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Katz DE, Rector NA, Ornstein T, McKinnon M, McCabe RE, Hawley LL, Rowa K, Richter MA, Regev R, Laposa JM. Neurocognitive performance in the context of acute symptom reduction in OCD: Treatment effects and the impact of BDNF. J Affect Disord 2024; 362:679-687. [PMID: 39009317 DOI: 10.1016/j.jad.2024.07.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 06/13/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has been associated with neurocognitive impairments. The present study examined the effect of treatment on neurocognitive performance in OCD and the relationship between neurocognitive change and symptom change. The present study also examined polymorphisms influencing brain derived neurotrophic factor (BDNF) as predictors of neurocognitive change. METHOD Treatment-seeking participants with OCD (N = 125) were assigned to cognitive behavioural therapy (CBT) alone, CBT combined with regular physical exercise, exercise alone, or a waitlist control group. Measures of OCD symptom severity and a neuropsychological battery were completed pre- and post-treatment. Blood or saliva samples were used to genotype the BDNF Val66Met polymorphism. RESULTS OCD symptom severity was not cross-sectionally associated with neurocognitive performance. Several neurocognitive measures improved over treatment. The BDNF Val66Met polymorphism was significantly associated with worse performance on the Stroop test but did not significantly predict change in neurocognitive performance over time. LIMITATIONS Limitations include lack of a healthy control group. CONCLUSION Improvement in neurocognitive performance corresponded to symptomatic improvement and was independent of the BDNF Val66Met genotype.
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Affiliation(s)
- Danielle E Katz
- Forest Hill Centre for Cognitive Behavioural Therapy, Toronto, Ontario, Canada
| | - Neil A Rector
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada.
| | - Tish Ornstein
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Margaret McKinnon
- McMaster University, Department of Psychology and Behavioural Neurosciences, Hamilton, Ontario, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Randi E McCabe
- McMaster University, Department of Psychology and Behavioural Neurosciences, Hamilton, Ontario, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Lance L Hawley
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Karen Rowa
- McMaster University, Department of Psychology and Behavioural Neurosciences, Hamilton, Ontario, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Margaret A Richter
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Rotem Regev
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
| | - Judith M Laposa
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Ontario, Canada
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Bednarek L, Glover S, Ma X, Pittenger C, Pushkarskaya H. Externally orienting cues improve cognitive control in OCD. J Behav Ther Exp Psychiatry 2024; 84:101959. [PMID: 38531125 PMCID: PMC11192454 DOI: 10.1016/j.jbtep.2024.101959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/31/2023] [Accepted: 03/01/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND AND OBJECTIVES An executive overload model of obsessive-compulsive disorder (OCD) posits that broad difficulties with executive functioning in OCD result from an overload on the executive system by obsessive thoughts. It implies that, if individuals with OCD "snap out" of their obsessive thoughts, their performance on neurocognitive tasks will improve. METHODS We test this prediction using the revised Attention Network Test, ANT-R, and distinct subsamples of data from unmedicated OCD and healthy controls (HC). ANT-R includes Simon and Flanker tasks; in both, incongruent trials take longer to resolve ('conflict costs'). On some trials, a warning cue helps participants to respond faster ('alerting benefits'). In OCD (N = 34) and HC (N = 46), matched on age, IQ, and sex, we tested (1) the effect of OCD on alerting benefits, and (2) the effect of OCD on warning cue related reductions in conflict costs. In a distinct subsample of OCD (N = 32) and HC (N = 51), we assessed whether alerting benefits and cue-related reductions in conflict costs are associated differently with different OCD symptoms. RESULTS A warning cue can help individuals with OCD more than HC to improve performance on Simon and Flanker tasks. This effect is positively associated with severity of contamination symptoms. LIMITATIONS This study did not directly assess how distracted participants are by obsessive thoughts. It relied on the ANT-R subtraction measures. Symptom severity was assessed using self-report measures. CONCLUSIONS Difficulties in resolving conflict during decision-making in OCD can be modulated by a warning cue presented immediately before an attentional task.
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Affiliation(s)
- Lora Bednarek
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Stephanie Glover
- PGSP-Stanford PsyD Consortium, Palo Alto University, Palo Alto, CA, United States
| | - Xiao Ma
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States; Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States; Wu Tsai Institute, Yale University, New Haven, CT, United States; Yale Center for Brain and Mind Health, Yale School of Medicine, New Haven, CT, United States
| | - Helen Pushkarskaya
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
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Clarke AT, Fineberg NA, Pellegrini L, Laws KR. The relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder: A systematic review and Meta-analysis. Compr Psychiatry 2024; 133:152491. [PMID: 38714143 DOI: 10.1016/j.comppsych.2024.152491] [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: 09/12/2023] [Revised: 01/23/2024] [Accepted: 03/04/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND This systematic review and meta-analysis explored the relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder (OCD). METHODS We searched Pubmed, Scopus, Cochrane Library and PsychINFO databases until February 2023 for studies comparing patients with OCD and healthy controls on cognitive tests of compulsivity and impulsivity. The study followed PRISMA guidelines and was pre-registered on PROSPERO (CRD42021299017). RESULTS Meta-analyses of 112 studies involving 8313 participants (4289 patients with OCD and 4024 healthy controls) identified significant impairments in compulsivity (g = -0.58, [95%CI -0.68, -0.47]; k = 76) and impulsivity (g = -0.48, [95%CI -0.57, -0.38]; k = 63); no significant difference between impairments. Medication use and comorbid psychiatric disorders were not significantly related to impairments. No associations were revealed with OCD severity, depression/anxiety, or illness duration. CONCLUSION Cognitive phenotypes of compulsivity and impulsivity in patients with OCD appear to be orthogonal to clinical variables, including severity of OCD symptomatology. Their clinical impact is poorly understood and may require different clinical assessment tools and interventions.
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Affiliation(s)
- Aaron T Clarke
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; Centre for Psychedelic Research, Imperial College London, London, UK
| | - Keith R Laws
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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Jalal B, Chamberlain SR, Sahakian BJ. Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction. Brain Behav 2023; 13:e3000. [PMID: 37137502 PMCID: PMC10275553 DOI: 10.1002/brb3.3000] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 03/14/2023] [Accepted: 03/24/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND This review provides an overview of obsessive-compulsive disorder (OCD) symptoms, including the four partially distinct subtypes of the disorder, current diagnostic criteria, and common comorbidities. Critically, it focuses on the etiology of OCD, including its underlying neuropathology, and examines cognitive dysfunction in OCD. METHODS This review study was conducted by library method. RESULTS We show how dysfunction in cortico-striato-thalamo-cortical (CSTC) circuits may underpin symptoms; and shed light on the putative neurochemistry within these loops such as the role of serotonin, dopamine, and glutamate systems. We also show how OCD is characterized by cognitive dysfunction including problems in cognitive flexibility, visuospatial memory, response inhibition, and goal-directed behavior, linked to aberrant activity within CSTC circuits. CONCLUSIONS In brief, research questions we shed light on include (1) what are the symptoms in OCD; (2) what is the etiology of the disorder and do existing models explain OCD; and (3) what are key cognitive deficits in OCD and do these improve with treatment?
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Affiliation(s)
- Baland Jalal
- Department of PsychiatryUniversity of Cambridge School of Clinical MedicineCambridgeUK
- Behavioural and Clinical Neuroscience Institute, Department of PsychologyUniversity of CambridgeCambridgeUK
| | - Samuel R. Chamberlain
- Faculty of Medicine, Department of PsychiatryUniversity of SouthamptonSouthamptonUK
- Specialist Clinic for Impulsive and Compulsive Disorders, and the Southern Gambling ServiceSouthern Health NHS Foundation TrustSouthamptonUK
| | - Barbara J. Sahakian
- Department of PsychiatryUniversity of Cambridge School of Clinical MedicineCambridgeUK
- Behavioural and Clinical Neuroscience Institute, Department of PsychologyUniversity of CambridgeCambridgeUK
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Pan Y, Xu C, He T, Wei Z, Seger CA, Chen Q, Peng Z. A network perspective on cognitive function and obsessive-compulsive related symptoms. J Affect Disord 2023; 329:428-437. [PMID: 36863477 DOI: 10.1016/j.jad.2023.02.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/31/2022] [Accepted: 02/17/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND The relationship between cognitive function and psychopathological symptoms has been an important research field in recent years. Previous studies have typically applied case-control designs to explore differences in certain cognitive variables. Multivariate analyses are needed to deepen our understanding of the intercorrelations among cognitive and symptom phenotypes in OCD. METHODS The present study used network analysis to construct networks of cognitive variables and OCD-related symptoms in patients with OCD and healthy controls (N = 226), aiming to explore the relationship among numerous cognitive function variables and OCD-related symptoms in detail and compare the network features between the two groups. RESULTS In the network of cognitive function and OCD-related symptoms, nodes representing IQ, letter/number span test, accuracy of task switching test and obsession were much important in the network in terms of their larger strengths and edges. By constructing the networks of these two groups respectively, there was a strong similarity except that the symptom's network in healthy group had a higher degree of overall connectivity. LIMITATIONS Due to the small sample size, the stability of the network cannot be guaranteed. Due to the cross-sectional nature of the data, we were unable to determine how the cognitive-symptom network would change with disease deterioration or treatment. CONCLUSIONS The present study highlights the important role of variables such as obsession and IQ from a network perspective. These results deepen our understanding of the multivariate relationship between cognitive dysfunction and OCD symptoms, and may promote the prediction and diagnosis of OCD.
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Affiliation(s)
- Yimeng Pan
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China
| | - Chuanyong Xu
- Department of Child Psychiatry and Rehabilitation, Institute of Maternity and Child Medical Research, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, 518017 Shenzhen, China
| | - Tingxin He
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China
| | - Zhen Wei
- Department of Child Psychiatry and Rehabilitation, Institute of Maternity and Child Medical Research, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, 518017 Shenzhen, China
| | - Carol A Seger
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China
| | - Qi Chen
- School of Psychology, Shenzhen University, 518061 Shenzhen, China.
| | - Ziwen Peng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China.
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Evaluating the Effectiveness of Visuospatial Memory Stimulation Using Virtual Reality in Head and Neck Cancer Patients—Pilot Study. Cancers (Basel) 2023; 15:cancers15061639. [PMID: 36980525 PMCID: PMC10046573 DOI: 10.3390/cancers15061639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
The prevalence of Cancer-related Cognitive Impairment (CRCI) in cancer patients necessitates the search for methods to help stimulate cognitive function. An innovative and repeatedly used method in oncology departments is virtual reality (VR). To date, no one has used VR for head and neck cancer patients in an attempt to stimulate their working memory. The goal of our research is to intervene with off-the-shelf VR applications in HNC patients to lower the risk of CRCI. Twenty-two patients with head and neck cancer were enrolled in this pilot study to characterize their visuospatial memory capacity, a form of working memory. During the oncological treatment, the patient had 30 min sessions, three times a week, using publicly available applications of VR. No significant changes were observed in the pre- and post-study. The individual patient results present a favorable trend of changes in their working memory after the intervention: despite oncological treatment, visual-spatial memory did not deteriorate in 88% of patients, including 28% of patients with higher scores than before the intervention. In this pilot study, VR was safely used in patients with head and neck cancer with no negative side effects. The use of VR may prevent CRCI in most HNC patients and, in some, VR may improve their cognitive functioning. A more rigorous study with larger numbers and controls is advised.
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Fornaro S, Vallesi A. Functional connectivity abnormalities of brain networks in obsessive–compulsive disorder: a systematic review. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Abstract
Obsessive-compulsive disorder (OCD) is characterized by cognitive abnormalities encompassing several executive processes. Neuroimaging studies highlight functional abnormalities of executive fronto-parietal network (FPN) and default-mode network (DMN) in OCD patients, as well as of the prefrontal cortex (PFC) more specifically. We aim at assessing the presence of functional connectivity (FC) abnormalities of intrinsic brain networks and PFC in OCD, possibly underlying specific computational impairments and clinical manifestations. A systematic review of resting-state fMRI studies investigating FC was conducted in unmedicated OCD patients by querying three scientific databases (PubMed, Scopus, PsycInfo) up to July 2022 (search terms: “obsessive–compulsive disorder” AND “resting state” AND “fMRI” AND “function* *connect*” AND “task-positive” OR “executive” OR “central executive” OR “executive control” OR “executive-control” OR “cognitive control” OR “attenti*” OR “dorsal attention” OR “ventral attention” OR “frontoparietal” OR “fronto-parietal” OR “default mode” AND “network*” OR “system*”). Collectively, 20 studies were included. A predominantly reduced FC of DMN – often related to increased symptom severity – emerged. Additionally, intra-network FC of FPN was predominantly increased and often positively related to clinical scores. Concerning PFC, a predominant hyper-connectivity of right-sided prefrontal links emerged. Finally, FC of lateral prefrontal areas correlated with specific symptom dimensions. Several sources of heterogeneity in methodology might have affected results in unpredictable ways and were discussed. Such findings might represent endophenotypes of OCD manifestations, possibly reflecting computational impairments and difficulties in engaging in self-referential processes or in disengaging from cognitive control and monitoring processes.
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Chen J, Wu S, Li F. Cognitive Neural Mechanism of Backward Inhibition and Deinhibition: A Review. Front Behav Neurosci 2022; 16:846369. [PMID: 35668866 PMCID: PMC9165717 DOI: 10.3389/fnbeh.2022.846369] [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: 12/31/2021] [Accepted: 04/19/2022] [Indexed: 11/18/2022] Open
Abstract
Task switching is one of the typical paradigms to study cognitive control. When switching back to a recently inhibited task (e.g., “A” in an ABA sequence), the performance is often worse compared to a task without N-2 task repetitions (e.g., CBA). This difference is called the backward inhibitory effect (BI effect), which reflects the process of overcoming residual inhibition from a recently performed task (i.e., deinhibition). The neural mechanism of backward inhibition and deinhibition has received a lot of attention in the past decade. Multiple brain regions, including the frontal lobe, parietal, basal ganglia, and cerebellum, are activated during deinhibition. The event-related potentials (ERP) studies have shown that deinhibition process is reflected in the P1/N1 and P3 components, which might be related to early attention control, context updating, and response selection, respectively. Future research can use a variety of new paradigms to separate the neural mechanisms of BI and deinhibition.
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Affiliation(s)
- Jiwen Chen
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Shujie Wu
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Fuhong Li
- School of Psychology, Jiangxi Normal University, Nanchang, China
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Pollak J. Neurocognitive Impairment as a Specifier for the
Diagnostic and Statistical Manual of Mental Disorders. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220124-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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10
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Wang P, Yan Z, Chen T, Cao W, Yang X, Meng F, Liu Y, Li Z. Visuospatial working memory capacity moderates the relationship between anxiety and OCD related checking behaviors. Front Psychiatry 2022; 13:1039849. [PMID: 36699497 PMCID: PMC9868399 DOI: 10.3389/fpsyt.2022.1039849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Compulsive checking behavior is the most prevalent compulsive behavior in patients with obsessive-compulsive disorder (OCD). While some studies have shown that anxiety and executive function influence compulsive checking behavior, the relationship between these constructs is inconclusive. Hence, we sought to explore the interplay between executive function, anxiety and compulsive checking behavior. MATERIALS AND METHODS 47 healthy participants (HC) and 51 patients with OCD participated in the study. Symptoms and emotional states were assessed using the Yale-Brown Obsessive Compulsive Scale, the Obsessive-Compulsive Inventory-Revised, the Beck Anxiety Inventory, and the Beck Depression Inventory. Participants also completed three tests of neuropsychological functioning: the Stop Signal Task, the Spatial working memory Task, and the Wisconsin card sorting test. We analyzed the relationships between anxiety, executive function, and compulsive checking symptoms. RESULTS Patients with OCD showed significantly greater anxiety (p < 0.001) and impairments in visuospatial working memory function (p = 0.030) compared to HC participants, while inhibition and set-shifting were not significantly different between the two groups. Visuospatial working memory was negatively related to compulsive checking behavior (p = 0.016). Visuospatial working memory also played a moderating role in the positive relationship between anxiety and compulsive checking behavior (β = -0.281, p = 0.022). CONCLUSION Anxiety symptoms play an important role in explaining compulsive checking behavior in patients with OCD who have relatively weak visuospatial working memory ability. These findings provide a foundation for further research regarding the roles of emotion and cognitive inflexibility in compulsive checking behavior in patients with OCD.
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Affiliation(s)
- Pengchong Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zijun Yan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tao Chen
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Wenwen Cao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiangyun Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fanqiang Meng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuqing Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhanjiang Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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