implications for guiding effective treatment strategies with CBT for OCD.
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14
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Suñol M, Saiz-Masvidal C, Contreras-Rodríguez O, Macià D, Martínez-Vilavella G, Martínez-Zalacaín I, Menchón JM, Pujol J, Sunyer J, Soriano-Mas C. Brain Functional Connectivity Correlates of Subclinical Obsessive-Compulsive Symptoms in Healthy Children. J Am Acad Child Adolesc Psychiatry 2021; 60:757-767. [PMID: 32950652 DOI: 10.1016/j.jaac.2020.08.435] [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: 02/05/2020] [Revised: 07/16/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Commonly observed subclinical obsessive-compulsive symptoms in healthy children may predispose to obsessive-compulsive disorder (OCD). Therefore, investigating the underlying neurobiology may be relevant to identify alterations in specific brain circuits potentially accounting for clinical heterogeneity in OCD without the confounding effects of clinical samples. We analyzed the brain correlates of different obsessive-compulsive symptoms in a large group of healthy children using functional connectivity measures. METHOD We evaluated 227 healthy children (52% girls; mean [SD] age 9.71 [0.86] years; range, 8-12.1 years). Participants underwent clinical assessment with the Obsessive-Compulsive Inventory-Child Version and a resting-state functional magnetic resonance imaging examination. Total and symptom-specific severity were correlated with voxelwise global functional connectivity degree values. Significant clusters were then used as seeds of interest in seed-to-voxel analyses. Modulating effects of age and sex were also assessed. RESULTS Global functional connectivity of the left ventral putamen and medial dorsal thalamus correlated negatively with total obsessive-compulsive symptom severity. Seed-to-voxel analyses revealed specific negative correlations from these clusters with limbic, sensorimotor, and insular regions in association with obsessing, ordering, and doubt-checking symptoms, respectively. Hoarding symptoms were associated with negative correlations between the left medial dorsal thalamus and a widespread pattern of regions, with such associations modulated by sex and age. CONCLUSION Our findings concur with prevailing neurobiological models of OCD on the importance of cortico-striato-thalamo-cortical dysfunction to account for symptom severity. Notably, we showed that changes in cortico-striato-thalamo-cortical connectivity are present at subclinical stages, which may result in an increased vulnerability for OCD. Moreover, we mapped different symptom dimensions onto specific cortico-striato-thalamo-cortical circuit attributes.
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Affiliation(s)
- Maria Suñol
- Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III-Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Spain
| | - Cristina Saiz-Masvidal
- Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Spain
| | - Oren Contreras-Rodríguez
- Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III-Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Dídac Macià
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Spain; Institut Guttmann of the Universitat Autònoma de Barcelona, Badalona, Spain
| | | | - Ignacio Martínez-Zalacaín
- Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Spain
| | - José Manuel Menchón
- Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III-Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Spain
| | - Jesús Pujol
- Instituto de Salud Carlos III-Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; MRI Research Unit, Hospital del Mar, Barcelona, Spain
| | - Jordi Sunyer
- Institut de Salut Global de Barcelona (ISGLOBAL), Centre de Recerca en Epidemiologia Ambiental (CREAL), Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Instituto de Salud Carlos III-Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Carles Soriano-Mas
- Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III-Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Universitat Autònoma de Barcelona, Barcelona, Spain.
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15
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La Buissonniere-Ariza V, Fitzgerald K, Meoded A, Williams LL, Liu G, Goodman WK, Storch EA. Neural correlates of cognitive behavioral therapy response in youth with negative valence disorders: A systematic review of the literature. J Affect Disord 2021; 282:1288-1307. [PMID: 33601708 DOI: 10.1016/j.jad.2020.12.182] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 11/25/2020] [Accepted: 12/24/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cognitive-behavioral therapy (CBT) is the gold-standard psychotherapeutic treatment for pediatric negative valence disorders. However, some youths do not respond optimally to treatment, which may be due to variations in neural functioning. METHODS We systematically reviewed functional magnetic resonance imaging studies in youths with negative valence disorders to identify pre- and post-treatment neural correlates of CBT response. RESULTS A total of 21 studies were identified, of overall weak to moderate quality. The most consistent findings across negative valence disorders consisted of associations of treatment response with pre- and post-treatment task-based activation and/or functional connectivity within and between the prefrontal cortex, the medial temporal lobe, and other limbic regions. Associations of CBT response with baseline and/or post-treatment activity in the striatum, precentral and postcentral gyri, medial and posterior cingulate cortices, and parietal cortex, connectivity within and between the default-mode, cognitive control, salience, and frontoparietal networks, and metrics of large-scale brain network organization, were also reported, although less consistently. LIMITATIONS The poor quality and limited number of studies and the important heterogeneity of study designs and results considerably limit the conclusions that can be drawn from this literature. CONCLUSIONS Despite these limitations, these findings provide preliminary evidence suggesting youths presenting certain patterns of brain function may respond better to CBT, whereas others may benefit from alternative or augmented forms of treatment.
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Affiliation(s)
- Valerie La Buissonniere-Ariza
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA.
| | - Kate Fitzgerald
- Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109, USA
| | - Avner Meoded
- Edward B. Singleton Department of Radiology, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
| | - Laurel L Williams
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA
| | - Gary Liu
- Department of Neuroscience, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza - BCM350, Houston, TX, 77030, USA
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16
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Heiden P, Hoevels M, Bayram D, Baldermann JC, Schüller T, Huys D, Visser-Vandewalle V, Andrade P. Connectivity Patterns of Deep Brain Stimulation Targets in Patients with Gilles de la Tourette Syndrome. Brain Sci 2021; 11:brainsci11010087. [PMID: 33440771 PMCID: PMC7826809 DOI: 10.3390/brainsci11010087] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/03/2021] [Accepted: 01/06/2021] [Indexed: 01/16/2023] Open
Abstract
Since 1999, several targets for deep brain stimulation (DBS) in Gilles de la Tourette syndrome (GTS) have emerged showing similar success rates. Studies using different tractography techniques have identified connectivity profiles associated with a better outcome for individual targets. However, GTS patients might need individualized therapy. The objective of this study is to analyze the connectivity profile of different DBS targets for GTS. We identified standard target coordinates for the centromedian nucleus/nucleus ventro-oralis internus (CM/Voi), the CM/parafascicular (CM-Pf) complex, the anteromedial globus pallidus internus (amGPi), the posteroventral GPi (pvGPi), the ventral anterior/ventrolateral thalamus (VA/VL), and the nucleus accumbens/anterior limb of the internal capsule (Nacc/ALIC). Probabilistic tractography was performed from the targets to different limbic and motor areas based on patient-specific imaging and a normative connectome (HCP). Our analysis showed significant differences between the connectivity profiles of standard DBS targets (p < 0.05). Among all targets, the pvGPi showed the strongest connection to the sensorimotor cortex, while the amGPi showed the strongest connection to the prefrontal cortex in patient-specific imaging. Differences were observed between the connectivity profiles when using probabilistic tractography based on patient data and HCP. Our findings showed that the connectivity profiles of different DBS targets to major motor and limbic areas differ significantly. In the future, these differences may be considered when planning DBS for GTS patients employing an individualized approach. There were compelling differences in connectivity profiles when using different tractography techniques.
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Affiliation(s)
- Petra Heiden
- Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, 50937 Cologne, Germany; (M.H.); (V.V.-V.); (P.A.)
- Department of Neurosurgery, University Hospital of Cologne, 50937 Cologne, Germany;
- Correspondence: ; Tel.: +49-221-478-82734
| | - Mauritius Hoevels
- Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, 50937 Cologne, Germany; (M.H.); (V.V.-V.); (P.A.)
| | - Dilruba Bayram
- Department of Neurosurgery, University Hospital of Cologne, 50937 Cologne, Germany;
| | - Juan C. Baldermann
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (J.C.B.); (T.S.); (D.H.)
- Department of Neurology, University Hospital of Cologne, 50937 Cologne, Germany
| | - Thomas Schüller
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (J.C.B.); (T.S.); (D.H.)
| | - Daniel Huys
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, 50937 Cologne, Germany; (J.C.B.); (T.S.); (D.H.)
| | - Veerle Visser-Vandewalle
- Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, 50937 Cologne, Germany; (M.H.); (V.V.-V.); (P.A.)
| | - Pablo Andrade
- Department of Stereotactic and Functional Neurosurgery, University Hospital of Cologne, 50937 Cologne, Germany; (M.H.); (V.V.-V.); (P.A.)
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17
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Abstract
In the last 20 years, functional magnetic resonance imaging (fMRI) has been extensively used to investigate system-level abnormalities in the brain of patients with obsessive-compulsive disorder (OCD). In this chapter, we start by reviewing the studies assessing regional brain differences between patients with OCD and healthy controls in task-based fMRI. Specifically, we review studies on executive functioning and emotional processing, protocols in which these patients have been described to show alterations at the behavioral level, as well as research using symptom provocation protocols. Next, we review studies on brain connectivity alterations, focusing on resting-state studies evaluating disruptions in fronto-subcortical functional connectivity and in cortical networks. Likewise, we also review research on effective connectivity, which, different from functional connectivity, allows for ascertaining the directionality of inter-regional connectivity alterations. We conclude by reviewing the most significant findings on a topic of translational impact, such as the use of different fMRI measurements to predict response across a variety of treatment approaches. Overall, results suggest that there exists a pattern of regions, involving, but not limited to, different nodes of the cortico-striatal-thalamo-cortical circuits, showing robust evidence of functional alteration across studies, although the nature of the alterations critically depends on the specific tasks and their particular demands. Moreover, such findings have been, to date, poorly translated into clinical practice. It is suggested that this may be partially accounted for by the difficulty to integrate into a common framework results obtained under a wide variety of analysis approaches.
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Affiliation(s)
- Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain. .,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain.
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18
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Fridgeirsson EA, Figee M, Luigjes J, van den Munckhof P, Schuurman PR, van Wingen G, Denys D. Deep brain stimulation modulates directional limbic connectivity in obsessive-compulsive disorder. Brain 2020; 143:1603-1612. [PMID: 32352147 PMCID: PMC7241947 DOI: 10.1093/brain/awaa100] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/12/2020] [Accepted: 03/16/2020] [Indexed: 01/07/2023] Open
Abstract
Deep brain stimulation is effective for patients with treatment-refractory obsessive-compulsive disorder. Deep brain stimulation of the ventral anterior limb of the internal capsule rapidly improves mood and anxiety with optimal stimulation parameters. To understand these rapid effects, we studied functional interactions within the affective amygdala circuit. We compared resting state functional MRI data during chronic stimulation versus 1 week of stimulation discontinuation in patients, and obtained two resting state scans from matched healthy volunteers to account for test-retest effects. Imaging data were analysed using functional connectivity analysis and dynamic causal modelling. Improvement in mood and anxiety following deep brain stimulation was associated with reduced amygdala-insula functional connectivity. Directional connectivity analysis revealed that deep brain stimulation increased the impact of the ventromedial prefrontal cortex on the amygdala, and decreased the impact of the amygdala on the insula. These results highlight the importance of the amygdala circuit in the pathophysiology of obsessive-compulsive disorder, and suggest a neural systems model through which negative mood and anxiety are modulated by stimulation of the ventral anterior limb of the internal capsule for obsessive-compulsive disorder and possibly other psychiatric disorders.
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Affiliation(s)
- Egill Axfjord Fridgeirsson
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Martijn Figee
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Judy Luigjes
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Pepijn van den Munckhof
- Department of Neurosurgery, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - P Richard Schuurman
- Department of Neurosurgery, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Guido van Wingen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands.,The Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
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19
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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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Zhang L, Hu X, Lu L, Li B, Hu X, Bu X, Li H, Tang S, Gao Y, Yang Y, Sweeney JA, Gong Q, Huang X. Anatomic alterations across amygdala subnuclei in medication-free patients with obsessive-compulsive disorder. J Psychiatry Neurosci 2020; 45:334-343. [PMID: 32293840 PMCID: PMC7850150 DOI: 10.1503/jpn.190114] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The amygdala has been implicated in obsessive-compulsive disorder (OCD), a common, disabling illness. However, the regional distribution of anatomic alterations in this structure and their association with the symptoms of OCD remains to be established. METHODS We collected high-resolution 3D T1-weighted images from 81 untreated patients with OCD and no lifetime history of comorbid psychotic, affective or anxiety disorders, and from 95 age- and sex-matched healthy controls. We extracted the volume of the central nucleus of the amygdala (CeA) and the basolateral complex of the amygdala (BLA) and compared them across groups using FreeSurfer 6.0. In exploratory analyses, we evaluated other subnuclei, including the cortical medial nuclei, the anterior amygdaloid area, and the corticoamygdaloid transition area. RESULTS Patients with OCD had reduced amygdala volume bilaterally compared with healthy controls (left, p = 0.034; right, p = 0.002). Volume reductions were greater in the CeA (left: -11.9%, p = 0.002; right: -13.3%, p < 0.001) than in the BLA (left lateral nucleus: -3.3%, p = 0.029; right lateral nucleus: -3.9%, p = 0.018; right basal nucleus: -4.1%, p = 0.017; left accessory basal nucleus: -6.5%, p = 0.001; right accessory basal nucleus: -9.3%, p < 0.001). Volume reductions in the CeA were associated with illness duration. Exploratory analysis revealed smaller medial (left: -15.4%, p < 0.001, η2 = 0.101) and cortical (left: -9.1%, p = 0.001, η2 = 0.058; right: -15.4%, p < 0.001, η2 = 0.175) nuclei in patients with OCD compared with healthy controls. LIMITATIONS Although the strict exclusion criteria used in the study helped us to identify OCD-specific alterations, they may have limited generalizability to the broader OCD population. CONCLUSION Our results provide a comprehensive anatomic profile of alterations in the amygdala subnuclei in untreated patients with OCD and highlight a distinctive pattern of volume reductions across subnuclei in OCD. Based on the functional properties of the amygdala subnuclei established from preclinical research, CeA impairment may contribute to behavioural inflexibility, and BLA disruption may be responsible for altered fear conditioning and the affective components of OCD.
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Affiliation(s)
- Lianqing Zhang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Xinyu Hu
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Lu Lu
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Bin Li
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Xiaoxiao Hu
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Xuan Bu
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Hailong Li
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Shi Tang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Yingxue Gao
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Yanchun Yang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - John A Sweeney
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Qiyong Gong
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
| | - Xiaoqi Huang
- From the Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Sweeney, Gong, Huang); the Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, PR China (Li, Yang); the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, USA (Sweeney); and the Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, Sichuan, China (Zhang, Xinyu Hu, Lu, Xiaoxiao Hu, Bu, Li, Tang, Gao, Gong, Huang)
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Drăgoi AM, Pecie LG, Patrichi BE, Ladea M. Morphopathological changes in obsessive-compulsive disorder. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2020; 61:51-60. [PMID: 32747895 PMCID: PMC7728136 DOI: 10.47162/rjme.61.1.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The pathophysiology of the obsessive-compulsive disorder (OCD) has been studied for many years using several structural magnetic resonance imaging, discovering that the anomalies of function and structure of the brain are widespread, they involve different areas, structures and circuits with a complex interconnectivity. More than that, these anomalies cover all the life of a patient, from early childhood, due to variations of developmental stages until adult life. The research is highly important also because OCD has a major hereditary factor, with the phenotype variance between 27–47% due to hereditary factors. Under this paper, that follows last 10 years studies in this area, we will find some relevant findings consisting on neuroanatomic changes, the morphology findings of striatum, globus pallidus and thalamus, the blood flow circuit changes in various regions of the brain, brain connectivity and various correlations of them. Not to forget that OCD must be understand as an emotional disorder but in the same time as a cognitive disorder too. This approach highlights the abnormalities that have been found in brain regions involved in the cognitive and emotional behavior, as for example: extended temporal, parietal, and occipital regions, anterior cingulate, frontal gyrus, amygdala.
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Affiliation(s)
- Ana Miruna Drăgoi
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital for Psychiatry, Bucharest, Romania;
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Abstract
Olfactory reference syndrome (ORS) describes a constellation of emotional and behavioral symptoms that cause clinically significant distress or impairment arising from the false belief that one is emitting an offensive odor. Despite cases of ORS reported throughout the world over the last century, our knowledge and understanding of ORS remain relatively poor because of the limited literature-mostly case studies and series, but no clinical trials. ORS continues to pose significant diagnostic challenges within our current frameworks of categorizing mental disorders, including the Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases. We review the ORS literature and discuss diagnostic parallels and challenges of placing ORS within specific categories. We also review the current research on the neurocircuitry of olfaction and of disorders with potential clinical relevance to patients presenting with ORS. While no primary neuroscientific research has specifically investigated ORS, an overlapping circuitry has been implicated in the neurobiology of obsessive-compulsive, trauma and stressor, and psychotic spectrum disorders, suggesting that the phenomenology of ORS can best be understood through a dimensional, rather than categorical, approach.
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Alemany-Navarro M, Cruz R, Real E, Segalàs C, Bertolín S, Rabionet R, Carracedo Á, Menchón JM, Alonso P. Looking into the genetic bases of OCD dimensions: a pilot genome-wide association study. Transl Psychiatry 2020; 10:151. [PMID: 32424139 PMCID: PMC7235014 DOI: 10.1038/s41398-020-0804-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/23/2020] [Accepted: 04/08/2020] [Indexed: 12/19/2022] Open
Abstract
The multidimensional nature of obsessive-compulsive disorder (OCD) has been consistently reported. Clinical and biological characteristics have been associated with OCD dimensions in different ways. Studies suggest the existence of specific genetic bases for the different OCD dimensions. In this study, we analyze the genomic markers, genes, gene ontology and biological pathways associated with the presence of aggressive/checking, symmetry/order, contamination/cleaning, hoarding, and sexual/religious symptoms, as assessed via the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS) in 399 probands. Logistic regression analyses were performed at the single-nucleotide polymorphism (SNP) level. Gene-based and enrichment analyses were carried out for common (SNPs) and rare variants. No SNP was associated with any dimension at a genome-wide level (p < 5 × 10-8). Gene-based analyses showed one gene to be associated with hoarding (SETD3, p = 1.89 × 10-08); a gene highly expressed in the brain and which plays a role in apoptotic processes and transcriptomic changes, and another gene associated with aggressive symptoms (CPE; p = 4.42 × 10-6), which is involved in neurotrophic functions and the synthesis of peptide hormones and neurotransmitters. Different pathways or biological processes were represented by genes associated with aggressive (zinc ion response and lipid metabolism), order (lipid metabolism), sexual/religious (G protein-mediated processes) and hoarding (metabolic processes and anion transport) symptoms after FDR correction; while no pathway was associated with contamination. Specific genomic bases were found for each dimension assessed, especially in the enrichment analyses. Further research with larger samples and different techniques, such as next-generation sequencing, are needed to better understand the differential genetics of OCD dimensions.
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Affiliation(s)
- María Alemany-Navarro
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. .,OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain. .,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain.
| | - Raquel Cruz
- grid.11794.3a0000000109410645Grupo de Medicina Xenómica, CIBERER, Centre for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Eva Real
- grid.418284.30000 0004 0427 2257Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain ,grid.411129.e0000 0000 8836 0780OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - Cinto Segalàs
- grid.418284.30000 0004 0427 2257Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain ,grid.411129.e0000 0000 8836 0780OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Bertolín
- grid.411129.e0000 0000 8836 0780OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Raquel Rabionet
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain ,grid.5841.80000 0004 1937 0247Institut de Biomedicina de la Universitat de Barcelona (IBUB), CIBERER, and Dept. Genetics, Microbiology & Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Ángel Carracedo
- grid.11794.3a0000000109410645Grupo de Medicina Xenómica, CIBERER, Centre for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain ,Fundación Pública Galega de Medicina Xenómica, SERGAS, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Jose M. Menchón
- grid.418284.30000 0004 0427 2257Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain ,grid.411129.e0000 0000 8836 0780OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - Pino Alonso
- grid.411129.e0000 0000 8836 0780OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
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Xia J, Fan J, Liu W, Du H, Zhu J, Yi J, Tan C, Zhu X. Functional connectivity within the salience network differentiates autogenous- from reactive-type obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2020; 98:109813. [PMID: 31785320 DOI: 10.1016/j.pnpbp.2019.109813] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. To better understand and treat patients, symptomatology of OCD has been categorized into more homogenous symptom dimensions. The autogenous-reactive classification model has proven helpful in the elucidation of the neurobiological substrates for clinical heterogeneity in OCD. The purpose of the current study was to systematically compare regional and network functional alterations between OCD subtypes based on the autogenous-reactive model. METHODS Autogenous-type OCD patients (OCD-AO, n = 40), reactive-type patients (OCD-RO, n = 42), and healthy controls (HC, n = 70) underwent functional magnetic resonance imaging (fMRI) scans. The amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) were compared among subjects. Areas of abnormal local spontaneous brain activity that differentiated OCD-AO and OCD-RO patients were identified and entered as seeds in functional connectivity (FC) analysis. RESULTS Compared to OCD-RO patients and HC participants, OCD-AO patients showed increased ALFF in the left anterior insula (AI), increased ReHo in the right AI, and hyperconnectivity between bilateral AI and anterior cingulate cortex (ACC). Both OCD-AO and OCD-RO patients shared regional function deficits in several areas within the prefrontal cortex, and stronger FC between bilateral AI and major nodes of the default mode network (DMN) compared to healthy controls. CONCLUSION The current results suggest that aberrant functional interaction between the salience network (SN) and the DMN may represent a common substrate in the pathophysiology of OCD, while impaired functional coupling within the SN is distinct to autogenous-type OCD patients. These findings provide further neurobiological evidence to support the autogenous-reactive classification model and contribute to the understanding of the neurobiological basis for clinical heterogeneity in OCD.
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Affiliation(s)
- Jie Xia
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Jie Fan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Wanting Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Hongyu Du
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Jiang Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Jinyao Yi
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Changlian Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
| | - Xiongzhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China.
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Picó-Pérez M, Moreira PS, de Melo Ferreira V, Radua J, Mataix-Cols D, Sousa N, Soriano-Mas C, Morgado P. Modality-specific overlaps in brain structure and function in obsessive-compulsive disorder: Multimodal meta-analysis of case-control MRI studies. Neurosci Biobehav Rev 2020; 112:83-94. [PMID: 32006553 DOI: 10.1016/j.neubiorev.2020.01.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/03/2020] [Accepted: 01/27/2020] [Indexed: 10/25/2022]
Abstract
Neuroimaging research has shown that patients with obsessive-compulsive disorder (OCD) may present brain structural and functional alterations, but the results across imaging modalities and task paradigms are difficult to reconcile. Are the same brain systems that are structurally different in OCD patients also involved in executive function and emotional processing? To answer this, we conducted separate meta-analyses of voxel-based morphometry studies, executive function functional magnetic resonance imaging (fMRI) studies, and emotional processing fMRI studies. Next, with a multimodal approach (conjunction analysis), we identified the common alterations across meta-analyses. Patients presented increased gray matter volume and hyperactivation in the putamen, but the putamen subregions affected differed depending on the psychological process. Left posterior/dorsal putamen showed hyperactivation during executive processing tasks, while predominantly right anterior/ventral putamen showed hyperactivation during emotional processing tasks. Interestingly, age was significantly associated with increased right putamen volume. Finally, the left dorsolateral prefrontal cortex was hyperactive in both functional domains. Our findings highlight task-specific correlates of brain structure and function in OCD and help integrate a growing literature.
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Affiliation(s)
- Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Vanessa de Melo Ferreira
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain
| | - David Mataix-Cols
- Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Carles Soriano-Mas
- Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain.
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal.
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Jansen M, Overgaauw S, De Bruijn ERA. Social Cognition and Obsessive-Compulsive Disorder: A Review of Subdomains of Social Functioning. Front Psychiatry 2020; 11:118. [PMID: 32231594 PMCID: PMC7082418 DOI: 10.3389/fpsyt.2020.00118] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
Disturbances in social cognitive processes such as the ability to infer others' mental states importantly contribute to social and functional impairments in psychiatric disorders. Yet, despite established social, emotional, and cognitive problems, the role of social cognition in obsessive-compulsive disorder is largely overlooked. The current review provides a first comprehensive overview of social (neuro)cognitive disturbances in adult patients with obsessive-compulsive disorder. Results of our review indicate various social cognitive alterations. Patients with obsessive-compulsive disorder show deficits in the recognition of affective social cues, specifically facial expressions of disgust, and more general deficits in theory of mind/mentalizing. Additionally, patients show heightened affective reactions and altered neural responding to emotions of self and others, as well as poor emotion regulation skills, which may contribute to poor social functioning of patients. However, the discrepancies in findings and scarcity of studies make it difficult to draw firm conclusions with regard to the specificity of social cognitive disturbances. The review offers directions for future research and highlights the need to investigate obsessive-compulsive disorder from an interactive social neurocognitive perspective in addition to the prevalent passive spectator perspective to advance our understanding of this intricate and burdensome disorder.
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Affiliation(s)
- Myrthe Jansen
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Sandy Overgaauw
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Ellen R A De Bruijn
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
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27
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Amygdala Changes in Chronic Insomnia and Their Association with Sleep and Anxiety Symptoms: Insight from Shape Analysis. Neural Plast 2019; 2019:8549237. [PMID: 31885536 PMCID: PMC6914992 DOI: 10.1155/2019/8549237] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/12/2019] [Accepted: 10/26/2019] [Indexed: 01/17/2023] Open
Abstract
Affective disorders, such as anxiety and depression, are common comorbidities associated with chronic insomnia disorder (CID). However, the underlying neural mechanisms of these comorbidities are still not clear. The present study is aimed at investigating structural changes in the amygdala of CID patients using surface-based shape analysis. A total of 65 medication-naive patients with CID and 55 healthy controls (HCs) matched for age, sex, and years of education were enrolled in this study and were subjected to structural magnetic resonance imaging (MRI). The Oxford Centre for Functional MRI of the Brain (FMRIB) created an Integrated Registration and Segmentation Tool (FIRST) that was employed in this study to assess the volumetric and surface alterations in patients with CID. Shape correlations between the amygdala and clinical features were also analyzed. Atrophic changes in the amygdala were observed at the local level, not for the entire amygdala volume. The left atrophic changes in the amygdala were in the superficial and basolateral nuclei while right atrophic changes were in the basolateral nuclei in CID patients. Insomnia severity was associated with the centromedial right amygdala while anxiety was linked with the basolateral nuclei. These findings indicate localized amygdala atrophy in CID. Separate amygdala regions are associated with insomnia and anxiety in CID. This evidence helps elucidate the neural mechanisms underlying the bidirectional relationship between insomnia and anxiety.
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Shafti SS, Kaviani H. Adjunctive quetiapine may help fluvoxamine-resistant obsessive-compulsive disorder among female in-patients: A randomized-controlled study. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1597584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Saeed Shoja Shafti
- Psychiatry, University of Social Welfare and Rehabilitation Sciences (USWR), Razi Psychiatric Hospital, Tehran, Iran
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Kubota Y, Sato W, Kochiyama T, Uono S, Yoshimura S, Sawada R, Toichi M. Corticostriatal-limbic correlates of sub-clinical obsessive-compulsive traits. Psychiatry Res Neuroimaging 2019; 285:40-46. [PMID: 30731370 DOI: 10.1016/j.pscychresns.2019.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/14/2019] [Accepted: 01/29/2019] [Indexed: 11/18/2022]
Abstract
Obsessive-compulsive (OC) traits such as intrusive worrisome ideas or excessive concerns for threats are frequent in general population (5%-13%). However, the structural neural correlates of the sub-clinical OC traits remain largely unknown. Based on the data of obsessive-compulsive disorder (OCD), we hypothesized that the subcortical and cortical structures, constituting the cortico-striatal-thalamo-cortical circuit (CSTC) and the limbic system, could be associated with OC traits. Here we conducted voxel-based morphometry (VBM) in order to investigate fine grained volume changes of these structures in 49 non-clinical subjects. Analysis of structural covariances of these structures was also conducted. We identified volume changes associated with OC traits in the left putamen and the left amygdala. The results of structural covariance analysis revealed increased covariances in relation to the heightened OC traits between the left putamen to bilateral medial prefrontal cortex and to the left cerebellum, and between the left globus pallidus to the bilateral anterior cingulate cortices. The present finding of volume changes of the corticostriatal-limbic structures may reflect neuroplasticity associated with OC traits. Since the abnormality of these structures were also observed in the clinical OCD, the subclinical subjects with OC traits shared "neuronal obsessive traits" that might precondition OCD at the network level.
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Affiliation(s)
- Yasutaka Kubota
- Health and Medical Services Center, Shiga University, 1-1-1, Baba, Hikone, Shiga 522-8522, Japan.
| | - Wataru Sato
- Department of Neurodevelopmental Psychiatry, Habilitation and Rehabilitation, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takanori Kochiyama
- ATR Brain Activity Imaging Center, 2-2-2, Hikaridai, Seika-cho, Souraku-gun, Kyoto 619-0288, Japan
| | - Shota Uono
- Department of Neurodevelopmental Psychiatry, Habilitation and Rehabilitation, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Organization for Promotion of Neurodevelopmental Disorder Research, Kyoto, Japan
| | - Sayaka Yoshimura
- Department of Neurodevelopmental Psychiatry, Habilitation and Rehabilitation, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Organization for Promotion of Neurodevelopmental Disorder Research, Kyoto, Japan
| | - Reiko Sawada
- Department of Neurodevelopmental Psychiatry, Habilitation and Rehabilitation, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Organization for Promotion of Neurodevelopmental Disorder Research, Kyoto, Japan
| | - Motomi Toichi
- Organization for Promotion of Neurodevelopmental Disorder Research, Kyoto, Japan; Faculty of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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30
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Early cognitive processes in OCD: An ERP study. J Affect Disord 2019; 246:429-436. [PMID: 30599365 DOI: 10.1016/j.jad.2018.12.109] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 12/11/2018] [Accepted: 12/24/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is characterized by persistent, intrusive, and distressing obsessions and/or compulsions and is associated with marked impairments in quality of life. The goal of the present study was to examine initial stages of information processing, specifically, perceptual and attention orientation phases that precede response preparation in OCD. METHODS The P3 event-related potential (ERP) component was used as a measure of early cognitive processes of visual stimulus perception. ERPs were recorded while 38 participants diagnosed with OCD and 38 healthy controls performed a passive visual oddball task with neutral and angry schematic faces. RESULTS OCD participants demonstrated significantly enhanced P3 amplitude over bilateral parietal areas in response to neutral stimuli that activate basic primary perceptual processes. Emotional valence reduced this effect such that OCD patients did not differ from healthy controls in P3 amplitude under the angry stimuli condition. LIMITATIONS Patients in this study were noncomorbid and unmedicated partially limiting the generalizability of the results. CONCLUSIONS Our hypothesis of altered early perceptual processes in OCD was supported. These alterations, specific to OCD and not anxiety and depression symptoms, may represent distracted primary cognitive processes in OCD, possibly serving as a basic source for compulsion initiation.
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31
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Picó-Pérez M, Ipser J, Taylor P, Alonso P, López-Solà C, Real E, Segalàs C, Roos A, Menchón JM, Stein DJ, Soriano-Mas C. Intrinsic functional and structural connectivity of emotion regulation networks in obsessive-compulsive disorder. Depress Anxiety 2019; 36:110-120. [PMID: 30253000 PMCID: PMC8980996 DOI: 10.1002/da.22845] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 08/18/2018] [Accepted: 09/02/2018] [Indexed: 01/20/2023] Open
Abstract
Despite emotion regulation being altered in patients with obsessive-compulsive disorder (OCD), no studies have investigated its relation to multimodal amygdala connectivity. We compared corticolimbic functional and structural connectivity between OCD patients and healthy controls (HCs), and correlated this with the dispositional use of emotion regulation strategies and with OCD severity. OCD patients (n = 73) and HCs (n = 42) were assessed for suppression and reappraisal strategies using the Emotion Regulation Questionnaire (ERQ) and for OCD severity using the Yale-Brown Obsessive-Compulsive Scale. Resting-state functional magnetic resonance imaging (rs-fMRI) connectivity maps were generated using subject-specific left amygdala (LA) and right amygdala (RA) masks. We identified between-group differences in amygdala whole-brain connectivity, and evaluated the moderating effect of ERQ strategies. Significant regions and amygdala seeds were used as targets in probabilistic tractography analysis. Patients scored higher in suppression and lower in reappraisal. We observed higher rs-fMRI RA-right postcentral gyrus (PCG) connectivity in HC, and in patients this was correlated with symptom severity. Reappraisal scores were associated with higher negative LA-left insula connectivity in HC, and suppression scores were negatively associated with LA-precuneus and angular gyri connectivity in OCD. Structurally, patients showed higher mean diffusivity in tracts connecting the amygdala with the other targets. RA-PCG connectivity is diminished in patients, while disrupted emotion regulation is related to altered amygdala connectivity with the insula and posterior brain regions. Our results are the first showing, from a multimodal perspective, the association between amygdala connectivity and specific emotional processing domains, emphasizing the importance of amygdala connectivity in OCD pathophysiology.
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Affiliation(s)
- Maria Picó-Pérez
- Department of Psychiatry, Bellvitge University
Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine,
University of Barcelona, Barcelona, Spain
| | - Jonathan Ipser
- Department of Psychiatry and Mental Health, University of
Cape Town, J-Block Groote Schuur Hospital, Observatory, 7925, South Africa
| | - Paul Taylor
- MRC/UCT Medical Imaging Research Unit, Department of Human
Biology, University of Cape Town, South Africa,African Institute for Mathematical Sciences, South
Africa,Scientific and Statistical Computing Core, National
Institute of Mental Health, Bethesda, MD, USA
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University
Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine,
University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERSam), Instituto Salud Carlos III
(ISCIII), Barcelona, Spain
| | - Clara López-Solà
- Adult Mental Health Unit, Parc Taulí University
Hospital, Sabadell, Spain
| | - Eva Real
- Department of Psychiatry, Bellvitge University
Hospital-IDIBELL, Barcelona, Spain,CIBER Salud Mental (CIBERSam), Instituto Salud Carlos III
(ISCIII), Barcelona, Spain
| | - Cinto Segalàs
- Department of Psychiatry, Bellvitge University
Hospital-IDIBELL, Barcelona, Spain,CIBER Salud Mental (CIBERSam), Instituto Salud Carlos III
(ISCIII), Barcelona, Spain
| | - Annerine Roos
- SU/UCT MRC Unit on Risk and Resilience in Mental Disorders,
Department of Psychiatry, Stellenbosch University, PO Box 241, Cape Town 8000, South
Africa
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University
Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine,
University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERSam), Instituto Salud Carlos III
(ISCIII), Barcelona, Spain
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of
Cape Town, J-Block Groote Schuur Hospital, Observatory, 7925, South Africa,SU/UCT MRC Unit on Risk and Resilience in Mental Disorders,
Department of Psychiatry, Stellenbosch University, PO Box 241, Cape Town 8000, South
Africa
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University
Hospital-IDIBELL, Barcelona, Spain,CIBER Salud Mental (CIBERSam), Instituto Salud Carlos III
(ISCIII), Barcelona, Spain,Department of Psychobiology and Methodology in Health
Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain,Corresponding author: Carles Soriano-Mas, PhD,
Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical
Research Institute-IDIBELL, Feixa Llarga s/n, 08907 L’Hospitalet de
Llobregat, Barcelona, Spain. Tel: (+34) 93 2607500 (ext. 2889) Fax: (+34)
932607658,
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Mier D, Schirmbeck F, Stoessel G, Esslinger C, Rausch F, Englisch S, Eisenacher S, de Haan L, Meyer-Lindenberg A, Kirsch P, Zink M. Reduced activity and connectivity of left amygdala in patients with schizophrenia treated with clozapine or olanzapine. Eur Arch Psychiatry Clin Neurosci 2019; 269:931-940. [PMID: 30539230 PMCID: PMC6841919 DOI: 10.1007/s00406-018-0965-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 12/06/2018] [Indexed: 01/01/2023]
Abstract
Obsessive-compulsive symptoms (OCS) in patients with schizophrenia are a common co-occurring condition, often associated with additional impairments. A subgroup of these patients develops OCS during treatment with second-generation antipsychotics (SGAs), most importantly clozapine and olanzapine. So far, little is known about possible neural mechanism of these SGAs, which seem to aggravate or induce OCS. To investigate the role of SGA treatment on neural activation and connectivity during emotional processing, patients were stratified according to their monotherapy into two groups (group I: clozapine or olanzapine, n = 20; group II: amisulpride or aripiprazole, n = 20). We used an fMRI approach, applying an implicit emotion recognition task. Group comparisons showed significantly higher frequency and severity of comorbid OCS in group I than group II. Task specific activation was attenuated in group I in the left amygdala. Furthermore, functional connectivity from left amygdala to right ventral striatum was reduced in group I. Reduced amygdala activation was associated with OCS severity. Recent literature suggests an involvement of an amygdala-cortico-striatal network in the pathogenesis of obsessive-compulsive disorder. The observed differential activation and connectivity pattern of the amygdala might thus indicate a neural mechanism for the development of SGA-associated OCS in patients with schizophrenia. Further neurobiological research and interventional studies are needed for causal inferences.
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Affiliation(s)
- Daniela Mier
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany ,Department of Psychology, University of Konstanz, Constance, Germany
| | - Frederike Schirmbeck
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. .,Department of Psychiatry, Arkin Institute for Mental Health, Amsterdam, The Netherlands.
| | - Gabriela Stoessel
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Christine Esslinger
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Franziska Rausch
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Susanne Englisch
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Sarah Eisenacher
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands ,Department of Psychiatry, Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Mathias Zink
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany ,Department of Psychiatry, Psychotherapy and Psychosomatics, District Hospital Ansbach, Ansbach, Germany
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Hazari N, Narayanaswamy JC, Venkatasubramanian G. Neuroimaging findings in obsessive-compulsive disorder: A narrative review to elucidate neurobiological underpinnings. Indian J Psychiatry 2019; 61:S9-S29. [PMID: 30745673 PMCID: PMC6343409 DOI: 10.4103/psychiatry.indianjpsychiatry_525_18] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Obsessive compulsive disorder (OCD) is a common psychiatric illness and significant research has been ongoing to understand its neurobiological basis. Neuroimaging studies right from the 1980s have revealed significant differences between OCD patients and healthy controls. Initial imaging findings showing hyperactivity in the prefrontal cortex (mainly orbitofrontal cortex), anterior cingulate cortex and caudate nucleus led to the postulation of the cortico-striato-thalamo-cortical (CSTC) model for the neurobiology of OCD. However, in the last two decades emerging evidence suggests the involvement of widespread associative networks, including regions of the parietal cortex, limbic areas (including amygdala) and cerebellum. This narrative review discusses findings from structural [Magnetic Resonance Imaging (MRI), Diffusion Tensor Imaging(DTI)], functional [(functional MRI (fMRI), Single photon emission computed tomography (SPECT), Positron emission tomography (PET), functional near-infrared spectroscopy (fNIRS)], combined structural and functional imaging studies and meta-analyses. Subsequently, we collate these findings to describe the neurobiology of OCD including CSTC circuit, limbic system, parietal cortex, cerebellum, default mode network and salience network. In future, neuroimaging may emerge as a valuable tool for personalised medicine in OCD treatment.
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Affiliation(s)
- Nandita Hazari
- Department of Psychiatry, Vidyasagar Institute of Mental Health and Neurosciences, Delhi, India
| | - Janardhanan C Narayanaswamy
- Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Thorsen AL, Kvale G, Hansen B, van den Heuvel OA. Symptom dimensions in obsessive-compulsive disorder as predictors of neurobiology and treatment response. ACTA ACUST UNITED AC 2018; 5:182-194. [PMID: 30237966 DOI: 10.1007/s40501-018-0142-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Purpose of review Specific symptom dimensions of obsessive-compulsive disorder (OCD) have been suggested as an approach to reduce the heterogeneity of obsessive-compulsive disorder, predict treatment outcome, and relate to brain structure and function. Here, we review studies addressing these issues. Recent findings The contamination and symmetry/ordering dimensions have not been reliably associated with treatment outcome. Some studies found that greater severity of sexual/aggressive/religious symptoms predicted a worse outcome after cognitive behavioral therapy (CBT) and a better outcome after serotonin reuptake inhibitors (SRIs). Contamination symptoms have been related to increased amygdala and insula activation in a few studies, while sexual/aggressive/religious symptoms have also been related to more pronounced alterations in the function and structure of the amygdala. Increased pre-treatment limbic responsiveness has been related to better outcomes of CBT, but most imaging studies show important limitations and replication in large-scale studies is needed. We review possible reasons for the strong limbic involvement of the amygdala in patients with more sexual/aggressive/religious symptoms, in relation to their sensitivity to CBT. Summary Symptom dimensions may predict treatment outcome, and patients with sexual/religious/aggressive symptoms are at a greater risk of not starting or delaying treatment. This is likely partly due to more shame and perceived immorality which is also related to stronger amygdala response. Competently delivered CBT is likely to help these patients improve to the same degree as patients with other symptoms.
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Affiliation(s)
- Anders Lillevik Thorsen
- OCD-team, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway.,Department of Anatomy & Neurosciences, VU university medical center (VUmc), Amsterdam, The Netherlands
| | - Gerd Kvale
- OCD-team, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Bjarne Hansen
- OCD-team, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Odile A van den Heuvel
- OCD-team, Haukeland University Hospital, Bergen, Norway.,Department of Anatomy & Neurosciences, VU university medical center (VUmc), Amsterdam, The Netherlands.,Department of Psychiatry, VUmc, Amsterdam, The Netherlands.,Neuroscience Amsterdam, Amsterdam, The Netherlands
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Thorsen AL, Hagland P, Radua J, Mataix-Cols D, Kvale G, Hansen B, van den Heuvel OA. Emotional Processing in Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis of 25 Functional Neuroimaging Studies. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:563-571. [PMID: 29550459 DOI: 10.1016/j.bpsc.2018.01.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 01/11/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Patients with obsessive-compulsive disorder (OCD) experience aversive emotions in response to obsessions, motivating avoidance and compulsive behaviors. However, there is considerable ambiguity regarding the brain circuitry involved in emotional processing in OCD, especially whether activation is altered in the amygdala. METHODS We conducted a systematic literature review and performed a meta-analysis-seed-based d mapping-of 25 whole-brain neuroimaging studies (including 571 patients and 564 healthy control subjects) using functional magnetic resonance imaging or positron emission tomography, comparing brain activation of patients with OCD and healthy control subjects during presentation of emotionally valenced versus neutral stimuli. Meta-regressions were employed to investigate possible moderators. RESULTS Patients with OCD, compared with healthy control subjects, showed increased activation in the bilateral amygdala, right putamen, orbitofrontal cortex extending into the anterior cingulate and ventromedial prefrontal cortex, and middle temporal and left inferior occipital cortices during emotional processing. Right amygdala hyperactivation was most pronounced in unmedicated patients. Symptom severity was related to increased activation in the orbitofrontal and anterior cingulate cortices and precuneus. Greater comorbidity with mood and anxiety disorders was associated with higher activation in the right amygdala, putamen, and insula as well as with lower activation in the left amygdala and right ventromedial prefrontal cortex. CONCLUSIONS Patients with OCD show increased emotional processing-related activation in limbic, frontal, and temporal regions. Previous mixed evidence regarding the role of the amygdala in OCD has likely been influenced by patient characteristics (such as medication status) and low statistical power.
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Affiliation(s)
- Anders Lillevik Thorsen
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway.
| | - Pernille Hagland
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Joaquim Radua
- FIDMAG Germanes Hospitalàries, Centre for Biomedical Research in Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, United Kingdom
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Gerd Kvale
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Bjarne Hansen
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Odile A van den Heuvel
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
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Altered connectivity within and between the default mode, central executive, and salience networks in obsessive-compulsive disorder. J Affect Disord 2017; 223:106-114. [PMID: 28743059 DOI: 10.1016/j.jad.2017.07.041] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/25/2017] [Accepted: 07/19/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Default mode network (DMN), central executive network (CEN) and salience network (SN) are the three most important intrinsic networks of the human brain. Recent studies emphasized the importance of the "triple-network model" which illustrated the interactions within and between DMN, CEN and SN in the pathophysiology of psychiatric disorders. However, previous studies of obsessive-compulsive disorder (OCD) just explored the altered connectivity within these networks while neglected the coupling between them. Hence, the present study was designed to fill this research gap. METHODS Resting-state functional magnetic resonance imaging (fMRI) data from 35 OCD patients and 32 healthy controls (HCs) were acquired. Independent component analysis (ICA) was used to extract sub-networks of the DMN, CEN, and SN. Functional connectivity (FC) values within and between these networks were measured. RESULTS OCD patients had increased FC within several DMN, CEN, and SN subsystems. In addition, OCD patients demonstrated aberrant functional interactions between the SN and anterior DMN (aDMN) as well as between the SN and the dorsal CEN (dCEN), and the interaction between the SN and dCEN significantly correlated with trait anxiety level in the OCD group. LIMITATION Lack of the assessments of cognitive functions is the main limitation of the present study. CONCLUSIONS Not only impaired coupling within the brain core intrinsic large-scale networks, but also coupling between large-scale neurocognitive networks, which reflect the difficulties in switching between task-negative and task-positive processing modes are involved in the neurobiological mechanism of OCD.
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Shavitt RG, Requena G, Alonso P, Zai G, Costa DLC, de Bragança Pereira CA, do Rosário MC, Morais I, Fontenelle L, Cappi C, Kennedy J, Menchon JM, Miguel E, Richter PMA. Quantifying dimensional severity of obsessive-compulsive disorder for neurobiological research. Prog Neuropsychopharmacol Biol Psychiatry 2017; 79:206-212. [PMID: 28673486 DOI: 10.1016/j.pnpbp.2017.06.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 06/27/2017] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
Abstract
Current research to explore genetic susceptibility factors in obsessive-compulsive disorder (OCD) has resulted in the tentative identification of a small number of genes. However, findings have not been readily replicated. It is now broadly accepted that a major limitation to this work is the heterogeneous nature of this disorder, and that an approach incorporating OCD symptom dimensions in a quantitative manner may be more successful in identifying both common as well as dimension-specific vulnerability genetic factors. As most existing genetic datasets did not collect specific dimensional severity ratings, a specific method to reliably extract dimensional ratings from the most widely used severity rating scale, the Yale-Brown Obsessive Compulsive Scale (YBOCS), for OCD is needed. This project aims to develop and validate a novel algorithm to extrapolate specific dimensional symptom severity ratings in OCD from the existing YBOCS for use in genetics and other neurobiological research. To accomplish this goal, we used a large data set comprising adult subjects from three independent sites: the Brazilian OCD Consortium, the Sunnybrook Health Sciences Centre in Toronto, Canada and the Hospital of Bellvitge, in Barcelona, Spain. A multinomial logistic regression was proposed to model and predict the quantitative phenotype [i.e., the severity of each of the five homogeneous symptom dimensions of the Dimensional YBOCS (DYBOCS)] in subjects who have only YBOCS (categorical) data. YBOCS and DYBOCS data obtained from 1183 subjects were used to build the model, which was tested with the leave-one-out cross-validation method. The model's goodness of fit, accepting a deviation of up to three points in the predicted DYBOCS score, varied from 78% (symmetry/order) to 84% (cleaning/contamination and hoarding dimensions). These results suggest that this algorithm may be a valuable tool for extracting dimensional phenotypic data for neurobiological studies in OCD.
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Affiliation(s)
- Roseli G Shavitt
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil.
| | - Guaraci Requena
- Institute of Mathematics and Statistics, University of Sao Paulo, R. do Matão, 1010 - Vila Universitaria, São Paulo, SP CEP 05508-090, Brazil
| | - Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Gwyneth Zai
- Sunnybrook Health Sciences Centre, Centre for Addiction and Mental Health, 2075 Bayview Avenue, Suite FG42, Toronto, ON M4N 3M5, Canada.
| | - Daniel L C Costa
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil
| | - Carlos Alberto de Bragança Pereira
- Institute of Mathematics and Statistics, University of Sao Paulo, R. do Matão, 1010 - Vila Universitaria, São Paulo, SP CEP 05508-090, Brazil
| | - Maria Conceição do Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), Rua Borges Lagoa 570, CEP04038-020 São Paulo, Brazil
| | - Ivanil Morais
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil
| | - Leonardo Fontenelle
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil. Av. Venceslau Braz, 71 fundos. Botafogo, Rio de Janeiro, RJ, 22290-140, Brazil
| | - Carolina Cappi
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil
| | - James Kennedy
- Sunnybrook Health Sciences Centre, Centre for Addiction and Mental Health, 2075 Bayview Avenue, Suite FG42, Toronto, ON M4N 3M5, Canada.
| | - Jose M Menchon
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Euripedes Miguel
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil
| | - Peggy M A Richter
- Sunnybrook Health Sciences Centre, Centre for Addiction and Mental Health, 2075 Bayview Avenue, Suite FG42, Toronto, ON M4N 3M5, Canada.
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Rasgon A, Lee WH, Leibu E, Laird A, Glahn D, Goodman W, Frangou S. Neural correlates of affective and non-affective cognition in obsessive compulsive disorder: A meta-analysis of functional imaging studies. Eur Psychiatry 2017; 46:25-32. [PMID: 28992533 DOI: 10.1016/j.eurpsy.2017.08.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 01/28/2023] Open
Abstract
Obsessive compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive ritualistic behaviors and has been associated with diverse functional brain abnormalities. We sought to synthesize current evidence from functional magnetic resonance imaging (fMRI) studies and examine their alignment to pathogenetic models of OCD. Following systematic review, we identified 54 task-fMRI studies published in the last decade comparing adults with OCD (n=1186) to healthy adults (n=1159) using tasks of affective and non-affective cognition. We used voxel-based quantitative meta-analytic methods to combine primary data on anatomical coordinates of case-control differences, separately for affective and non-affective tasks. We found that functional abnormalities in OCD cluster within cortico-striatal thalamic circuits. Within these circuits, the abnormalities identified showed significant dependence on the affective or non-affective nature of the tasks employed as circuit probes. In studies using affective tasks, patients overactivated regions involved in salience, arousal and habitual responding (anterior cingulate cortex, insula, caudate head and putamen) and underactivated regions implicated in cognitive and behavioral control (medial prefrontal cortex, posterior caudate). In studies using non-affective cognitive tasks, patients overactivated regions involved in self-referential processing (precuneus, posterior cingulate cortex) and underactivated subcortical regions that support goal-directed cognition and motor control (pallidum, ventral anterior thalamus, posterior caudate). The overall pattern suggests that OCD-related brain dysfunction involves increased affective and self-referential processing, enhanced habitual responding and blunted cognitive control.
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Affiliation(s)
- A Rasgon
- Department of psychiatry, Icahn school of medicine, 1425, Madison avenue, 10029 New York, Mount Sinai, USA
| | - W H Lee
- Department of psychiatry, Icahn school of medicine, 1425, Madison avenue, 10029 New York, Mount Sinai, USA
| | - E Leibu
- Department of psychiatry, Icahn school of medicine, 1425, Madison avenue, 10029 New York, Mount Sinai, USA
| | - A Laird
- Neuroinformatics and brain connectivity laboratory, Florida international university, Florida, USA
| | - D Glahn
- Division of neurocognition, neurocomputation, and neurogenetics, Yale university, New Haven, CT, USA
| | - W Goodman
- Menninger department of psychiatry and behavioral sciences, Baylor college of medicine, Waco, TX, USA
| | - S Frangou
- Department of psychiatry, Icahn school of medicine, 1425, Madison avenue, 10029 New York, Mount Sinai, USA.
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Servaes S, Glorie D, Verhaeghe J, Stroobants S, Staelens S. Preclinical molecular imaging of glutamatergic and dopaminergic neuroreceptor kinetics in obsessive compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2017; 77:90-98. [PMID: 28365375 DOI: 10.1016/j.pnpbp.2017.02.027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 02/06/2017] [Accepted: 02/27/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Molecular neuroimaging was applied in the quinpirole rat model for compulsive checking in OCD to visualize the D2- and mGluR5-receptor occupancy with Raclopride and ABP-688 microPET/CT. METHODS Animals (n=48) were exposed to either saline (CTRL; 1mL/kg) or quinpirole (QP; dopamine D2-agonist, 0.5mg/kg) in a single injection (RAC and ABP acute groups) or twice-weekly during 7weeks (chronic group). Animals underwent PET/CT after the 1st injection (acute) or before initial exposure and following the 10th injection in week 5 (chronic). For the latter, each injection was paired with an open field test and video tracking. RESULTS The QP animals displayed a strong increase in visiting frequency (checking) in the chronic group (+699.29%) compared to the control animals. Acute administration of the drug caused significant (p<0.01) decreases in D2R occupancy in the CP (-42.03%±4.01%). Chronical exposure resulted in significantly stronger decreases in the CP (-52.29%±3.79%). Furthermore significant increases in mGluR5 occupancy were found in the CP (10.36%±4.09%), anterior cingulate cortex (13.26%±4.01%), amygdala (24.36%±6.86%), entorhinal cortex (18.49%±5.14%) and nucleus accumbens (13.8%±4.87%) of the chronic group, not present after acute exposure. CONCLUSIONS Compared to acute exposure, sensitisation to QP as a model for OCD differs both on a dopaminergic and glutamateric level, indicating involvement of processes such as receptor internalization and changes in extracellular availability of both neurotransmitters.
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Affiliation(s)
- S Servaes
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - D Glorie
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - J Verhaeghe
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - S Stroobants
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium; Department of Nuclear Medicine, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Antwerp, Belgium.
| | - S Staelens
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
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40
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Dayan A, Berger A, Anholt GE. Enhanced action tendencies in obsessive-compulsive disorder: An ERP study. Behav Res Ther 2017; 93:13-21. [DOI: 10.1016/j.brat.2017.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/25/2017] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
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Liu JP, Li J, Lu Y, Wang L, Chen G. Impulse control disorder, lysosomal malfunction and ATP13A2 insufficiency in Parkinsonism. Clin Exp Pharmacol Physiol 2016; 44:172-179. [PMID: 27997702 DOI: 10.1111/1440-1681.12714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 12/27/2022]
Abstract
Lysosomal transport of cargos in neurons is essential for neuronal proteostasis, transmission and functional motors and behaviours. Lysosomal malfunction including storage disorders is involved in the pathogenesis of Parkinson's disease (PD). Given the unclear molecular mechanisms of diverse defects in PD phenotypes, especially behavioural deficits, this mini review explores the cellular contexts of PD impulse control disorders and the molecular aspects of lysosomal cross-membrane transports. Focuses are paid to trace metal involvements in α-synuclein assembly in Lewy bodies, the functions and molecular interactions of ATP13A2 as ATPase transporters in lysosomal membranes for cross-membrane trafficking and lysosomal homeostasis, and our current understandings of the neural circuits in ICD. Erroneously polarized distributions of cargos such as metals and lipids on each side of lysosomal membranes triggered by gene mutations and deregulated expression of ATP13A2 may thus instigate sensing protein structural changes such as aggregations, organelle degeneration, and specific neuronal ageing and death in Parkinsonism.
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Affiliation(s)
- Jun-Ping Liu
- School of Medicine, Institute of Ageing Research, Hangzhou Normal University, Hangzhou, Zhejiang Province, China.,Department of Molecular and Translational Science, Faculty of Medicine, Hudson Institute of Medical Research, Monash University, Clayton, VIC, Australia.,Department of Immunology, Faculty of Medicine, Central Clinical School, Monash University, Prahran, VIC, Australia
| | - Jianfeng Li
- School of Medicine, Institute of Ageing Research, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Yanhua Lu
- School of Medicine, Institute of Ageing Research, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Lihui Wang
- School of Medicine, Institute of Ageing Research, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Gang Chen
- School of Medicine, Institute of Ageing Research, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
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42
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Functional and structural connectivity of the amygdala in obsessive-compulsive disorder. NEUROIMAGE-CLINICAL 2016; 13:246-255. [PMID: 28018851 PMCID: PMC5167243 DOI: 10.1016/j.nicl.2016.12.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 12/04/2016] [Accepted: 12/08/2016] [Indexed: 11/20/2022]
Abstract
Background The amygdala is known to be involved in anxiety processing, but its role in the psychopathology of obsessive-compulsive disorder (OCD) is still unclear. Aims In this MRI study we investigated potential alterations in structural and functional connectivity of the amygdala in 42 adult patients with OCD and 37 healthy subjects. Method Psychophysiological interaction analysis was used to explore amygdala functional connectivity during a negative affective task. Probabilistic tractography was then employed to study structural connectivity and integrity of underlying white matter fiber tracts. Results Compared to controls, OCD patients showed a significantly increased functional connectivity of the left amygdala with mostly parieto-occipital regions during task. No structural connectivity differences could be found between the groups. In addition, only patients showed a significant association between functional and structural connectivity of these regions. Moreover, symptom severity was negatively associated with structural integrity of the underlying white matter tracts. Conclusions Present results emphasize the relevance of the amygdala for OCD and may reflect that neuronal alterations in structural connectivity could be associated with functional connectivity alterations in broader networks.
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43
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Rǎdulescu A, Marra R. A mathematical model of reward and executive circuitry in obsessive compulsive disorder. J Theor Biol 2016; 414:165-175. [PMID: 27915073 DOI: 10.1016/j.jtbi.2016.11.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 10/07/2016] [Accepted: 11/29/2016] [Indexed: 01/01/2023]
Abstract
The neuronal circuit that controls obsessive and compulsive behaviors involves a complex network of brain regions (some with known involvement in reward processing). Among these are cortical regions, the striatum and the thalamus (which compose the CSTC pathway), limbic areas such as the amygdala and the hippocampus, as well as dopamine pathways. Abnormal dynamic behavior in this brain network is a hallmark feature of patients with increased anxiety and motor activity, like the ones affected by OCD. There is currently no clear understanding of precisely what mechanisms generate these behaviors. We attempt to investigate a collection of connectivity hypotheses of OCD by means of a computational model of the brain circuitry that governs reward and motion execution. Mathematically, we use methods from ordinary differential equations and continuous time dynamical systems. We use classical analytical methods as well as computational approaches to study phenomena in the phase plane (e.g., behavior of the system's solutions when given certain initial conditions) and in the parameter space (e.g., sensitive dependence of initial conditions). We find that different obsessive-compulsive subtypes may correspond to different abnormalities in the network connectivity profiles. We suggest that it is a combination of parameters (connectivity strengths between regions), rather than the value of any one parameter taken independently, that provide the best basis for predicting behavior, and for understanding the heterogeneity of the illness.
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Affiliation(s)
- Anca Rǎdulescu
- Department of Mathematics, State University of New York at New Paltz, New Paltz, NY, USA.
| | - Rachel Marra
- Department of Astronomy, State University of New York at New Paltz, New Paltz, NY 12561, USA
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44
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Servaes S, Glorie D, Verhaeghe J, Wyffels L, Stroobants S, Staelens S. [18F]-FDG PET neuroimaging in rats with quinpirole-induced checking behavior as a model for obsessive compulsive disorder. Psychiatry Res Neuroimaging 2016; 257:31-38. [PMID: 27771554 DOI: 10.1016/j.pscychresns.2016.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 09/19/2016] [Accepted: 10/14/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Stijn Servaes
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - Dorien Glorie
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - Jeroen Verhaeghe
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
| | - Leonie Wyffels
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium; Department of Nuclear Medicine, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp, Belgium.
| | - Sigrid Stroobants
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium; Department of Nuclear Medicine, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp, Belgium.
| | - Steven Staelens
- Molecular Imaging Center Antwerp (MICA), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Antwerp, Belgium.
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45
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Kim HW, Kang JI, Lee SH, An SK, Sohn SY, Hwang EH, Lee SY, Kim SJ. Common variants of HTR3 genes are associated with obsessive-compulsive disorder and its phenotypic expression. Sci Rep 2016; 6:32564. [PMID: 27616601 PMCID: PMC5018838 DOI: 10.1038/srep32564] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 08/09/2016] [Indexed: 12/24/2022] Open
Abstract
Evidence from literature supports the existence of associations between serotonin-related genetic variants and obsessive-compulsive disorder (OCD), but few studies have explored the involvement of serotonin receptor type 3 genes (HTR3) in OCD. To identify whether HTR3 variability affects an individual’s susceptibility to OCD, we examined 10 HTR3 variants in 596 individuals with OCD and 599 controls. A significant difference existed in the genotypic distribution of the HTR3B variant rs1176744 between individuals with OCD and controls (odds ratio [OR] = 0.74, 95% confidence interval [CI] = 0.60–0.91, P = 0.0043). A protective haplotype in HTR3B was also associated with OCD (OR = 0.77, CI = 0.63–0.95, permutated P = 0.0179). Analyses of OCD sub-phenotypes demonstrated significant associations between rs3758987 and early onset OCD in male subjects (OR = 0.49, CI = 0.31–0.79, P = 0.0031) and among rs6766410, rs6443930, and the cleaning dimension in female subjects (OR = 0.36, CI = 0.18–0.69, P = 0.0016 and OR = 0.47, CI = 0.29–0.79, P = 0.0030, respectively). Additionally, rs6766410 was related to contamination-based disgust in OCD (P = 0.0044). These results support that common HTR3 variants are involved in OCD and some of its clinical phenotypes.
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Affiliation(s)
- Hae Won Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee In Kang
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Yun Sohn
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Hee Hwang
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Su Young Lee
- Department of Psychiatry, Cheil General Hospital &Women's Healthcare Center, Dankook University College of Medicine, Seoul, Republic of Korea
| | - Se Joo Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Connectomics-based structural network alterations in obsessive-compulsive disorder. Transl Psychiatry 2016; 6:e882. [PMID: 27598966 PMCID: PMC5048203 DOI: 10.1038/tp.2016.163] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 07/11/2016] [Accepted: 07/18/2016] [Indexed: 01/12/2023] Open
Abstract
Given the strong involvement of affect in obsessive-compulsive disorder (OCD) and recent findings, the current cortico-striato-thalamo-cortical (CSTC) model of pathophysiology has repeatedly been questioned regarding the specific role of regions involved in emotion processing such as limbic areas. Employing a connectomics approach enables us to characterize structural connectivity on a whole-brain level, extending beyond the CSTC circuitry. Whole-brain structural networks of 41 patients and 42 matched healthy controls were analyzed based on 83 × 83 connectivity matrices derived from cortical and subcortical parcellation of structural T1-weighted magnetic resonance scans and deterministic fiber tracking based on diffusion tensor imaging data. To assess group differences in structural connectivity, the framework of network-based statistic (NBS) was applied. Graph theoretical measures were calculated to further assess local and global network characteristics. The NBS analysis revealed a single network consistently displaying decreased structural connectivity in patients comprising orbitofrontal, striatal, insula and temporo-limbic areas. In addition, graph theoretical measures indicated local alterations for amygdala and temporal pole while the overall topology of the network was preserved. To the best of our knowledge, this is the first study combining the NBS with graph theoretical measures in OCD. Along with regions commonly described in the CSTC model of pathophysiology, our results indicate an involvement of mainly temporo-limbic regions typically associated with emotion processing supporting their importance for neurobiological alterations in OCD.
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47
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Gonçalves ÓF, Carvalho S, Leite J, Fernandes-Gonçalves A, Carracedo A, Sampaio A. Cognitive and emotional impairments in obsessive-compulsive disorder: Evidence from functional brain alterations. Porto Biomed J 2016; 1:92-105. [PMID: 32258557 DOI: 10.1016/j.pbj.2016.07.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
There is a common agreement on the existence of dysfunctional cortico-striatal-thalamus-cortical pathways in OCD. Despite this consensus, recent studies showed that brain regions other than the CSTC loops are needed to understand the complexity and diversity of cognitive and emotional deficits in OCD. This review presents examples of research using functional neuroimaging, reporting abnormal brain processes in OCD that may underlie specific cognitive/executive (inhibitory control, cognitive flexibility, working memory), and emotional impairments (fear/defensive, disgust, guilt, shame). Studies during resting state conditions show that OCD patients have alterations in connectivity not only within the CSTC pathways but also in more extended resting state networks, particularly the default mode network and the fronto-parietal network. Additionally, abnormalities in brain functioning have been found in several cognitive and emotionally task conditions, namely: inhibitory control (e.g., CSTC loops, fronto-parietal networks, anterior cingulate); cognitive flexibility (e.g., CSTC loops, extended temporal, parietal, and occipital regions); working memory (e.g., CSTC loops, frontal parietal networks, dorsal anterior cingulate); fear/defensive (e.g., amygdala, additional brain regions associated with perceptual - parietal, occipital - and higher level cognitive processing - prefrontal, temporal); disgust (e.g., insula); shame (e.g., decrease activity in middle frontal gyrus and increase in frontal, limbic, temporal regions); and guilt (e.g., decrease activity anterior cingulate and increase in frontal, limbic, temporal regions). These findings may contribute to the understanding of OCD as both an emotional (i.e., anxiety) and cognitive (i.e., executive control) disorder.
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Affiliation(s)
- Óscar F Gonçalves
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal.,Spaulding Center of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Applied Psychology, Bouvé College of Health Sciences, Northeastern University, Boston, USA
| | - Sandra Carvalho
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal.,Spaulding Center of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jorge Leite
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal.,Spaulding Center of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Angel Carracedo
- Forensic Genetics Unit, Institute of Legal Medicine, Faculty of Medicine, University of Santiago de Compostela, Galicia, Spain
| | - Adriana Sampaio
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
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48
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Weidt S, Lutz J, Rufer M, Delsignore A, Jakob NJ, Herwig U, Bruehl AB. Common and differential alterations of general emotion processing in obsessive-compulsive and social anxiety disorder. Psychol Med 2016; 46:1427-1436. [PMID: 26804333 DOI: 10.1017/s0033291715002998] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) and social anxiety disorder (SAD) are characterized by biased perception and processing of potentially threatening stimuli. A hyper-reactivity of the fear-circuit [e.g. amygdala, anterior cingulate (ACC)] has been consistently reported using functional magnetic resonance imaging (fMRI) in SAD in comparison with healthy controls (HCs). Studies investigating the processing of specific emotional stimuli in OCD reported mainly orbitofrontal-striatal abnormalities. The goal of this study was to examine similar/common and differential neurobiological responses in OCD and SAD using unspecific emotional stimuli. METHOD Fifty-four subjects participated: two groups (each n = 18) of outpatients with a current diagnosis of OCD or SAD, and 18 HCs. All subjects underwent fMRI while anticipating and perceiving unspecific visual stimuli with prior announced emotional valence (e.g. positive). RESULTS Compared to HCs, the combined patient group showed increased activation in amygdala, caudate and prefrontal/orbitofrontal cortex while anticipating unspecific emotional stimuli. Caudate was more active in the combined patient group during perception. A comparison between the OCD and the SAD samples revealed increased amygdala and decreased rostral ACC activation in OCD patients during perception, but no differences in the anticipation phase. CONCLUSIONS Overall, we could identify common fronto-subcortical hyper-reactivity in OCD and SAD while anticipating and perceiving unspecific emotional stimuli. While differential neurobiological responses between OCD and SAD when processing specific stimuli are evident from the literature, differences were less pronounced using unspecific stimuli. This could indicate a disturbance of emotion regulation common to both OCD and SAD.
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Affiliation(s)
- S Weidt
- Department of Psychiatry and Psychotherapy,University Hospital,University of Zurich,Zurich,Switzerland
| | - J Lutz
- Department of Psychiatry, Psychotherapy and Psychosomatics,Psychiatric Hospital,University of Zurich,Switzerland
| | - M Rufer
- Department of Psychiatry and Psychotherapy,University Hospital,University of Zurich,Zurich,Switzerland
| | - A Delsignore
- Department of Psychiatry and Psychotherapy,University Hospital,University of Zurich,Zurich,Switzerland
| | - N J Jakob
- Sanatorium Kilchberg,Kilchberg,Switzerland
| | - U Herwig
- Department of Psychiatry, Psychotherapy and Psychosomatics,Psychiatric Hospital,University of Zurich,Switzerland
| | - A B Bruehl
- Behavioural and Clinical Neuroscience Institute and Department of Psychiatry,University of Cambridge,UK
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49
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van den Heuvel OA, van Wingen G, Soriano-Mas C, Alonso P, Chamberlain SR, Nakamae T, Denys D, Goudriaan AE, Veltman DJ. Brain circuitry of compulsivity. Eur Neuropsychopharmacol 2016; 26:810-27. [PMID: 26711687 DOI: 10.1016/j.euroneuro.2015.12.005] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 08/28/2015] [Accepted: 12/01/2015] [Indexed: 01/27/2023]
Abstract
Compulsivity is associated with alterations in the structure and the function of parallel and interacting brain circuits involved in emotional processing (involving both the reward and the fear circuits), cognitive control, and motor functioning. These brain circuits develop during the pre-natal period and early childhood under strong genetic and environmental influences. In this review we bring together literature on cognitive, emotional, and behavioral processes in compulsivity, based mainly on studies in patients with obsessive-compulsive disorder and addiction. Disease symptoms normally change over time. Goal-directed behaviors, in response to reward or anxiety, often become more habitual over time. During the course of compulsive disorders the mental processes and repetitive behaviors themselves contribute to the neuroplastic changes in the involved circuits, mainly in case of chronicity. On the other hand, successful treatment is able to normalize altered circuit functioning or to induce compensatory mechanisms. We conclude that insight in the neurobiological characteristics of the individual symptom profile and disease course, including the potential targets for neuroplasticity is an unmet need to advance the field.
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Affiliation(s)
- Odile A van den Heuvel
- Department of Psychiatry, VU University Medical Center (VUmc), Amsterdam, The Netherlands; Department of Anatomy & Neurosciences, VUmc, Amsterdam, The Netherlands; The Obsessive-Compulsive Disorder Team, Haukeland University Hospital, Bergen, Norway.
| | - Guido van Wingen
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Carles Soriano-Mas
- OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge University Hospital; Bellvitge Biomedical Research Institute (IDIBELL), and CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Barcelona, Spain; Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge University Hospital; Bellvitge Biomedical Research Institute (IDIBELL), and CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge, United Kingdom
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anna E Goudriaan
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands; Arkin Mental Health and Jellinek Addiction Treatment, Amsterdam, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center (VUmc), Amsterdam, The Netherlands
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50
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López-Solà C, Fontenelle LF, Verhulst B, Neale MC, Menchón JM, Alonso P, Harrison BJ. DISTINCT ETIOLOGICAL INFLUENCES ON OBSESSIVE-COMPULSIVE SYMPTOM DIMENSIONS: A MULTIVARIATE TWIN STUDY. Depress Anxiety 2016; 33:179-91. [PMID: 26630089 PMCID: PMC4775288 DOI: 10.1002/da.22455] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 10/15/2015] [Accepted: 11/01/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is characterized by five major dimensions, including contamination/washing, harm/checking, symmetry/ordering, hoarding, and forbidden thoughts. How these dimensions may relate etiologically to the symptoms of other obsessive-compulsive related disorders (OCRDs) and anxiety disorders (ADs) is not well known. The aim of this study was to examine the genetic and environmental overlap between each major obsessive-compulsive dimension with the symptoms of other OCRDs and ADs. METHODS Two thousand four hundred ninety-five twins of both sexes, aged between 18 and 45 years, were recruited from the Australian Twin Registry. Measures used scores on four dimensions (obsessing (forbidden thoughts), washing, checking, and ordering) of the Obsessive-Compulsive Inventory-Revised, Dysmorphic Concerns Questionnaire, Hoarding Rating Scale, Anxiety Sensitivity Index, Social Phobia Inventory, and Stress subscale of the Depression, Anxiety, and Stress Scale. Multivariate twin modeling methods using continuous and categorized variables were performed, also controlling for age and gender. RESULTS Our findings suggested that forbidden thoughts and washing demonstrated the strongest genetic overlap with other AD symptoms, while ordering was genetically related to OCRD symptoms. Common genetic influences on checking symptoms were best estimated when modeling OCRDs together with AD symptoms. Common environmental factors of ordering and checking were shared with AD symptoms. CONCLUSIONS Important shared genetic and environmental risk factors exist between OCD, OCRDs, and ADs, but which vary alongside the expression of its major dimensions.
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Affiliation(s)
- Clara López-Solà
- Department of Psychiatry, Bellvitge Biomedical Research Institute—IDIBELL, Bellvitge University Hospital, CIBERSAM (G17), Barcelona, Spain,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Leonardo F. Fontenelle
- Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil,lnstituto D’Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, RJ, Brazil,Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, RJ, Brazil
| | - Brad Verhulst
- Virginia Institute for Psychiatric and Behavioral Genetics (VIPBG), Virginia Commonwealth University, Richmond, Virginia
| | - Michael C. Neale
- Virginia Institute for Psychiatric and Behavioral Genetics (VIPBG), Virginia Commonwealth University, Richmond, Virginia
| | - José M. Menchón
- Department of Psychiatry, Bellvitge Biomedical Research Institute—IDIBELL, Bellvitge University Hospital, CIBERSAM (G17), Barcelona, Spain,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Pino Alonso
- Department of Psychiatry, Bellvitge Biomedical Research Institute—IDIBELL, Bellvitge University Hospital, CIBERSAM (G17), Barcelona, Spain,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Ben J. Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia,Correspondence: Ben J. Harrison, Melbourne Neuropsychiatry Centre, The University of Melbourne, Level 3, 161 Barry Street, Carlton, 3053 Melbourne, Australia.
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