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Segalàs C, Cernadas E, Puialto M, Fernández-Delgado M, Arrojo M, Bertolin S, Real E, Menchón JM, Carracedo A, Tubío-Fungueiriño M, Alonso P, Fernández-Prieto M. Cognitive and clinical predictors of a long-term course in obsessive compulsive disorder: A machine learning approach in a prospective cohort study. J Affect Disord 2024; 350:648-655. [PMID: 38246282 DOI: 10.1016/j.jad.2024.01.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/20/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is a disabling illness with a chronic course, yet data on long-term outcomes are scarce. This study aimed to examine the long-term course of OCD in patients treated with different approaches (drugs, psychotherapy, and psychosurgery) and to identify predictors of clinical outcome by machine learning. METHOD We included outpatients with OCD treated at our referral unit. Demographic and neuropsychological data were collected at baseline using standardized instruments. Clinical data were collected at baseline, 12 weeks after starting pharmacological treatment prescribed at study inclusion, and after follow-up. RESULTS Of the 60 outpatients included, with follow-up data available for 5-17 years (mean = 10.6 years), 40 (67.7 %) were considered non-responders to adequate treatment at the end of the study. The best machine learning model achieved a correlation of 0.63 for predicting the long-term Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score by adding clinical response (to the first pharmacological treatment) to the baseline clinical and neuropsychological characteristics. LIMITATIONS Our main limitations were the sample size, modest in the context of traditional ML studies, and the sample composition, more representative of rather severe OCD cases than of patients from the general community. CONCLUSIONS Many patients with OCD showed persistent and disabling symptoms at the end of follow-up despite comprehensive treatment that could include medication, psychotherapy, and psychosurgery. Machine learning algorithms can predict the long-term course of OCD using clinical and cognitive information to optimize treatment options.
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Affiliation(s)
- C Segalàs
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, 32 Barcelona, Spain
| | - E Cernadas
- Centro Singular de Investigación en Tecnoloxías Intelixentes da USC (CiTIUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - M Puialto
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - M Fernández-Delgado
- Centro Singular de Investigación en Tecnoloxías Intelixentes da USC (CiTIUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - M Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - S Bertolin
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - E Real
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, 32 Barcelona, Spain
| | - A Carracedo
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Genetics Group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - M Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain.
| | - P Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, 32 Barcelona, Spain
| | - M Fernández-Prieto
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
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Kim BG, Kim G, Abe Y, Alonso P, Ameis S, Anticevic A, Arnold PD, Balachander S, Banaj N, Bargalló N, Batistuzzo MC, Benedetti F, Bertolín S, Beucke JC, Bollettini I, Brem S, Brennan BP, Buitelaar JK, Calvo R, Castelo-Branco M, Cheng Y, Chhatkuli RB, Ciullo V, Coelho A, Couto B, Dallaspezia S, Ely BA, Ferreira S, Fontaine M, Fouche JP, Grazioplene R, Gruner P, Hagen K, Hansen B, Hanna GL, Hirano Y, Höxter MQ, Hough M, Hu H, Huyser C, Ikuta T, Jahanshad N, James A, Jaspers-Fayer F, Kasprzak S, Kathmann N, Kaufmann C, Kim M, Koch K, Kvale G, Kwon JS, Lazaro L, Lee J, Lochner C, Lu J, Manrique DR, Martínez-Zalacaín I, Masuda Y, Matsumoto K, Maziero MP, Menchón JM, Minuzzi L, Moreira PS, Morgado P, Narayanaswamy JC, Narumoto J, Ortiz AE, Ota J, Pariente JC, Perriello C, Picó-Pérez M, Pittenger C, Poletti S, Real E, Reddy YCJ, van Rooij D, Sakai Y, Sato JR, Segalas C, Shavitt RG, Shen Z, Shimizu E, Shivakumar V, Soreni N, Soriano-Mas C, Sousa N, Sousa MM, Spalletta G, Stern ER, Stewart SE, Szeszko PR, Thomas R, Thomopoulos SI, Vecchio D, Venkatasubramanian G, Vriend C, Walitza S, Wang Z, Watanabe A, Wolters L, Xu J, Yamada K, Yun JY, Zarei M, Zhao Q, Zhu X, Thompson PM, Bruin WB, van Wingen GA, Piras F, Piras F, Stein DJ, van den Heuvel OA, Simpson HB, Marsh R, Cha J. Correction: White matter diffusion estimates in obsessive-compulsive disorder across 1653 individuals: machine learning findings from the ENIGMA OCD Working Group. Mol Psychiatry 2024:10.1038/s41380-024-02494-9. [PMID: 38454086 DOI: 10.1038/s41380-024-02494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Affiliation(s)
- Bo-Gyeom Kim
- Department of Psychology, College of Social Sciences, Seoul National University, Seoul, Republic of Korea
| | - Gakyung Kim
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Yoshinari Abe
- Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Department of Psychiatry, Kyoto City, Japan
| | - Pino Alonso
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Stephanie Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Srinivas Balachander
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Nuria Bargalló
- Center of Image Diagnostic, Hospital Clínic de Barcelona, Barcelona, Spain
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marcelo C Batistuzzo
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, SP, Brazil
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Sara Bertolín
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
| | - Jan Carl Beucke
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Psychology, Medical School Hamburg, Hamburg, Germany
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Brian P Brennan
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jan K Buitelaar
- Radboudumc, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Rosa Calvo
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548, Coimbra, Portugal
- Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ritu Bhusal Chhatkuli
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ana Coelho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Beatriz Couto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Sara Dallaspezia
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benjamin A Ely
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Martine Fontaine
- Columbia University Medical College, Columbia University, New York, NY, USA
| | - Jean-Paul Fouche
- SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Cape Town, South Africa
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Kristen Hagen
- Hospital of Molde, Møre og Romsdal Hospital Trust, Molde, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Marcelo Q Höxter
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Morgan Hough
- Highfield Unit Oxford, Warneford Hospital, Warneford Lane, Headington, Oxford, Oxfordshire, OX3 7JX, UK
| | - Hao Hu
- Shanghai Mental Health Center, Shanghai, China
| | - Chaim Huyser
- Levvel, academic center for child and adolescent care, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, University of Mississippi, Oxford, MS, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Anthony James
- Department of Psychiatry University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Fern Jaspers-Fayer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Selina Kasprzak
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - 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
| | - Kathrin Koch
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universitat Munchen, München, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Luisa Lazaro
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Junhee Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Uijeongbu, Republic of Korea
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Jin Lu
- Department of Psychiatry, First Affiliated Hospitalof Kunming Medical University, Kunming, China
| | - Daniela Rodriguez Manrique
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universitat Munchen, München, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-University, Munich, Germany
| | - Ignacio Martínez-Zalacaín
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Radiology, Bellvitge University Hospital, Barcelona, Spain
| | | | - Koji Matsumoto
- Chiba University Hospital, Chiba University, Chiba, Japan
| | - Maria Paula Maziero
- LIM 23, Instituto de Psiquiatria, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Faculty of Medicine, City University of Sao Paulo, Sao Paulo, Brazil
| | - Jose M Menchón
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Luciano Minuzzi
- Anxiety Treatment and Research Clinic, St. Joseph's Hamilton Healthcare, Hamilton, ON, Canada
- Dapartmente of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Janardhanan C Narayanaswamy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ana E Ortiz
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Junko Ota
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Jose C Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Chris Perriello
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Child Study Center, Yale University, New Haven, CT, USA
- Center for Brain and Mind Health, Yale University, New Haven, CT, USA
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Eva Real
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Y C Janardhan Reddy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Daan van Rooij
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André, Brazil
- Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Cinto Segalas
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Roseli G Shavitt
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Zonglin Shen
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Venkataram Shivakumar
- National Institute of Mental Health and Neurosciences, Department of Integrative Medicine, Bengaluru, India
| | - Noam Soreni
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Carles Soriano-Mas
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Mafalda Machado Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, USA
| | - Emily R Stern
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
- Clinical Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children's Hospital, Psychiatry, Vancouver, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Philip R Szeszko
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Rajat Thomas
- Weill-Cornell Medicine Qatar, Education City, Doha, Qatar
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ganesan Venkatasubramanian
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Chris Vriend
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anri Watanabe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Lidewij Wolters
- Norwegian University of Science and Technology (NTNU), Faculty of Medicine, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Klostergata 46, 7030, Trondheim, Norway
| | - Jian Xu
- Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Qing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Willem B Bruin
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam UMC, Universiteit van Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Guido A van Wingen
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam UMC, Universiteit van Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | | | - Rachel Marsh
- Columbia University Medical College, Columbia University, New York, NY, USA
| | - Jiook Cha
- Department of Psychology, College of Social Sciences, Seoul National University, Seoul, Republic of Korea.
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
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Mar-Barrutia L, Ibarrondo O, Mar J, Real E, Segalàs C, Bertolín S, Aparicio MA, Plans G, Menchón JM, Alonso P. Sex differences in clinical response to deep brain stimulation in resistant obsessive-compulsive disorder. Span J Psychiatry Ment Health 2024:S2950-2853(24)00013-9. [PMID: 38331320 DOI: 10.1016/j.sjpmh.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Deep brain stimulation (DBS) is an effective alternative to treat severe refractory obsessive-compulsive disorder (OCD), although little is known on factors predicting response. The objective of this study was to explore potential sex differences in the pattern of response to DBS in OCD patients. METHODS We conducted a prospective observational study in 25 patients with severe resistant OCD. Response to treatment was defined as a ≥35% reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score. Logistic regression models were calculated to measure the likelihood of response at short and long-term follow-up by sex as measured by Y-BOCS score. Similar analyses were carried out to study changes in depressive symptomatology assessed with the Hamilton Depression Rating Scale (HDRS). Additionally, effect sizes were calculated to assess clinical significance. RESULTS We did not observe significant clinical differences between men and women prior to DBS implantation, nor in the response after one year of stimulation. At long-term follow-up, 76.9% of men could be considered responders to DBS versus only 33.3% of women. The final response odds ratio in men was 10.05 with significant confidence intervals (88.90-1.14). No other predictors of response were identified. The sex difference in Y-BOCS reduction was clinically significant, with an effect size of 3.2. The main limitation was the small sample size. CONCLUSIONS Our results suggest that gender could influence the long-term response to DBS in OCD, a finding that needs to be confirmed in new studies given the paucity of results on predictors of response to DBS.
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Affiliation(s)
- Lorea Mar-Barrutia
- OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge Hospital, Barcelona, Spain; Osakidetza Basque Health Service, Araba University Hospital, Department of Psychiatry, Vitoria-Gasteiz, Spain; Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
| | - Oliver Ibarrondo
- Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Research Unit, Arrasate-Mondragón, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Spain
| | - Javier Mar
- Osakidetza Basque Health Service, Debagoiena Integrated Health Organisation, Research Unit, Arrasate-Mondragón, Spain; Biodonostia Health Research Institute, Donostia-San Sebastián, Spain; Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Eva Real
- OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge Hospital, Barcelona, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain
| | - Cinto Segalàs
- OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge Hospital, Barcelona, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Spain
| | - Sara Bertolín
- OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge Hospital, Barcelona, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain
| | | | - Gerard Plans
- Department of Neurosurgery, Hospital de Bellvitge, Barcelona, Spain
| | - José Manuel Menchón
- OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge Hospital, Barcelona, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Spain
| | - Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge Hospital, Barcelona, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid, Spain; Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Spain.
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4
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Kim BG, Kim G, Abe Y, Alonso P, Ameis S, Anticevic A, Arnold PD, Balachander S, Banaj N, Bargalló N, Batistuzzo MC, Benedetti F, Bertolín S, Beucke JC, Bollettini I, Brem S, Brennan BP, Buitelaar JK, Calvo R, Castelo-Branco M, Cheng Y, Chhatkuli RB, Ciullo V, Coelho A, Couto B, Dallaspezia S, Ely BA, Ferreira S, Fontaine M, Fouche JP, Grazioplene R, Gruner P, Hagen K, Hansen B, Hanna GL, Hirano Y, Höxter MQ, Hough M, Hu H, Huyser C, Ikuta T, Jahanshad N, James A, Jaspers-Fayer F, Kasprzak S, Kathmann N, Kaufmann C, Kim M, Koch K, Kvale G, Kwon JS, Lazaro L, Lee J, Lochner C, Lu J, Manrique DR, Martínez-Zalacaín I, Masuda Y, Matsumoto K, Maziero MP, Menchón JM, Minuzzi L, Moreira PS, Morgado P, Narayanaswamy JC, Narumoto J, Ortiz AE, Ota J, Pariente JC, Perriello C, Picó-Pérez M, Pittenger C, Poletti S, Real E, Reddy YCJ, van Rooij D, Sakai Y, Sato JR, Segalas C, Shavitt RG, Shen Z, Shimizu E, Shivakumar V, Soreni N, Soriano-Mas C, Sousa N, Sousa MM, Spalletta G, Stern ER, Stewart SE, Szeszko PR, Thomas R, Thomopoulos SI, Vecchio D, Venkatasubramanian G, Vriend C, Walitza S, Wang Z, Watanabe A, Wolters L, Xu J, Yamada K, Yun JY, Zarei M, Zhao Q, Zhu X, Thompson PM, Bruin WB, van Wingen GA, Piras F, Piras F, Stein DJ, van den Heuvel OA, Simpson HB, Marsh R, Cha J. White matter diffusion estimates in obsessive-compulsive disorder across 1653 individuals: machine learning findings from the ENIGMA OCD Working Group. Mol Psychiatry 2024:10.1038/s41380-023-02392-6. [PMID: 38326559 DOI: 10.1038/s41380-023-02392-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/27/2023] [Accepted: 12/19/2023] [Indexed: 02/09/2024]
Abstract
White matter pathways, typically studied with diffusion tensor imaging (DTI), have been implicated in the neurobiology of obsessive-compulsive disorder (OCD). However, due to limited sample sizes and the predominance of single-site studies, the generalizability of OCD classification based on diffusion white matter estimates remains unclear. Here, we tested classification accuracy using the largest OCD DTI dataset to date, involving 1336 adult participants (690 OCD patients and 646 healthy controls) and 317 pediatric participants (175 OCD patients and 142 healthy controls) from 18 international sites within the ENIGMA OCD Working Group. We used an automatic machine learning pipeline (with feature engineering and selection, and model optimization) and examined the cross-site generalizability of the OCD classification models using leave-one-site-out cross-validation. Our models showed low-to-moderate accuracy in classifying (1) "OCD vs. healthy controls" (Adults, receiver operator characteristic-area under the curve = 57.19 ± 3.47 in the replication set; Children, 59.8 ± 7.39), (2) "unmedicated OCD vs. healthy controls" (Adults, 62.67 ± 3.84; Children, 48.51 ± 10.14), and (3) "medicated OCD vs. unmedicated OCD" (Adults, 76.72 ± 3.97; Children, 72.45 ± 8.87). There was significant site variability in model performance (cross-validated ROC AUC ranges 51.6-79.1 in adults; 35.9-63.2 in children). Machine learning interpretation showed that diffusivity measures of the corpus callosum, internal capsule, and posterior thalamic radiation contributed to the classification of OCD from HC. The classification performance appeared greater than the model trained on grey matter morphometry in the prior ENIGMA OCD study (our study includes subsamples from the morphometry study). Taken together, this study points to the meaningful multivariate patterns of white matter features relevant to the neurobiology of OCD, but with low-to-moderate classification accuracy. The OCD classification performance may be constrained by site variability and medication effects on the white matter integrity, indicating room for improvement for future research.
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Affiliation(s)
- Bo-Gyeom Kim
- Department of Psychology, College of Social Sciences, Seoul National University, Seoul, Republic of Korea
| | - Gakyung Kim
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Yoshinari Abe
- Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Department of Psychiatry, Kyoto City, Japan
| | - Pino Alonso
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Stephanie Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Srinivas Balachander
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Nuria Bargalló
- Center of Image Diagnostic, Hospital Clínic de Barcelona, Barcelona, Spain
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marcelo C Batistuzzo
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, SP, Brazil
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Sara Bertolín
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
| | - Jan Carl Beucke
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Psychology, Medical School Hamburg, Hamburg, Germany
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Brian P Brennan
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jan K Buitelaar
- Radboudumc, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Rosa Calvo
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548, Coimbra, Portugal
- Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ritu Bhusal Chhatkuli
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ana Coelho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Beatriz Couto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Sara Dallaspezia
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benjamin A Ely
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Martine Fontaine
- Columbia University Medical College, Columbia University, New York, NY, USA
| | - Jean-Paul Fouche
- SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Cape Town, South Africa
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Kristen Hagen
- Hospital of Molde, Møre og Romsdal Hospital Trust, Molde, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Marcelo Q Höxter
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Morgan Hough
- Highfield Unit Oxford, Warneford Hospital, Warneford Lane, Headington, Oxford, Oxfordshire, OX3 7JX, UK
| | - Hao Hu
- Shanghai Mental Health Center, Shanghai, China
| | - Chaim Huyser
- Levvel, academic center for child and adolescent care, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, University of Mississippi, Oxford, MS, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Anthony James
- Department of Psychiatry University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Fern Jaspers-Fayer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Selina Kasprzak
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - 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
| | - Kathrin Koch
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universitat Munchen, München, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Luisa Lazaro
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Junhee Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Uijeongbu, Republic of Korea
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Jin Lu
- Department of Psychiatry, First Affiliated Hospitalof Kunming Medical University, Kunming, China
| | - Daniela Rodriguez Manrique
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universitat Munchen, München, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-University, Munich, Germany
| | - Ignacio Martínez-Zalacaín
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Radiology, Bellvitge University Hospital, Barcelona, Spain
| | | | - Koji Matsumoto
- Chiba University Hospital, Chiba University, Chiba, Japan
| | - Maria Paula Maziero
- LIM 23, Instituto de Psiquiatria, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Faculty of Medicine, City University of Sao Paulo, Sao Paulo, Brazil
| | - Jose M Menchón
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Luciano Minuzzi
- Anxiety Treatment and Research Clinic, St. Joseph's Hamilton Healthcare, Hamilton, ON, Canada
- Dapartmente of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Janardhanan C Narayanaswamy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ana E Ortiz
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Junko Ota
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Jose C Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Chris Perriello
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Child Study Center, Yale University, New Haven, CT, USA
- Center for Brain and Mind Health, Yale University, New Haven, CT, USA
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Eva Real
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Y C Janardhan Reddy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Daan van Rooij
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André, Brazil
- Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Cinto Segalas
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Roseli G Shavitt
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Zonglin Shen
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Venkataram Shivakumar
- National Institute of Mental Health and Neurosciences, Department of Integrative Medicine, Bengaluru, India
| | - Noam Soreni
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Carles Soriano-Mas
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Mafalda Machado Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, USA
| | - Emily R Stern
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
- Clinical Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children's Hospital, Psychiatry, Vancouver, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Philip R Szeszko
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Rajat Thomas
- Weill-Cornell Medicine Qatar, Education City, Doha, Qatar
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ganesan Venkatasubramanian
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Chris Vriend
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anri Watanabe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Lidewij Wolters
- Norwegian University of Science and Technology (NTNU), Faculty of Medicine, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Klostergata 46, 7030, Trondheim, Norway
| | - Jian Xu
- Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Qing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Willem B Bruin
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam UMC, Universiteit van Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Guido A van Wingen
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam UMC, Universiteit van Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | | | - Rachel Marsh
- Columbia University Medical College, Columbia University, New York, NY, USA
| | - Jiook Cha
- Department of Psychology, College of Social Sciences, Seoul National University, Seoul, Republic of Korea.
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
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Okutman O, Gürbüz AS, Büyük U, Real E, Leconte R, Chennen K, Mayer C, Muller J, Le May N, Viville S. Pathogenic missense variation in PABPC1L/EPAB causes female infertility due to oocyte maturation arrest at the germinal vesicle stage. J Assist Reprod Genet 2024; 41:311-322. [PMID: 38177974 PMCID: PMC10894787 DOI: 10.1007/s10815-023-03009-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/13/2023] [Indexed: 01/06/2024] Open
Abstract
Women undergoing controlled ovarian hyperstimulation prior to in vitro fertilization (IVF) are treated using various protocols to induce multiple follicular growths. Complete failure of all oocytes to mature during IVF cycles is rare; however, it is a known cause of primary female infertility. Recently, pathogenic variations in a few genes have been identified in women with oocyte maturation defects; however, the underlying genetic causes remain largely unknown.This study included a Turkish family comprising three sisters with recurring oocyte maturation arrest at the germinal vesicle stage after multiple ovarian stimulations. Exome sequencing revealed a homozygous missense variant (c.1037C>T, p.Ala346Val) in the EPAB gene (also known as PABPC1L) in all three affected sisters, which was either absent or heterozygous in the unaffected family members. Functional experiments confirming the pathogenicity of the variant were performed by transfecting HEK293T cells and demonstrated the instability and increased rate of proteolysis of the mutated PABPC1L/EPAB protein. The identified variant, located in the well-conserved fourth RNA recognition motif (RRM4), in silico 3D modelling suggested changes in the physical properties of the pathogenic variant of PABPC1L/EPAB. Our findings validate PABPC1L/EPAB as an essential genetic contributor to the oocyte maturation process in humans and have direct implications for the genetic counselling of patients and their family members.
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Affiliation(s)
- O Okutman
- Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B), Hôpital Erasme, Service de Gynécologie-Obstetrique, Clinique de Fertilité, Route de Lennik, 808, 1070, Brussels, Belgium
| | | | - U Büyük
- Department of Molecular Biology and Genetics, Institute of Graduate Studies in Sciences, Istanbul University, Istanbul, Turkey
| | - E Real
- Laboratoire de Génétique Médicale LGM, Institut de Génétique Médicale d'Alsace IGMA, INSERM UMR 1112, Université de Strasbourg, Strasbourg, France
| | - R Leconte
- Laboratoire de Génétique Médicale LGM, Institut de Génétique Médicale d'Alsace IGMA, INSERM UMR 1112, Université de Strasbourg, Strasbourg, France
| | - K Chennen
- Complex Systems and Translational Bioinformatics, ICube UMR 7357, Université de Strasbourg, 67000, Strasbourg, France
| | - C Mayer
- Complex Systems and Translational Bioinformatics, ICube UMR 7357, Université de Strasbourg, 67000, Strasbourg, France
- UFR Sciences de La Vie, Université Paris Cité, 75013, Paris, France
| | - J Muller
- Laboratoire de Génétique Médicale LGM, Institut de Génétique Médicale d'Alsace IGMA, INSERM UMR 1112, Université de Strasbourg, Strasbourg, France
- Unité Fonctionnelle de Bioinformatique Médicale Appliquée Au Diagnostic (UF7363), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - N Le May
- Laboratoire de Génétique Médicale LGM, Institut de Génétique Médicale d'Alsace IGMA, INSERM UMR 1112, Université de Strasbourg, Strasbourg, France
| | - S Viville
- Laboratoire de Génétique Médicale LGM, Institut de Génétique Médicale d'Alsace IGMA, INSERM UMR 1112, Université de Strasbourg, Strasbourg, France.
- Laboratoire de Diagnostic Génétique, Unité de Génétique de L'infertilité (UF3472), Hôpitaux Universitaires de Strasbourg, 67091, Strasbourg, France.
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6
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Alemany-Navarro M, Tubío-Fungueiriño M, Diz-de Almeida S, Cruz R, Lombroso A, Real E, Soria V, Bertolín S, Fernández-Prieto M, Alonso P, Menchón JM, Carracedo A, Segalàs C. The genomics of visuospatial neurocognition in obsessive-compulsive disorder: A preliminary GWAS. J Affect Disord 2023; 333:365-376. [PMID: 37094658 DOI: 10.1016/j.jad.2023.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND The study of Obsessive-Compulsive Disorder (OCD) genomics has primarily been tackled by Genome-wide association studies (GWAS), which have encountered troubles in identifying replicable single nucleotide polymorphisms (SNPs). Endophenotypes have emerged as a promising avenue of study in trying to elucidate the genomic bases of complex traits such as OCD. METHODS We analyzed the association of SNPs across the whole genome with the construction of visuospatial information and executive performance through four neurocognitive variables assessed by the Rey-Osterrieth Complex Figure Test (ROCFT) in a sample of 133 OCD probands. Analyses were performed at SNP- and gene-level. RESULTS No SNP reached genome-wide significance, although there was one SNP almost reaching significant association with copy organization (rs60360940; P = 9.98E-08). Suggestive signals were found for the four variables at both SNP- (P < 1E-05) and gene-levels (P < 1E-04). Most of the suggestive signals pointed to genes and genomic regions previously associated with neurological function and neuropsychological traits. LIMITATIONS Our main limitations were the sample size, which was limited to identify associated signals at a genome-wide level, and the composition of the sample, more representative of rather severe OCD cases than a population-based OCD sample with a broad severity spectrum. CONCLUSIONS Our results suggest that studying neurocognitive variables in GWAS would be more informative on the genetic basis of OCD than the classical case/control GWAS, facilitating the genetic characterization of OCD and its different clinical profiles, the development of individualized treatment approaches, and the improvement of prognosis and treatment response.
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Affiliation(s)
- M Alemany-Navarro
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; IBIS (Universidad de Sevilla, HUVR, Junta de Andalucia, CSIC) Sevilla, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain.
| | - M Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - S Diz-de Almeida
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - R Cruz
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - A Lombroso
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - E Real
- Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - V Soria
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - S Bertolín
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Fernández-Prieto
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - P Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - A Carracedo
- Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - C Segalàs
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
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Tubío-Fungueiriño M, Alemany-Navarro M, Alonso P, Arrojo M, Real E, Bertolin S, Menchón JM, Carracedo A, Fernández-Prieto M, Segalàs C. Neuropsychological performance and predictors of pharmacological treatment response in obsessive compulsive disorder. J Affect Disord 2022; 317:52-58. [PMID: 36029870 DOI: 10.1016/j.jad.2022.08.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/09/2022] [Accepted: 08/21/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obsessive Compulsive Disorder (OCD) is characterized by the presence of executive dysfunctions. As organizational strategies may play an important role as a possible endophenotype of the disorder, we decided to investigate non-verbal memory and organizational abilities in OCD. We also investigated how organization and non-verbal memory differ between responder and non-responder patients to pharmacological treatment, to test whether cognitive functions can predict the response to pharmacological treatment. METHODS In Study 1, executive and clinical functioning measures were applied to 162 OCD and 95 controls. In Study 2, clinical, intelligence and executive functioning measures were applied to 72 OCD responders and 63 OCD non-responder patients. RESULTS OCD patients and controls from Study 1 differed in copy organization (p < 0.01) and delayed recall (p = 0.048). In Study 2, the OCD responders displayed better copy organization (p = 0.013) and lower depressive, anxious and OCD symptoms (p < 0.01 in the three cases). Scores in the following instruments were found to predict the response to pharmacological treatment: HDRS, Y-BOCS, Raven progressive matrices, and Direct digit subtest from the Wechsler's scale (p < 0.01 in all four cases). LIMITATIONS In Study 1, the imbalance of the sample can be considered a limitation, whilst in Study 2, some of the levels of pharmacological resistance were not represented. CONCLUSIONS In this study, non-verbal memory and organization was affected in OCD. Responder patients also displayed better executive functioning and fluid intelligence. Organizational ability is a predictor of pharmacological response to SSRI monotherapy in a predictive model controlling for anxious symptoms.
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Affiliation(s)
- M Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - M Alemany-Navarro
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - P Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - M Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - E Real
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - S Bertolin
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - A Carracedo
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain; Fundación Pública Galega de Medicina Xenómica- IDIS, SERGAS, Santiago de Compostela, Spain
| | - M Fernández-Prieto
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain.
| | - C Segalàs
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
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8
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Tubío-Fungueiriño M, Cernadas E, Gonçalves ÓF, Segalas C, Bertolín S, Mar-Barrutia L, Real E, Fernández-Delgado M, Menchón JM, Carvalho S, Alonso P, Carracedo A, Fernández-Prieto M. Viability Study of Machine Learning-Based Prediction of COVID-19 Pandemic Impact in Obsessive-Compulsive Disorder Patients. Front Neuroinform 2022; 16:807584. [PMID: 35221957 PMCID: PMC8866769 DOI: 10.3389/fninf.2022.807584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/10/2022] [Indexed: 11/22/2022] Open
Abstract
Background Machine learning modeling can provide valuable support in different areas of mental health, because it enables to make rapid predictions and therefore support the decision making, based on valuable data. However, few studies have applied this method to predict symptoms’ worsening, based on sociodemographic, contextual, and clinical data. Thus, we applied machine learning techniques to identify predictors of symptomatologic changes in a Spanish cohort of OCD patients during the initial phase of the COVID-19 pandemic. Methods 127 OCD patients were assessed using the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) and a structured clinical interview during the COVID-19 pandemic. Machine learning models for classification (LDA and SVM) and regression (linear regression and SVR) were constructed to predict each symptom based on patient’s sociodemographic, clinical and contextual information. Results A Y-BOCS score prediction model was generated with 100% reliability at a score threshold of ± 6. Reliability of 100% was reached for obsessions and/or compulsions related to COVID-19. Symptoms of anxiety and depression were predicted with less reliability (correlation R of 0.58 and 0.68, respectively). The suicidal thoughts are predicted with a sensitivity of 79% and specificity of 88%. The best results are achieved by SVM and SVR. Conclusion Our findings reveal that sociodemographic and clinical data can be used to predict changes in OCD symptomatology. Machine learning may be valuable tool for helping clinicians to rapidly identify patients at higher risk and therefore provide optimized care, especially in future pandemics. However, further validation of these models is required to ensure greater reliability of the algorithms for clinical implementation to specific objectives of interest.
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Affiliation(s)
- María Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
- Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Eva Cernadas
- Centro Singular de Investigación en Tecnoloxías Intelixentes (CiTIUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Óscar F. Gonçalves
- Proaction Lab, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Department of Physical Medicine and Rehabilitation, Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA, United States
| | - Cinto Segalas
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
- Institut d’ Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - Sara Bertolín
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
- Institut d’ Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Lorea Mar-Barrutia
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Eva Real
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
- Institut d’ Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Fernández-Delgado
- Centro Singular de Investigación en Tecnoloxías Intelixentes (CiTIUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Jose M. Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
- Institut d’ Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - Sandra Carvalho
- Translational Neuropsychology Lab, Department of Education and Psychology and William James Center for Research (WJCR), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Pino Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
- Institut d’ Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - Angel Carracedo
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Genetics Group GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
- Grupo de Medicina Xenómica, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Montse Fernández-Prieto
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
- Genetics Group GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
- *Correspondence: Montse Fernández-Prieto,
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Mar-Barrutia L, Real E, Segalás C, Bertolín S, Menchón JM, Alonso P. Deep brain stimulation for obsessive-compulsive disorder: A systematic review of worldwide experience after 20 years. World J Psychiatry 2021; 11:659-680. [PMID: 34631467 PMCID: PMC8474989 DOI: 10.5498/wjp.v11.i9.659] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/02/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Twenty years after its first use in a patient with obsessive-compulsive disorder (OCD), the results confirm that deep brain stimulation (DBS) is a promising therapy for patients with severe and resistant forms of the disorder. Nevertheless, many unknowns remain, including the optimal anatomical targets, the best stimulation parameters, the long-term (LT) effects of the therapy, and the clinical or biological factors associated with response. This systematic review of the articles published to date on DBS for OCD assesses the short and LT efficacy of the therapy and seeks to identify predictors of response.
AIM To summarize the existing knowledge on the efficacy and tolerability of DBS in treatment-resistant OCD.
METHODS A comprehensive search was conducted in the PubMed, Cochrane, Scopus, and ClinicalTrials.gov databases from inception to December 31, 2020, using the following strategy: “(Obsessive-compulsive disorder OR OCD) AND (deep brain stimulation OR DBS).” Clinical trials and observational studies published in English and evaluating the effectiveness of DBS for OCD in humans were included and screened for relevant information using a standardized collection tool. The inclusion criteria were as follows: a main diagnosis of OCD, DBS conducted for therapeutic purposes and variation in symptoms of OCD measured by the Yale-Brown Obsessive-Compulsive scale (Y-BOCS) as primary outcome. Data were analyzed with descriptive statistics.
RESULTS Forty articles identified by the search strategy met the eligibility criteria. Applying a follow-up threshold of 36 mo, 29 studies (with 230 patients) provided information on short-term (ST) response to DBS in, while 11 (with 155 patients) reported results on LT response. Mean follow-up period was 18.5 ± 8.0 mo for the ST studies and 63.7 ± 20.7 mo for the LT studies. Overall, the percentage of reduction in Y-BOCS scores was similar in ST (47.4%) and LT responses (47.2%) to DBS, but more patients in the LT reports met the criteria for response (defined as a reduction in Y-BOCS scores > 35%: ST, 60.6% vs LT, 70.7%). According to the results, the response in the first year predicts the extent to which an OCD patient will benefit from DBS, since the maximum symptom reduction was achieved in most responders in the first 12-14 mo after implantation. Reports indicate a consistent tendency for this early improvement to be maintained to the mid-term for most patients; but it is still controversial whether this improvement persists, increases or decreases in the long term. Three different patterns of LT response emerged from the analysis: 49.5% of patients had good and sustained response to DBS, 26.6% were non responders, and 22.5% were partial responders, who might improve at some point but experience relapses during follow-up. A significant improvement in depressive symptoms and global functionality was observed in most studies, usually (although not always) in parallel with an improvement in obsessive symptoms. Most adverse effects of DBS were mild and transient and improved after adjusting stimulation parameters; however, some severe adverse events including intracranial hemorrhages and infections were also described. Hypomania was the most frequently reported psychiatric side effect. The relationship between DBS and suicide risk is still controversial and requires further study. Finally, to date, no clear clinical or biological predictors of response can be established, probably because of the differences between studies in terms of the neuroanatomical targets and stimulation protocols assessed.
CONCLUSION The present review confirms that DBS is a promising therapy for patients with severe resistant OCD, providing both ST and LT evidence of efficacy.
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Affiliation(s)
- Lorea Mar-Barrutia
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona 08907, Spain
| | - Eva Real
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona 08907, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Barcelona 08907, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid 28029, Spain
| | - Cinto Segalás
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona 08907, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Barcelona 08907, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid 28029, Spain
| | - Sara Bertolín
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona 08907, Spain
| | - José Manuel Menchón
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona 08907, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Barcelona 08907, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid 28029, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona 08907, Spain
| | - Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona 08907, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Barcelona 08907, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Madrid 28029, Spain
- Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona 08907, Spain
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10
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Cano M, Martínez-Zalacaín I, Giménez M, Torrents-Rodas D, Real E, Alonso P, Segalàs C, Munuera J, Menchón JM, Cardoner N, Soriano-Mas C, Fullana MA. Neural correlates of fear conditioning and fear extinction and its association with cognitive-behavioral therapy outcome in adults with obsessive-compulsive disorder. Behav Res Ther 2021; 144:103927. [PMID: 34237645 DOI: 10.1016/j.brat.2021.103927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/23/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022]
Abstract
Recent neurobiological models of obsessive-compulsive disorder (OCD) have highlighted the potential role of abnormalities in fear learning processes. We compared brain activation -as assessed with whole-brain functional magnetic resonance imaging- during fear conditioning, fear extinction learning, and fear extinction recall in patients with OCD (n = 18) and healthy controls (n = 18). We also investigated whether brain activation during any of these processes was associated with exposure-based cognitive-behavioral therapy (CBT) outcome in patients. Patients with OCD showed significantly lower brain activation in the right insulo-opercular region and the dorsal anterior cingulate cortex during fear conditioning in comparison to healthy controls. Moreover, brain activation in the right insula predicted CBT outcome, with lower activation predicting a better outcome. Brain activation during extinction learning or recall did not differ between patients and controls or predicted CBT outcome in patients. Our results suggest that neural activations during fear conditioning in patients with OCD are abnormal and predict CBT outcome.
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Affiliation(s)
- Marta Cano
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Tauli (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Sabadell, Spain; Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, and CIBERSAM, Carlos III Health Institute, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Mònica Giménez
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, and CIBERSAM, Carlos III Health Institute, L'Hospitalet de Llobregat, Spain
| | | | - Eva Real
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, and CIBERSAM, Carlos III Health Institute, L'Hospitalet de Llobregat, Spain
| | - Pino Alonso
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, and CIBERSAM, Carlos III Health Institute, L'Hospitalet de Llobregat, Spain
| | - Cinto Segalàs
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, and CIBERSAM, Carlos III Health Institute, L'Hospitalet de Llobregat, Spain
| | - Josep Munuera
- Diagnostic Imaging Department, Fundació de Recerca Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - José Manuel Menchón
- Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, and CIBERSAM, Carlos III Health Institute, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Narcís Cardoner
- Mental Health Department, Unitat de Neurociència Traslacional, Parc Tauli University Hospital, Institut d'Investigació i Innovació Sanitària Parc Tauli (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Sabadell, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Carles Soriano-Mas
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Bellaterra, Spain; Department of Psychiatry, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, and CIBERSAM, Carlos III Health Institute, L'Hospitalet de Llobregat, Spain.
| | - Miquel A Fullana
- Adult Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERSAM, Barcelona, Spain.
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11
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Alonso P, Bertolín S, Segalàs J, Tubío-Fungueiriño M, Real E, Mar-Barrutia L, Fernández-Prieto M, Carvalho S, Carracedo A, Menchón JM. How is COVID-19 affecting patients with obsessive-compulsive disorder? A longitudinal study on the initial phase of the pandemic in a Spanish cohort. Eur Psychiatry 2021; 64:e45. [PMID: 34100343 PMCID: PMC8280462 DOI: 10.1192/j.eurpsy.2021.2214] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although the consequences of the COVID-19 pandemic on emotional health are evident, little is known about its impact on patients with obsessive-compulsive disorder (OCD). METHODS One hundred and twenty-seven patients with OCD who attended a specialist OCD Clinic in Barcelona, Spain, were assessed by phone from April 27 to May 25, 2020, during the early phase of the pandemic, using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and a structured interview that collected clinical and sociodemographic information. Results were compared with those for 237 healthy controls from the same geographic area who completed an online survey. RESULTS Although 65.3% of the patients with OCD described a worsening of their symptoms, only 31.4% had Y-BOCS scores that increased >25%. The risk of getting infected by SARS-CoV2 was reported as a new obsession by 44.8%, but this only became the main obsessive concern in approximately 10% of the patients. Suicide-related thoughts were more frequent among the OCD cohort than among healthy controls. The presence of prepandemic depression, higher Y-BOCS scores, contamination/washing symptoms, and lower perceived social support all predicted a significantly increased risk of OCD worsening. CONCLUSIONS Most patients with OCD appear to be capable of coping with the emotional stress of the COVID-19 outbreak and its consequences during the initial phase of the pandemic. Nevertheless, the current crisis constitutes a risk factor for a significant worsening of symptoms and suicidal ideation. Action is needed to ensure effective and individualized follow-up care for patients with OCD in the COVID-19 era.
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Affiliation(s)
- P Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain.,CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - S Bertolín
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - J Segalàs
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain.,CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - M Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain.,Grupo de Medicina Xenómica, U‑711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain.,Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - E Real
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - L Mar-Barrutia
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - M Fernández-Prieto
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain.,Grupo de Medicina Xenómica, U‑711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain.,Grupo de Genética, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - S Carvalho
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal.,Department of Education and Psychology, University of Aveiro, Portugal; Department of Biology and William James Center for Research, University of Aveiro, Portugal
| | - A Carracedo
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain.,Grupo de Medicina Xenómica, U‑711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain.,Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain.,Grupo de Genética, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain.,CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
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12
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Bertolín S, Alonso P, Segalàs C, Real E, Alemany-Navarro M, Soria V, Jiménez-Murcia S, Crespo JM, Menchón JM. First manic/hypomanic episode in obsessive-compulsive disorder patients treated with antidepressants: A systematic review. J Psychiatr Res 2021; 137:319-327. [PMID: 33744511 DOI: 10.1016/j.jpsychires.2021.02.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/28/2022]
Abstract
High doses of antidepressants, particularly clomipramine and selective serotonin reuptake inhibitors (SSRIs), are the well-established treatment for obsessive-compulsive disorder (OCD), but manic/hypomanic episodes are potential adverse events associated with this treatment. A systematic literature review was performed on manic/hypomanic episodes in non-bipolar OCD patients. Clinical, sociodemographic and antidepressant characteristics during the manic/hypomanic switch were extracted using descriptive statistics. Data were obtained from 20 case reports and case series. Switching episodes mostly appeared in the first 12 weeks after antidepressant initiation and took place more frequently during SSRI use (mostly fluoxetine) in 64.3% of cases. Clomipramine and SSRI use differed non-significantly between the switching episodes that appeared during the first 12 weeks of antidepressant treatment and the episodes that appeared beyond 12 weeks. Switching episodes emerging before 12 weeks were associated with a lower defined daily dose of antidepressants than episodes emerging after 12 weeks. These findings suggest that there are two independent characteristics involved in manic/hypomanic switch in OCD: a) they appeared most frequently with SSRI use (fluoxetine) regardless of the time of it use, and b) episodes appeared in the first 12 weeks after SSRI or clomipramine initiation had a lower dose of antidepressant than episodes appeared after 12 weeks.
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Affiliation(s)
- Sara Bertolín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain
| | - Cinto Segalàs
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain
| | - Eva Real
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - María Alemany-Navarro
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain
| | - Virginia Soria
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ciber Fisiopatología Obsesidad, Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - José Manuel Crespo
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain.
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13
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Cano-Catala M, Martinez-Zalacain I, Real E, Alonso P, Menchon J, Álvarez NC, Fullana M, Soriano-Mas C. Neurofunctional predictive biomarkers of cognitive-behavioral therapy during fear conditioning in patients with obsessive-compulsive disorder. Eur Psychiatry 2021. [PMCID: PMC9470821 DOI: 10.1192/j.eurpsy.2021.376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction Altered fear learning processes could be mechanistically linked to the development and/or maintenance of obsessive-compulsive disorder (OCD). From a clinical perspective, the first-line psychological treatment for OCD is cognitive-behavioral therapy (CBT), which is based on the principles of fear learning. However, no previous functional magnetic resonance imaging (fMRI) studies have evaluated the predictive capacity of regional brain activations during fear learning on CBT response in patients with OCD. Objectives We aimed at exploring whether brain activation during fear learning in patients with OCD are associated with CBT outcome. Methods We assessed 18 patients with OCD and 18 healthy participants during a 2-day experimental protocol where brain activation and skin conductance responses (SCR) where assessed during fear conditioning, extinction learning, and extinction recall within the fMRI scanner. Following the protocol, patients with OCD received CBT. Results We found non-significant between-group differences in SCR during fear learning. Patients with OCD showed significantly diminished activation of the dorsal anterior cingulate cortex and the right insula during fear conditioning. Importantly, our analyses revealed a significant negative association between clinical improvement after CBT and activity at the right insula during fear conditioning (x = 39, y = 12, z = -11; t = 5.64; p<0.001; k = 928). This finding is displayed in Figure 1 below.![]() Conclusions Patients with OCD may require less fear-conditioned brain responses to achieve the same level of psychophysiological fear conditioning as healthy participants. Interestingly, insula activations during fear-conditioned responses may represent a potential predictor biomarker of response to CBT for OCD. Disclosure No significant relationships.
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Salvat-Pujol N, Labad J, Urretavizcaya M, de Arriba-Arnau A, Segalàs C, Real E, Ferrer A, Crespo JM, Jiménez-Murcia S, Soriano-Mas C, Menchón JM, Soria V. Childhood maltreatment interacts with hypothalamic-pituitary-adrenal axis negative feedback and major depression: effects on cognitive performance. Eur J Psychotraumatol 2021; 12:1857955. [PMID: 33796230 PMCID: PMC7968873 DOI: 10.1080/20008198.2020.1857955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: Childhood maltreatment (CM) is associated with impaired hypothalamic-pituitary-adrenal (HPA) axis negative feedback and cognitive dysfunction, resembling those abnormalities linked to major depressive disorder (MDD). Objectives: We aimed to assess the potential modulating effects of MDD diagnosis or HPA axis function in the association between different types of CM and cognitive performance in adulthood. Methods: Sixty-eight MDD patients and 87 healthy controls were recruited. CM was assessed with the Childhood Trauma Questionnaire. We obtained three latent variables for neuropsychological performance (verbal memory, visual memory and executive function/processing speed) after running a confirmatory factor analysis with cognitive tests applied. Dexamethasone suppression test ratio (DSTR) was performed using dexamethasone 0.25 mg. Results: Different types of CM had different effects on cognition, modulated by MDD diagnosis and HPA axis function. Individuals with physical maltreatment and MDD presented with enhanced cognition in certain domains. The DSTR differentially modulated the association between visual memory and physical neglect or sexual abuse. Conclusions: HPA axis-related neurobiological mechanisms leading to cognitive impairment might differ depending upon the type of CM. Our results suggest a need for early assessment and intervention on cognition and resilience mechanisms in individuals exposed to CM to minimize its deleterious and lasting effects.
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Affiliation(s)
- Neus Salvat-Pujol
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Corporació Sanitària Parc Taulí, Department of Mental Health, I3PT, Sabadell, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Javier Labad
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Institut d'Investigació i Innovació Parc Taulí (I3PT), Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Spain
| | - Mikel Urretavizcaya
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Aida de Arriba-Arnau
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Cinto Segalàs
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Eva Real
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Alex Ferrer
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Corporació Sanitària Parc Taulí, Department of Mental Health, I3PT, Sabadell, Spain
| | - José M Crespo
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología Obesidad y Nutrición (CIBEROBN), Carlos III Health Institute, Madrid, Spain
| | - Carles Soriano-Mas
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - José M Menchón
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Virginia Soria
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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15
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Segalàs C, Labad J, Salvat-Pujol N, Real E, Alonso P, Bertolín S, Jiménez-Murcia S, Soriano-Mas C, Monasterio C, Menchón JM, Soria V. Sleep disturbances in obsessive-compulsive disorder: influence of depression symptoms and trait anxiety. BMC Psychiatry 2021; 21:42. [PMID: 33446149 PMCID: PMC7809865 DOI: 10.1186/s12888-021-03038-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/28/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Sleep disturbances have been reported in obsessive-compulsive disorder (OCD) patients, with heterogeneous results. The aim of our study was to assess sleep function in OCD and to investigate the relationship between sleep and the severity of obsessive-compulsive (OC) symptoms, depressive symptoms and trait anxiety. METHODS Sleep quality was measured in 61 OCD patients and 100 healthy controls (HCs) using the Pittsburgh Sleep Quality Index (PSQI). Multiple linear regression was conducted to explore the association between sleep and psychopathological measures; a mediation analysis was also performed. RESULTS OCD patients showed poor sleep quality and more sleep disturbances compared to HCs. The severity of depression, trait anxiety and OC symptomatology were correlated with poor sleep quality. Multiple linear regression analyses controlling for potential confounders revealed that the severity of depression and trait anxiety were independently related to poor sleep quality in OCD. A mediation analysis showed that both the severity of trait anxiety and depression mediate the relationship between the severity of OC symptoms and poor sleep quality among patients with OCD. CONCLUSIONS Our findings support the existence of sleep disturbances in OCD. Trait anxiety and depression play a key role in sleep quality among OCD patients.
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Affiliation(s)
- Cinto Segalàs
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Javier Labad
- grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain ,Department of Mental Health, Consorci Sanitari del Maresme. Institut d’Investigació i Innovació Parc Taulí(I3PT), Barcelona, Spain
| | - Neus Salvat-Pujol
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain ,Department of Mental Health, Consorci Sanitari del Maresme. Institut d’Investigació i Innovació Parc Taulí(I3PT), Barcelona, Spain
| | - Eva Real
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain
| | - Pino Alonso
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Sara Bertolín
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Susana Jiménez-Murcia
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fisiopatología Obesidad y Nutrición (CIBEROBN), Carlos III Health Institute, Madrid, Spain
| | - Carles Soriano-Mas
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain ,grid.7080.fDepartment of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Carmen Monasterio
- grid.417656.7Multidisciplinary Sleep Unit, Department of Respiratory Medicine, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Section of Respiratory Medicine, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Carlos III Health Institute, Madrid, Spain
| | - José M. Menchón
- grid.411129.e0000 0000 8836 0780Department of Psychiatry, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Feixa Llarga s/n. 08907, L’Hospitalet de Llobregat, Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Virginia Soria
- Department of Psychiatry, Bellvitge University Hospital. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Feixa Llarga s/n. 08907, L'Hospitalet de Llobregat, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Madrid, Spain. .,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
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16
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Menchón JM, Real E, Alonso P, Aparicio MA, Segalas C, Plans G, Luyten L, Brunfaut E, Matthijs L, Raymakers S, Bervoets C, Higueras A, Katati M, Guerrero J, Hurtado M, Prieto M, Stieglitz LH, Löffelholz G, Walther S, Pollo C, Zurowski B, Tronnier V, Kordon A, Gambini O, Ranieri R, Franzini A, Messina G, Radu-Djurfeldt D, Schechtmann G, Chen LL, Eitan R, Israel Z, Bergman H, Brelje T, Brionne TC, Conseil A, Gielen F, Schuepbach M, Nuttin B, Gabriëls L. A prospective international multi-center study on safety and efficacy of deep brain stimulation for resistant obsessive-compulsive disorder. Mol Psychiatry 2021; 26:1234-1247. [PMID: 31664175 PMCID: PMC7985042 DOI: 10.1038/s41380-019-0562-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 09/30/2019] [Accepted: 10/12/2019] [Indexed: 02/07/2023]
Abstract
Deep brain stimulation (DBS) has been proposed for severe, chronic, treatment-refractory obsessive-compulsive disorder (OCD) patients. Although serious adverse events can occur, only a few studies report on the safety profile of DBS for psychiatric disorders. In a prospective, open-label, interventional multi-center study, we examined the safety and efficacy of electrical stimulation in 30 patients with DBS electrodes bilaterally implanted in the anterior limb of the internal capsule. Safety, efficacy, and functionality assessments were performed at 3, 6, and 12 months post implant. An independent Clinical Events Committee classified and coded all adverse events (AEs) according to EN ISO14155:2011. All patients experienced AEs (195 in total), with the majority of these being mild (52% of all AEs) or moderate (37%). Median time to resolution was 22 days for all AEs and the etiology with the highest AE incidence was 'programming/stimulation' (in 26 patients), followed by 'New illness, injury, condition' (13 patients) and 'pre-existing condition, worsening or exacerbation' (11 patients). Sixteen patients reported a total of 36 serious AEs (eight of them in one single patient), mainly transient anxiety and affective symptoms worsening (20 SAEs). Regarding efficacy measures, Y-BOCS reduction was 42% at 12 months and the responder rate was 60%. Improvements in GAF, CGI, and EuroQol-5D index scores were also observed. In sum, although some severe AEs occurred, most AEs were mild or moderate, transient and related to programming/stimulation and tended to resolve by adjustment of stimulation. In a severely treatment-resistant population, this open-label study supports that the potential benefits outweigh the potential risks of DBS.
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Affiliation(s)
- José M. Menchón
- grid.5841.80000 0004 1937 0247Bellvitge University Hospital-IDIBELL, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Eva Real
- grid.5841.80000 0004 1937 0247Bellvitge University Hospital-IDIBELL, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Pino Alonso
- grid.5841.80000 0004 1937 0247Bellvitge University Hospital-IDIBELL, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Marco Alberto Aparicio
- grid.5841.80000 0004 1937 0247Bellvitge University Hospital-IDIBELL, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Cinto Segalas
- grid.5841.80000 0004 1937 0247Bellvitge University Hospital-IDIBELL, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Gerard Plans
- grid.5841.80000 0004 1937 0247Bellvitge University Hospital-IDIBELL, University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Laura Luyten
- grid.5596.f0000 0001 0668 7884KU Leuven and/or UZ Leuven and/or UPC KU Leuven, Leuven, Belgium
| | - Els Brunfaut
- grid.5596.f0000 0001 0668 7884KU Leuven and/or UZ Leuven and/or UPC KU Leuven, Leuven, Belgium
| | - Laurean Matthijs
- grid.5596.f0000 0001 0668 7884KU Leuven and/or UZ Leuven and/or UPC KU Leuven, Leuven, Belgium
| | - Simon Raymakers
- grid.5596.f0000 0001 0668 7884KU Leuven and/or UZ Leuven and/or UPC KU Leuven, Leuven, Belgium
| | - Chris Bervoets
- grid.5596.f0000 0001 0668 7884KU Leuven and/or UZ Leuven and/or UPC KU Leuven, Leuven, Belgium
| | - Antonio Higueras
- grid.411380.f0000 0000 8771 3783Hospital Virgen de las Nieves, Granada, Spain
| | - Majed Katati
- grid.411380.f0000 0000 8771 3783Hospital Virgen de las Nieves, Granada, Spain
| | - José Guerrero
- grid.411380.f0000 0000 8771 3783Hospital Virgen de las Nieves, Granada, Spain
| | - Mariena Hurtado
- grid.411380.f0000 0000 8771 3783Hospital Virgen de las Nieves, Granada, Spain
| | - Mercedes Prieto
- grid.411380.f0000 0000 8771 3783Hospital Virgen de las Nieves, Granada, Spain
| | | | - Georg Löffelholz
- grid.411656.10000 0004 0479 0855Inselspital Bern, Bern, Switzerland
| | - Sebastian Walther
- grid.411656.10000 0004 0479 0855Inselspital Bern, Bern, Switzerland ,grid.412559.e0000 0001 0694 3235Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland
| | - Claudio Pollo
- grid.411656.10000 0004 0479 0855Inselspital Bern, Bern, Switzerland
| | - Bartosz Zurowski
- grid.412468.d0000 0004 0646 2097Universitätsklinik Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Volker Tronnier
- grid.412468.d0000 0004 0646 2097Universitätsklinik Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Andreas Kordon
- grid.5963.9Oberbergklinik Schwarzwald, Hornberg, and Universitätsklinikum Freiburg, Klinik für Psychiatrie und Psychotherapie, Freiburg, Germany
| | - Orsola Gambini
- grid.415093.aDepartment of Health Sciences, University of Milano, San Paolo Hospital Milano, Milano, Italy
| | - Rebecca Ranieri
- grid.415093.aDepartment of Health Sciences, University of Milano, San Paolo Hospital Milano, Milano, Italy
| | - Angelo Franzini
- Fondazione IRCCS Istituto Naz Neurologico C.Besta, Milano, Italy
| | - Giuseppe Messina
- Fondazione IRCCS Istituto Naz Neurologico C.Besta, Milano, Italy
| | - Diana Radu-Djurfeldt
- grid.24381.3c0000 0000 9241 5705Psykiatri Sydvast, OCD-departement, Karolinska University Hospital-region in Huddinge, Stockholm, Sweden
| | - Gaston Schechtmann
- grid.24381.3c0000 0000 9241 5705Department of Neurosurgery, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Long-Long Chen
- grid.24381.3c0000 0000 9241 5705Department of Neurosurgery, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Renana Eitan
- grid.17788.310000 0001 2221 2926Psychiatry Department, Hadassah-University Hospital, Jerusalem, Israel
| | - Zvi Israel
- grid.17788.310000 0001 2221 2926Psychiatry Department, Hadassah-University Hospital, Jerusalem, Israel
| | - Hagai Bergman
- grid.17788.310000 0001 2221 2926Psychiatry Department, Hadassah-University Hospital, Jerusalem, Israel
| | - Tim Brelje
- grid.419673.e0000 0000 9545 2456Medtronic, Minneapolis, USA
| | - Thomas C. Brionne
- grid.471158.e0000 0004 0384 6386Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - Aurélie Conseil
- grid.471158.e0000 0004 0384 6386Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - Frans Gielen
- grid.419671.c0000 0004 1771 1765Medtronic Bakken Research Center, Maastricht, The Netherlands
| | | | - Bart Nuttin
- grid.5596.f0000 0001 0668 7884KU Leuven and/or UZ Leuven and/or UPC KU Leuven, Leuven, Belgium
| | - Loes Gabriëls
- grid.5596.f0000 0001 0668 7884KU Leuven and/or UZ Leuven and/or UPC KU Leuven, Leuven, Belgium
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17
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Labad J, Melia CS, Segalàs C, Alonso P, Salvat-Pujol N, Real E, Ferrer Á, Jiménez-Murcia S, Soriano-Mas C, Soria V, Menchón JM. Sex differences in the association between obsessive-compulsive symptom dimensions and diurnal cortisol patterns. J Psychiatr Res 2021; 133:191-196. [PMID: 33352399 DOI: 10.1016/j.jpsychires.2020.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 10/25/2020] [Accepted: 12/09/2020] [Indexed: 11/30/2022]
Abstract
Previous studies in non-clinical populations suggest that obsessive-compulsive symptoms are associated with hypothalamic-pituitary-adrenal (HPA) axis measures and that there are sex differences in these associations. We aimed to replicate these findings in a sample of 57 patients with obsessive-compulsive disorder (OCD) and 98 healthy subjects. Current and lifetime OCD symptom dimensions were assessed with the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS). Depressive symptoms and state and trait anxiety were also assessed. The following HPA axis measures were analysed in saliva: the diurnal cortisol slope (calculated using two formulas: [1] awakening to 11 p.m. [AWE diurnal slope] and [2] considering fixed time points [FTP diurnal slope] from 10 a.m. to 11 p.m.) and the dexamethasone suppression test ratio (DSTR) after 0.25 mg of dexamethasone. Multiple linear regression analyses were conducted to explore the contribution of OCD symptom dimensions to each HPA axis measure while adjusting for age, sex, BMI, smoking, trait anxiety and depressive symptoms. A sex-specific association between current ordering/symmetry symptoms and AWE diurnal cortisol slope (positive association [flattened slope] in men, inverse association [stepper slope] in women) was found. Two similar sex by OCD dimensions interactions were found for lifetime aggressive and ordering/symmetry symptoms and both (FTP, AWE) diurnal cortisol slopes. Current and lifetime hoarding symptoms were associated to a more flattened FTP diurnal cortisol slope in women. The DSTR was not associated with OCD symptoms. The lifetime interference in functionality was associated with a more flattened AWE diurnal cortisol slope. In conclusion, our study suggests that there are sex differences in the association between OCD subtypes and specific HPA axis measures.
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Affiliation(s)
- Javier Labad
- Consorci Sanitari del Maresme, Mataró, Spain; Institut d'Investigació Sanitària Parc Taulí (I3PT), Sabadell, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristian Sebastian Melia
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Spain
| | - Cinto Segalàs
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Spain
| | - Pino Alonso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Spain
| | - Neus Salvat-Pujol
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Spain; Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Spain
| | - Eva Real
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain
| | - Álex Ferrer
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Spain; Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Carles Soriano-Mas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Virginia Soria
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Spain.
| | - José Manuel Menchón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group-Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Spain.
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18
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Giménez M, Cano M, Martínez-Zalacaín I, Real E, Alonso P, Segalàs C, Munuera J, Kegeles LS, Weinstein JJ, Xu X, Menchón JM, Cardoner N, Soriano-Mas C, Fullana MA. Is glutamate associated with fear extinction and cognitive behavior therapy outcome in OCD? A pilot study. Eur Arch Psychiatry Clin Neurosci 2020; 270:1003-1014. [PMID: 31432262 DOI: 10.1007/s00406-019-01056-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 08/07/2019] [Indexed: 12/15/2022]
Abstract
Cognitive behavioral therapy (CBT) including exposure and response prevention is a well-established treatment for obsessive-compulsive disorder (OCD) and is based on the principles of fear extinction. Fear extinction is linked to structural and functional variability in the ventromedial prefrontal cortex (vmPFC) and has been consistently associated with glutamate neurotransmission. The relationship between vmPFC glutamate and fear extinction and its effects on CBT outcome have not yet been explored in adults with OCD. We assessed glutamate levels in the vmPFC using 3T magnetic resonance spectroscopy, and fear extinction (learning and recall) using skin conductance responses during a 2-day experimental paradigm in OCD patients (n = 17) and in healthy controls (HC; n = 13). Obsessive-compulsive patients (n = 12) then received manualized CBT. Glutamate in the vmPFC was negatively associated with fear extinction recall and positively associated with CBT outcome (with higher glutamate levels predicting a better outcome) in OCD patients. Glutamate levels in the vmPFC in OCD patients were not significantly different from those in HC, and were not associated with OCD severity. Our results suggest that glutamate in the vmPFC is associated with fear extinction recall and CBT outcome in adult OCD patients.
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Affiliation(s)
- M Giménez
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain
| | - M Cano
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - E Real
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain
| | - P Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - C Segalàs
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain
| | - J Munuera
- Diagnostic Imaging Department, Fundació de Recerca Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, Esplugues de Llobregat, 08950, Barcelona, Spain
| | - L S Kegeles
- Department of Psychiatry and Radiology, Columbia University, 622 W 168th St, New York, 10032, USA.,New York State Psychiatric Institute, 1051 Riverside Dr, New York, 10032, USA
| | - J J Weinstein
- Department of Psychiatry and Radiology, Columbia University, 622 W 168th St, New York, 10032, USA.,New York State Psychiatric Institute, 1051 Riverside Dr, New York, 10032, USA.,Department of Psychiatry, Stony Brook University, Stony Brook, 101 Nicolls Rd, Stony Brook, New York, 11794, USA
| | - X Xu
- Department of Psychiatry and Radiology, Columbia University, 622 W 168th St, New York, 10032, USA.,New York State Psychiatric Institute, 1051 Riverside Dr, New York, 10032, USA
| | - J M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Casanova 143, 08036, Barcelona, Spain
| | - N Cardoner
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, Parc Taulí 1, 08208, Sabadell, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193, Cerdanyola Del Vallès Barcelona, Barcelona, Spain
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain.,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Building B1, Ca n'Altayó, s/n, Bellaterra, 08193, Barcelona, Spain
| | - M A Fullana
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental-CIBERSAM, Av. de Monforte de Lemos 5, 28029, Madrid, Spain. .,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193, Cerdanyola Del Vallès Barcelona, Barcelona, Spain. .,Psychiatry Department, Hospital Clínic-Institute of Neurosciences, CIBERSAM, C/Rosselló 140, 08036, Barcelona, Spain.
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Alemany-Navarro M, Cruz R, Real E, Segalàs C, Bertolín S, Baenas I, Domènech L, Rabionet R, Carracedo Á, Menchón JM, Alonso P. Corrigendum to `Exploring Genetic Variants in Obsessive Compulsive Disorder Severity: A GWAS Approach.' Journal of Affective Disorders 267 (2020) 23-32. J Affect Disord 2020; 274:1222. [PMID: 32663960 DOI: 10.1016/j.jad.2020.05.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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..
| | - Raquel Cruz
- Grupo 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
- 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
| | - Cinto Segalàs
- 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
| | - Sara Bertolín
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Isabel Baenas
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Laura Domènech
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona 08003, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Raquel Rabionet
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), CIBERER, and Dept. Genetics, Microbiology & statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Ángel Carracedo
- Grupo 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
- 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; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - Pino Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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21
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Alemany-Navarro M, Cruz R, Real E, Segalàs C, Bertolín S, Baenas I, Domènech L, Rabionet R, Carracedo Á, Menchón JM, Alonso P. Exploring genetic variants in obsessive compulsive disorder severity: A GWAS approach. J Affect Disord 2020; 267:23-32. [PMID: 32063569 DOI: 10.1016/j.jad.2020.01.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/22/2019] [Accepted: 01/28/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND The severity of Obsessive-Compulsive Disorder (OCD) varies significantly among probands. No study has specifically investigated the genetic base of OCD severity. A previous study from our group found an OCD polygenic risk score to predict pre- and post-treatment severity. This study explores the genomic bases of OCD severity. METHODS We administered the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to 401 patients at their first visit to our clinic to measure their OCD severity. Genotyping data was collected by using the Infinium PsychArray-24 BeadChip kit (Illumina). We analyzed genetic association with OCD severity in a linear regression analysis at single-nucleotide polymorphism (SNP)- and gene-levels, this last also considering rare variants. Enrichment analyses were performed from gene-based analyses' results. RESULTS No SNP reached significant association (p < 10-8) with the YBOCS. Six markers showed suggestive association (p < 10-5). The top SNP was an intergenic variant in chromosome 2: rs7578149 (p < 1.89 × 10-6), located in a region suggestively associated with MDD. Linkage disequilibrium was found for two clusters of SNPs located between SLC16A14 and SP110 in chromosome 2, all of them forming one peak of association. Enrichment analyses revealed OCD genes to be associated with porin activity (FDR = 0.01) and transmembrane structure (FDR = 0.04). LIMITATIONS The size of the sample and the transversal nature of the severity measure are limitations of this study. CONCLUSION This study contributes to better characterize OCD at an individual level, helping to know more about the prognosis of the disorder and develop more individualized treatments.
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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.
| | - Raquel Cruz
- Grupo 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
- 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
| | - Cinto Segalàs
- 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
| | - Sara Bertolín
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Isabel Baenas
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Laura Domènech
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona 08003, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Raquel Rabionet
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), CIBERER, and Dept. Genetics, Microbiology & statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Ángel Carracedo
- Grupo 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
- 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; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - Pino Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
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22
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Suñol M, Martínez-Zalacaín I, Picó-Pérez M, López-Solà C, Real E, Fullana MÀ, Pujol J, Cardoner N, Menchón JM, Alonso P, Soriano-Mas C. Differential patterns of brain activation between hoarding disorder and obsessive-compulsive disorder during executive performance. Psychol Med 2020; 50:666-673. [PMID: 30907337 DOI: 10.1017/s0033291719000515] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Preliminary evidence suggests that hoarding disorder (HD) and obsessive-compulsive disorder (OCD) may show distinct patterns of brain activation during executive performance, although results have been inconclusive regarding the specific neural correlates of their differential executive dysfunction. In the current study, we aim to evaluate differences in brain activation between patients with HD, OCD and healthy controls (HCs) during response inhibition, response switching and error processing. METHODS We assessed 17 patients with HD, 18 patients with OCD and 19 HCs. Executive processing was assessed inside a magnetic resonance scanner by means of two variants of a cognitive control protocol (i.e. stop- and switch-signal tasks), which allowed for the assessment of the aforementioned executive domains. RESULTS OCD patients performed similar to the HCs, differing only in the number of successful go trials in the switch-signal task. However, they showed an anomalous hyperactivation of the right rostral anterior cingulate cortex during error processing in the switch-signal task. Conversely, HD patients performed worse than OCD and HC participants in both tasks, showing an impulsive-like pattern of response (i.e. shorter reaction time and more commission errors). They also exhibited hyperactivation of the right lateral orbitofrontal cortex during successful response switching and abnormal deactivation of frontal regions during error processing in both tasks. CONCLUSIONS Our results support that patients with HD and OCD present dissimilar cognitive profiles, supported by distinct neural mechanisms. Specifically, while alterations in HD resemble an impulsive pattern of response, patients with OCD present increased error processing during response conflict protocols.
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Affiliation(s)
- Maria Suñol
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomedica en Red de Salud Mental - CIBERSAM, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Maria Picó-Pérez
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Clara López-Solà
- Carlos III Health Institute, Centro de Investigación Biomedica en Red de Salud Mental - CIBERSAM, Barcelona, Spain
- Department of Mental Health, Corporació Sanitaria Parc Taulí-i3PT, Sabadell, Spain
| | - Eva Real
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain
| | - Miquel Àngel Fullana
- Carlos III Health Institute, Centro de Investigación Biomedica en Red de Salud Mental - CIBERSAM, Barcelona, Spain
- Department of Psychiatry, Hospital Clínic-Institute of Neurosciences, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesús Pujol
- Carlos III Health Institute, Centro de Investigación Biomedica en Red de Salud Mental - CIBERSAM, Barcelona, Spain
- MRI Research Unit, Radiology Department, Hospital del Mar, Barcelona, Spain
| | - Narcís Cardoner
- Carlos III Health Institute, Centro de Investigación Biomedica en Red de Salud Mental - CIBERSAM, Barcelona, Spain
- Department of Mental Health, Corporació Sanitaria Parc Taulí-i3PT, Sabadell, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Manuel Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomedica en Red de Salud Mental - CIBERSAM, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomedica en Red de Salud Mental - CIBERSAM, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute - IDIBELL, Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomedica 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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Menchon JM, Bobes J, Alamo C, Alonso P, García-Portilla MP, Ibáñez Á, Real E, Bousoño M, Saiz-Gonzalez MD, Saiz-Ruiz J. Pharmacological treatment of obsessive compulsive disorder in adults: A clinical practice guideline based on the ADAPTE methodology. Rev Psiquiatr Salud Ment (Engl Ed) 2019; 12:77-91. [PMID: 30850318 DOI: 10.1016/j.rpsm.2019.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 12/31/2018] [Accepted: 01/08/2019] [Indexed: 01/04/2023]
Abstract
Despite the existence of effective evidence-based treatments for the management of obsessive-compulsive disorder (OCD), the therapeutic approach to this disease remains suboptimal. The availability of a therapeutic pharmacological guideline for OCD could help to improve the management of the disease in our setting and to reduce the burden of disease for the patient. With the sponsorship of the Spanish Society of Psychiatry, a group of experts has developed a guideline for the pharmacological treatment of OCD based on the recommendations of existing guidelines and following the methodology of the ADAPTE Collaboration. This article summarises the process of preparing this guideline and the recommendations adopted by consensus by a guideline panel grouped into five areas of interest: acute treatment, duration of treatment, predictors of response and special symptoms, partial response to lack of response to treatment, and special populations.
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Affiliation(s)
- Jose M Menchon
- Servicio de Psiquiatría, Hospital Universitario de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregrat, Barcelona, España; Instituto de Investigación Biomédica de Bellvitge (IDIBELL); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM).
| | - Julio Bobes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Departamento. de Medicina - Psiquiatría, Universidad de Oviedo, Oviedo, Asturias, España; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA)
| | - Cecilio Alamo
- Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, Alcalá de Henares, Madrid, España
| | - Pino Alonso
- Servicio de Psiquiatría, Hospital Universitario de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregrat, Barcelona, España; Instituto de Investigación Biomédica de Bellvitge (IDIBELL); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)
| | - María Paz García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Departamento. de Medicina - Psiquiatría, Universidad de Oviedo, Oviedo, Asturias, España
| | - Ángela Ibáñez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); Servicio de Psiquiatría, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, España; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - Eva Real
- Servicio de Psiquiatría, Hospital Universitario de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregrat, Barcelona, España; Instituto de Investigación Biomédica de Bellvitge (IDIBELL); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM)
| | - Manuel Bousoño
- Departamento. de Medicina - Psiquiatría, Universidad de Oviedo, Oviedo, Asturias, España
| | | | - Jeronimo Saiz-Ruiz
- Servicio de Psiquiatría, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, España
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Alemany-Navarro M, Costas J, Real E, Segalàs C, Bertolín S, Domènech L, Rabionet R, Carracedo Á, Menchón JM, Alonso P. Do polygenic risk and stressful life events predict pharmacological treatment response in obsessive compulsive disorder? A gene-environment interaction approach. Transl Psychiatry 2019; 9:70. [PMID: 30718812 PMCID: PMC6362161 DOI: 10.1038/s41398-019-0410-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/18/2018] [Accepted: 11/08/2018] [Indexed: 12/13/2022] Open
Abstract
The rate of response to pharmacological treatment in Obsessive-compulsive disorder (OCD) oscillates between 40 and 70%. Genetic and environmental factors have been associated with treatment response in OCD. This study analyzes the predictive ability of a polygenic risk score (PRS) built from OCD-risk variants, for treatment response in OCD, and the modulation role of stressful life events (SLEs) at the onset of the disorder. PRSs were calculated for a sample of 103 patients. Yale-Brown Obsessive Compulsive Scale (YBOCS) scores were obtained before and after a 12-week treatment. Regression analyses were performed to analyze the influence of the PRS and SLEs at onset on treatment response. PRS did not predict treatment response. The best predictive model for post-treatment YBOCS (post YBOCS) included basal YBOCS and age. PRS appeared as a predictor for basal and post YBOCS. SLEs at onset were not a predictor for treatment response when included in the regression model. No evidence for PRS predictive ability for treatment response was found. The best predictor for treatment response was age, agreeing with previous literature specific for SRI treatment. Suggestions are made on the possible role of neuroplasticity as a mediator on this association. PRS significantly predicted OCD severity independent on pharmacological treatment. SLE at onset modulation role was not evidenced. Further research is needed to elucidate the genetic and environmental bases of treatment response in OCD.
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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, L'Hospitalet de Llobregat (Barcelona), Spain.
| | - Javier Costas
- 0000 0000 9403 4738grid.420359.9Grupo de Xenética Psiquiátrica, Instituto de Investigación Sanitaria de Santiago, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde, Santiago de Compostela, Spain
| | - Eva Real
- Institut d’ Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Spain ,0000 0000 8836 0780grid.411129.eOCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Spain
| | - Cinto Segalàs
- Institut d’ Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Spain ,0000 0000 8836 0780grid.411129.eOCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Spain
| | - Sara Bertolín
- 0000 0000 8836 0780grid.411129.eOCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Spain
| | - Laura Domènech
- grid.473715.3Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona, 08003 Spain ,0000 0001 2172 2676grid.5612.0Universitat Pompeu Fabra (UPF), Barcelona, Spain ,CIBER in Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Raquel Rabionet
- grid.473715.3Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Dr. Aiguader 88, Barcelona, 08003 Spain ,0000 0001 2172 2676grid.5612.0Universitat Pompeu Fabra (UPF), Barcelona, Spain ,CIBER in Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Ángel Carracedo
- 0000 0000 9403 4738grid.420359.9Grupo de Xenética Psiquiátrica, Instituto de Investigación Sanitaria de Santiago, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde, Santiago de Compostela, Spain ,0000000109410645grid.11794.3aGrupo de Medicina Xenómica, Universidade de Santiago de Compostela, Centro Nacional de Genotipado - Instituto Carlos III, Santiago de Compostela, Spain ,0000 0004 1791 1185grid.452372.5Centro de Investigación Biomédica en Red de Enfermedades Raras, Santiago de Compostela, Spain
| | - Jose M. Menchón
- Institut d’ Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Spain ,0000 0000 8836 0780grid.411129.eOCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Spain ,0000 0000 9314 1427grid.413448.eCIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain ,0000 0004 1937 0247grid.5841.8Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Pino Alonso
- Institut d’ Investigació Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Spain ,0000 0000 8836 0780grid.411129.eOCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Spain ,0000 0000 9314 1427grid.413448.eCIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain ,0000 0004 1937 0247grid.5841.8Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
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25
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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26
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Ferrer A, Costas J, Labad J, Salvat-Pujol N, Segalàs C, Urretavizcaya M, Real E, de Arriba-Arnau A, Alonso P, Crespo JM, Barrachina M, Soriano-Mas C, Carracedo Á, Menchón JM, Soria V. FKBP5 polymorphisms and hypothalamic-pituitary-adrenal axis negative feedback in major depression and obsessive-compulsive disorder. J Psychiatr Res 2018; 104:227-234. [PMID: 30107269 DOI: 10.1016/j.jpsychires.2018.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 07/22/2018] [Accepted: 08/01/2018] [Indexed: 11/18/2022]
Abstract
Major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) have both been linked to abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis. Polymorphisms in the genes involved in HPA axis activity, such as FKBP5, and their interactions with childhood trauma have been associated with stress-related mental disorders. Our goal was to study the role of FKBP5 genetic variants in HPA axis negative feedback regulation as a possible risk factor for different mental disorders such as MDD and OCD, while controlling for childhood trauma, anxiety and depressive symptoms. The sample included 266 participants divided into three groups: 1) MDD (n = 89 [n = 73 melancholic; n = 3 atypical]), 2) OCD (n = 51; 39% with comorbid MDD [n = 13 melancholic; n = 7 atypical]) and 3) healthy controls (n = 126). Childhood trauma, trait anxiety and depressive symptoms were assessed. HPA negative feedback was analyzed using the dexamethasone suppression test ratio (DSTR) after administration of 0.25 mg of dexamethasone. Twelve SNPs in the FKBP5 gene were selected for genotyping. Multiple linear regressions, after adjusting for the covariates considered, showed a reduced DSTR in individuals with the rs9470079-A variant that was significant after correction for multiple testing. Childhood trauma did not moderate the association between the rs9470079 and DSTR. Our results support the evidence that FKBP5 genetic variation could lead to abnormal HPA axis negative feedback independent of diagnosis. Therefore, this association can be identified as a transdiagnostic feature, offering an interesting opportunity to identify patients with higher stress vulnerability. Further studies focusing on the influence of FKBP5 on measurable biological endophenotypes are needed.
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Affiliation(s)
- Alex Ferrer
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Javier Costas
- Grupo de Xenética Psiquiátrica, Instituto de Investigación Sanitaria de Santiago, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde, Santiago de Compostela, Spain
| | - Javier Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Neus Salvat-Pujol
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Cinto Segalàs
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Mikel Urretavizcaya
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Eva Real
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Aida de Arriba-Arnau
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - José M Crespo
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Marta Barrachina
- Neuropathology Group, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Carlos III Health Institute, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Ángel Carracedo
- Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela, Centro Nacional de Genotipado - Instituto Carlos III, Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Carlos III Health Institute, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Virginia Soria
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
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27
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Giménez M, Guinea-Izquierdo A, Villalta-Gil V, Martínez-Zalacaín I, Segalàs C, Subirà M, Real E, Pujol J, Harrison BJ, Haro JM, Sato JR, Hoexter MQ, Cardoner N, Alonso P, Menchón JM, Soriano-Mas C. Brain alterations in low-frequency fluctuations across multiple bands in obsessive compulsive disorder. Brain Imaging Behav 2018; 11:1690-1706. [PMID: 27771857 DOI: 10.1007/s11682-016-9601-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The extent of functional abnormalities in frontal-subcortical circuits in obsessive-compulsive disorder (OCD) is still unclear. Although neuroimaging studies, in general, and resting-state functional Magnetic Resonance Imaging (rs-fMRI), in particular, have provided relevant information regarding such alterations, rs-fMRI studies have been typically limited to the analysis of between-region functional connectivity alterations at low-frequency signal fluctuations (i.e., <0.08 Hz). Conversely, the local attributes of Blood Oxygen Level Dependent (BOLD) signal across different frequency bands have been seldom studied, although they may provide valuable information. Here, we evaluated local alterations in low-frequency fluctuations across different oscillation bands in OCD. Sixty-five OCD patients and 50 healthy controls underwent an rs-fMRI assessment. Alterations in the fractional amplitude of low-frequency fluctuations (fALFF) were evaluated, voxel-wise, across four different bands (from 0.01 Hz to 0.25 Hz). OCD patients showed decreased fALFF values in medial orbitofrontal regions and increased fALFF values in the dorsal-medial prefrontal cortex (DMPFC) at frequency bands <0.08 Hz. This pattern was reversed at higher frequencies, where increased fALFF values also appeared in medial temporal lobe structures and medial thalamus. Clinical variables (i.e., symptom-specific severities) were associated with fALFF values across the different frequency bands. Our findings provide novel evidence about the nature and regional distribution of functional alterations in OCD, which should contribute to refine neurobiological models of the disorder. We suggest that the evaluation of the local attributes of BOLD signal across different frequency bands may be a sensitive approach to further characterize brain functional alterations in psychiatric disorders.
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Affiliation(s)
- Mònica Giménez
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
| | - Andrés Guinea-Izquierdo
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907, Barcelona, Spain
| | - Victoria Villalta-Gil
- Research Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, University of Barcelona, 08950, Sant Boi de Llobregat, Barcelona, Spain.,Affective Neuroscience Laboratory, Department of Psychology, Vanderbilt University, Nashville, TN, 37240, USA
| | - Ignacio Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Cinto Segalàs
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
| | - Marta Subirà
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907, Barcelona, Spain
| | - Eva Real
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain
| | - Jesús Pujol
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain.,MRI Research Unit, Department of Radiology, Hospital del Mar, 08003, Barcelona, Spain
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, 3010, Australia
| | - Josep Maria Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain.,Research Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, University of Barcelona, 08950, Sant Boi de Llobregat, Barcelona, Spain
| | - Joao R Sato
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, 5001, Brazil
| | - Marcelo Q Hoexter
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, 05403-903, Brazil
| | - Narcís Cardoner
- Depression and Anxiety Program, Department of Mental Health, Parc Taulí Sabadell, Hospital Universitari, 08208, Sabadell, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, 08193, Cerdanyola, Barcelona, Spain
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907, Barcelona, Spain
| | - José Manuel Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907, Barcelona, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Barcelona, Spain. .,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, 08193, Cerdanyola, Barcelona, Spain.
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28
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Labad J, Soria V, Salvat-Pujol N, Segalàs C, Real E, Urretavizcaya M, de Arriba-Arnau A, Ferrer A, Crespo JM, Jiménez-Murcia S, Soriano-Mas C, Alonso P, Menchón JM. Hypothalamic-pituitary-adrenal axis activity in the comorbidity between obsessive-compulsive disorder and major depression. Psychoneuroendocrinology 2018; 93:20-28. [PMID: 29684711 DOI: 10.1016/j.psyneuen.2018.04.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 03/04/2018] [Accepted: 04/10/2018] [Indexed: 12/11/2022]
Abstract
Major depressive disorder (MDD) is the most common psychiatric comorbidity in patients with obsessive-compulsive disorder (OCD). Hypothalamic-pituitary-adrenal (HPA) axis abnormalities have been described in both disorders and might play a role in the association between them. We aimed to study the role of HPA axis activity in the comorbidity between OCD and MDD, while controlling for psychopathological dimensions such as anxiety and depressive symptoms. We studied 324 participants belonging to four diagnostic groups: 1) MDD (n = 101), 2) OCD with comorbid MDD (n = 33), 3) OCD without MDD (n = 52), and 4) healthy subjects (n = 138). State anxiety, trait anxiety and depressive symptoms were assessed. Three HPA axis measures were analyzed in saliva: cortisol awakening response (CAR), diurnal cortisol slope (calculated using two formulas: [1] awakening to 11 p.m. [AWE diurnal slope]; [2] considering fixed time points [FTP diurnal slope] from 10 a.m. to 11 p.m.), and dexamethasone suppression test ratio after 0.25 mg of dexamethasone (DSTR). Multiple linear regression analyses were conducted to explore the contribution of clinical diagnosis and symptom dimensions to each HPA axis measure. A more flattened FTP diurnal cortisol slope was observed for OCD patients with comorbid MDD. Regarding the CAR and DSTR, a significant interaction was found between trait anxiety and OCD, as OCD patients with greater trait anxiety showed an increased CAR and reduced cortisol suppression after dexamethasone administration. Our results suggest that trait anxiety plays an important role in the relationship between HPA axis measures and OCD/MDD comorbidity.
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Affiliation(s)
- Javier Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Virginia Soria
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
| | - Neus Salvat-Pujol
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Cinto Segalàs
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Eva Real
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Mikel Urretavizcaya
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Aida de Arriba-Arnau
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Alex Ferrer
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - José M Crespo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología Obesidad y Nutrición (CIBEROBN), Carlos III Health Institute, Spain
| | - Carles Soriano-Mas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - Pino Alonso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - José M Menchón
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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29
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Cano M, Alonso P, Martínez-Zalacaín I, Subirà M, Real E, Segalàs C, Pujol J, Cardoner N, Menchón JM, Soriano-Mas C. Altered functional connectivity of the subthalamus and the bed nucleus of the stria terminalis in obsessive-compulsive disorder. Psychol Med 2018; 48:919-928. [PMID: 28826410 DOI: 10.1017/s0033291717002288] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The assessment of inter-regional functional connectivity (FC) has allowed for the description of the putative mechanism of action of treatments such as deep brain stimulation (DBS) of the nucleus accumbens in patients with obsessive-compulsive disorder (OCD). Nevertheless, the possible FC alterations of other clinically-effective DBS targets have not been explored. Here we evaluated the FC patterns of the subthalamic nucleus (STN) and the bed nucleus of the stria terminalis (BNST) in patients with OCD, as well as their association with symptom severity. METHODS Eighty-six patients with OCD and 104 healthy participants were recruited. A resting-state image was acquired for each participant and a seed-based analysis focused on our two regions of interest was performed using statistical parametric mapping software (SPM8). Between-group differences in FC patterns were assessed with two-sample t test models, while the association between symptom severity and FC patterns was assessed with multiple regression analyses. RESULTS In comparison with controls, patients with OCD showed: (1) increased FC between the left STN and the right pre-motor cortex, (2) decreased FC between the right STN and the lenticular nuclei, and (3) increased FC between the left BNST and the right frontopolar cortex. Multiple regression analyses revealed a negative association between clinical severity and FC between the right STN and lenticular nucleus. CONCLUSIONS This study provides a neurobiological framework to understand the mechanism of action of DBS on the STN and the BNST, which seems to involve brain circuits related with motor response inhibition and anxiety control, respectively.
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Affiliation(s)
- M Cano
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - P Alonso
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - M Subirà
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - E Real
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - C Segalàs
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - J Pujol
- CIBERSAM, Carlos III Health Institute, Madrid,Spain
| | - N Cardoner
- CIBERSAM, Carlos III Health Institute, Madrid,Spain
| | - J M Menchón
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
| | - C Soriano-Mas
- Department of Psychiatry,Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat,Barcelona,Spain
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Fullana MA, Zhu X, Alonso P, Cardoner N, Real E, López-Solà C, Segalàs C, Subirà M, Galfalvy H, Menchón JM, Simpson HB, Marsh R, Soriano-Mas C. Basolateral amygdala-ventromedial prefrontal cortex connectivity predicts cognitive behavioural therapy outcome in adults with obsessive-compulsive disorder. J Psychiatry Neurosci 2017; 42. [PMID: 28632120 PMCID: PMC5662459 DOI: 10.1503/jpn.160215] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cognitive behavioural therapy (CBT), including exposure and ritual prevention, is a first-line treatment for obsessive-compulsive disorder (OCD), but few reliable predictors of CBT outcome have been identified. Based on research in animal models, we hypothesized that individual differences in basolateral amygdala-ventromedial prefrontal cortex (BLA-vmPFC) communication would predict CBT outcome in patients with OCD. METHODS We investigated whether BLA-vmPFC resting-state functional connectivity (rs-fc) predicts CBT outcome in patients with OCD. We assessed BLA-vmPFC rs-fc in patients with OCD on a stable dose of a selective serotonin reuptake inhibitor who then received CBT and in healthy control participants. RESULTS We included 73 patients with OCD and 84 healthy controls in our study. Decreased BLA-vmPFC rs-fc predicted a better CBT outcome in patients with OCD and was also detected in those with OCD compared with healthy participants. Additional analyses revealed that decreased BLA-vmPFC rs-fc uniquely characterized the patients with OCD who responded to CBT. LIMITATIONS We used a sample of convenience, and all patients were receiving pharmacological treatment for OCD. CONCLUSION In this large sample of patients with OCD, BLA-vmPFC functional connectivity predicted CBT outcome. These results suggest that future research should investigate the potential of BLA-vmPFC pathways to inform treatment selection for CBT across patients with OCD and anxiety disorders.
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Affiliation(s)
- Miquel A. Fullana
- Correspondence to: M.A. Fullana, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Passeig Marítim, 25/29, 08003 Barcelona, Spain;
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Cano M, Alonso P, Martínez-Zalacaín I, Subirà M, Real E, Segalàs C, Pujol J, Cardoner N, Menchón J, Soriano-Mas C. Altered functional connectivity of the subthalamus and the bed nucleus of the stria terminalis in obsessive-compulsive disorder. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Salvat-Pujol N, Labad J, Urretavizcaya M, de Arriba-Arnau A, Segalàs C, Real E, Ferrer A, Crespo JM, Jiménez-Murcia S, Soriano-Mas C, Menchón JM, Soria V. Hypothalamic-pituitary-adrenal axis activity and cognition in major depression: The role of remission status. Psychoneuroendocrinology 2017; 76:38-48. [PMID: 27883963 DOI: 10.1016/j.psyneuen.2016.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 11/04/2016] [Accepted: 11/05/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Neuropsychological deficits and hypothalamic-pituitary-adrenal (HPA) axis dysfunction have been described in major depressive disorder (MDD). We conducted an exploratory study to investigate the role of remission status in the relationship between HPA axis and cognition in MDD. METHODS Ninety-seven MDD patients (44 remitted, 53 non-remitted) and 97 healthy controls (HC) were evaluated. We measured verbal and visual memory, working memory, processing speed, attention, and executive function. Three HPA axis measures were assessed: cortisol awakening response (CAR), diurnal cortisol slope, and cortisol suppression ratio with 0.25mg of dexamethasone (DSTR). Multiple linear regression analyses were performed to study the relationship between cortisol measures and cognition while controlling for potential confounders. We conducted an overall analysis in all participants to compare both MDD-remitted and MDD non-remitted groups with respect to HC. Another analysis including MDD patients only was used to explore a moderating effect by remission status. RESULTS MDD patients showed poorer cognitive performance compared with HC, without significant differences between remitters and non-remitters. Cortisol measures did not differ between remitters and non-remitters. Although most HPA axis measures were not associated with cognitive dysfunction, we found significant associations between cognitive performance in MDD-remitters and cortisol measures for visual memory, processing speed and executive function. A significant moderating effect for remission status was found between cortisol diurnal slope (but neither CAR nor DSTR) and performance in processing speed or executive function. CONCLUSIONS Remission status in MDD appears to moderate the association between some cognitive domains (processing speed and executive function) and HPA axis activity.
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Affiliation(s)
- Neus Salvat-Pujol
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Javier Labad
- Corporació Sanitària Parc Taulí, Department of Mental Health, I3PT, Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Mikel Urretavizcaya
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Aida de Arriba-Arnau
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - Cinto Segalàs
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Eva Real
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Alex Ferrer
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain
| | - José M Crespo
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología Obesidad y Nutrición (CIBEROBN), Carlos III Health Institute, Spain
| | - Carles Soriano-Mas
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain
| | - José M Menchón
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Virginia Soria
- Bellvitge University Hospital, Psychiatry Department, Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain.
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Menchón JM, van Ameringen M, Dell'Osso B, Denys D, Figee M, Grant JE, Hollander E, Marazziti D, Nicolini H, Pallanti S, Ruck C, Shavitt R, Stein DJ, Andersson E, Bipeta R, Cath DC, Drummond L, Feusner J, Geller DA, Hranov G, Lochner C, Matsunaga H, McCabe RE, Mpavaenda D, Nakamae T, O'Kearney R, Pasquini M, Pérez Rivera R, Poyurovsky M, Real E, do Rosário MC, Soreni N, Swinson RP, Vulink N, Zohar J, Fineberg N. Standards of care for obsessive-compulsive disorder centres. Int J Psychiatry Clin Pract 2016; 20:204-8. [PMID: 27359333 PMCID: PMC4950405 DOI: 10.1080/13651501.2016.1197275] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In recent years, many assessment and care units for obsessive-compulsive disorder (OCD) have been set up in order to detect, diagnose and to properly manage this complex disorder, but there is no consensus regarding the key functions that these units should perform. The International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) together with the Obsessive Compulsive and Related Disorders Network (OCRN) of the European College of Neuropsychopharmacology (ECNP) and the Anxiety and Obsessive Compulsive Disorders Section of the World Psychiaric Association (WPA) has developed a standards of care programme for OCD centres. The goals of this collaborative initiative are promoting basic standards, improving the quality of clinical care and enhance the validity and reliability of research results provided by different facilities and countries.
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Affiliation(s)
- José M Menchón
- a Psychiatry Department , Bellvitge University Hospital_IDIBELL , Barcelona , Spain ;,b Carlos III Health Institute_CIBERSAM , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
| | - Michael van Ameringen
- d Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , Ontario , Canada
| | - Bernardo Dell'Osso
- e Department of Psychiatry , University of Milan , Milan , Italy ;,f Fondazione IRCCS Ca' Granda Policlinico , Milan , Italy
| | - Damiaan Denys
- g Academic Medical Center , Department of Psychiatry , University of Amsterdam , Amsterdam , The Netherlands ;,h Brain and Cognition , Amsterdam , The Netherlands ;,i Netherlands Institute for Neuroscience , Amsterdam , The Netherlands ;,j Royal Netherlands Academy of Arts and Sciences , Amsterdam , The Netherlands
| | - Martijn Figee
- g Academic Medical Center , Department of Psychiatry , University of Amsterdam , Amsterdam , The Netherlands
| | - Jon E Grant
- k Department of Psychiatry and Behavioral Neuroscience , University of Chicago , Chicago , IL , USA
| | - Eric Hollander
- l Department of Psychiatry and Behavioral Sciences , Albert Einstein College of Medicine , NY , USA ;,m Montefiore Medical Center , NY , USA
| | - Donatella Marazziti
- n Dipartimento di Medicina Clinica e Sperimentale, Sezione di Psichiatria , University of Pisa , Pisa , Italy
| | - Humberto Nicolini
- o National Institute of Genomic Medicine , Mexico City , Mexico ;,p Carracci Medical Group , Mexico City , Mexico
| | - Stefano Pallanti
- q Psychiatry and Behavioral Sciences , UC Davis Health System , Sacramento , CA , USA ;,r Istituto di Neuroscienze , Florence , Italy
| | - Christian Ruck
- s Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Roseli Shavitt
- t Department and Institute of Psychiatry , University of São Paulo School of Medicine , São Paulo , Brazil
| | - Dan J Stein
- u Psychiatry and Mental Health Department , University of Cape Town , Cape Town , South Africa ;,v Groote Schuur Hospital , Cape Town , South Africa ;,w MRC Unit on Anxiety and Stress Disorders , South Africa
| | - Erik Andersson
- s Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | | | - Danielle C Cath
- y Department of Clinical Psychology , Utrecht University , Utrecht , The Netherlands
| | - Lynne Drummond
- z South West London and St George's Mental Health NHS Trust , London , United Kingdom ;,aa St George's, University of London , London , United Kingdom
| | - Jamie Feusner
- ab Semel Institute for Neuroscience and Human Behavior , Los Angeles , CA , USA ;,ac David Geffen School of Medicine at UCLA University of California , Los Angeles , CA , USA
| | - Daniel A Geller
- ad Department of Psychiatry , Massachusetts General Hospital , Boston , MA , USA ;,ae Harvard Medical School , Boston , MA , USA
| | | | - Christine Lochner
- w MRC Unit on Anxiety and Stress Disorders , South Africa ;,ag Department of Psychiatry , Stellenbosch University , South Africa
| | - Hisato Matsunaga
- ah Department of Neuropsychiatry , Hyogo College of Medicine , Nishinomiya , Hyogo , Japan
| | - Randy E McCabe
- d Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , Ontario , Canada ;,ai Anxiety Treatment and Research Center , St. Joseph's Healthcare Hamilton , Hamilton , Canada
| | - Davis Mpavaenda
- aj Hertfordshire Partnership University NHS Foundation Trust , Hertfordshire , United Kingdom
| | - Takashi Nakamae
- ak Department of Psychiatry, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kyoto , Japan
| | - Richard O'Kearney
- al The Australian National University , Research School of Psychology , Canberra , Australia
| | - Massimo Pasquini
- am Department of Neurology and Psychiatry , Sapienza University of Rome , Rome , Italy
| | | | | | - Eva Real
- a Psychiatry Department , Bellvitge University Hospital_IDIBELL , Barcelona , Spain ;,b Carlos III Health Institute_CIBERSAM , Spain
| | - Maria Conceição do Rosário
- ap Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Noam Soreni
- d Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , Ontario , Canada ;,aq Pediatric OCD Consultation Service, Anxiety Treatment and Research Center , St. Joseph's HealthCare , Hamilton , Ontario , Canada
| | - Richard P Swinson
- d Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , Ontario , Canada
| | - Nienke Vulink
- g Academic Medical Center , Department of Psychiatry , University of Amsterdam , Amsterdam , The Netherlands
| | - Joseph Zohar
- ar Tel Aviv University , Sackler School of Medicine , NY , USA
| | - Naomi Fineberg
- aj Hertfordshire Partnership University NHS Foundation Trust , Hertfordshire , United Kingdom
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Real E, Subirà M, Alonso P, Segalàs C, Labad J, Orfila C, López-Solà C, Martínez-Zalacaín I, Via E, Cardoner N, Jiménez-Murcia S, Soriano-Mas C, Menchón JM. Brain structural correlates of obsessive-compulsive disorder with and without preceding stressful life events. World J Biol Psychiatry 2016; 17:366-77. [PMID: 26784523 DOI: 10.3109/15622975.2016.1142606] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives There is growing evidence supporting a role for stressful life events (SLEs) at obsessive-compulsive disorder (OCD) onset, but neurobiological correlates of such effect are not known. We evaluated regional grey matter (GM) changes associated with the presence/absence of SLEs at OCD onset. Methods One hundred and twenty-four OCD patients and 112 healthy controls were recruited. Patients were split into two groups according to the presence (n = 56) or absence (n = 68) of SLEs at disorder's onset. A structural magnetic resonance image was acquired for each participant and pre-processed with Statistical Parametric Mapping software (SPM8) to obtain a volume-modulated GM map. Between-group differences in sociodemographic, clinical and whole-brain regional GM volumes were assessed. Results SLEs were associated with female sex, later age at disorder's onset, more contamination/cleaning and less hoarding symptoms. In comparison with controls, patients without SLEs showed GM volume increases in bilateral dorsal putamen and the central tegmental tract of the brainstem. By contrast, patients with SLEs showed specific GM volume increases in the right anterior cerebellum. Conclusions Our findings support the idea that neuroanatomical alterations of OCD patients partially depend on the presence of SLEs at disorder's onset.
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Affiliation(s)
- E Real
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain
| | - M Subirà
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
| | - P Alonso
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
| | - C Segalàs
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain
| | - J Labad
- d Mental Health Department , Corporació Sanitària Parc Taulí , Sabadell , Spain ;,e Department of Psychiatry and Forensic Medicine , Universitat Autònoma De Barcelona , Barcelona , Spain
| | - C Orfila
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain
| | - C López-Solà
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
| | - I Martínez-Zalacaín
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain
| | - E Via
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
| | - N Cardoner
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,d Mental Health Department , Corporació Sanitària Parc Taulí , Sabadell , Spain ;,e Department of Psychiatry and Forensic Medicine , Universitat Autònoma De Barcelona , Barcelona , Spain
| | - S Jiménez-Murcia
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,f Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBERobn) , Carlos III Health Institute , Madrid , Spain
| | - C Soriano-Mas
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,g Department of Psychobiology and Methodology in Health Sciences , Universitat Autònoma de Barcelona , Barcelona , Spain
| | - J M Menchón
- a Psychiatry Department , Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL) , Barcelona , Spain ;,b Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) , Carlos III Health Institute , Spain ;,c Department of Clinical Sciences, School of Medicine , University of Barcelona , Barcelona , Spain
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Costas J, Carrera N, Alonso P, Gurriarán X, Segalàs C, Real E, López-Solà C, Mas S, Gassó P, Domènech L, Morell M, Quintela I, Lázaro L, Menchón JM, Estivill X, Carracedo Á. Exon-focused genome-wide association study of obsessive-compulsive disorder and shared polygenic risk with schizophrenia. Transl Psychiatry 2016; 6:e768. [PMID: 27023174 PMCID: PMC4872458 DOI: 10.1038/tp.2016.34] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 12/11/2015] [Accepted: 02/10/2016] [Indexed: 12/17/2022] Open
Abstract
Common single-nucleotide polymorphisms (SNPs) account for a large proportion of the heritability of obsessive-compulsive disorder (OCD). Co-ocurrence of OCD and schizophrenia is commoner than expected based on their respective prevalences, complicating the clinical management of patients. This study addresses two main objectives: to identify particular genes associated with OCD by SNP-based and gene-based tests; and to test the existence of a polygenic risk shared with schizophrenia. The primary analysis was an exon-focused genome-wide association study of 370 OCD cases and 443 controls from Spain. A polygenic risk model based on the Psychiatric Genetics Consortium schizophrenia data set (PGC-SCZ2) was tested in our OCD data. A polygenic risk model based on our OCD data was tested on previous data of schizophrenia from our group. The most significant association at the gene-based test was found at DNM3 (P=7.9 × 10(-5)), a gene involved in synaptic vesicle endocytosis. The polygenic risk model from PGC-SCZ2 data was strongly associated with disease status in our OCD sample, reaching its most significant value after removal of the major histocompatibility complex region (lowest P=2.3 × 10(-6), explaining 3.7% of the variance). The shared polygenic risk was confirmed in our schizophrenia data. In conclusion, DNM3 may be involved in risk to OCD. The shared polygenic risk between schizophrenia and OCD may be partially responsible for the frequent comorbidity of both disorders, explaining epidemiological data on cross-disorder risk. This common etiology may have clinical implications.
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Affiliation(s)
- J Costas
- Grupo de Xenética Psiquiátrica, Instituto de Investigación Sanitaria de Santiago, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde, Santiago de Compostela, Spain,Grupo de Xenética Psiquiátrica, Instituto de Investigación Sanitaria de Santiago, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde, despacho 15, E-15706 Santiago de Compostela, Spain. E-mail:
| | - N Carrera
- Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK,Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
| | - P Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain,Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - X Gurriarán
- Grupo de Xenética Psiquiátrica, Instituto de Investigación Sanitaria de Santiago, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde, Santiago de Compostela, Spain,Grupo de Medicina Xenómica, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - C Segalàs
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain,Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - E Real
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain,Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - C López-Solà
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain,Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain
| | - S Mas
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain,Department of Anatomic Pathology, Pharmacology and Microbiology, University of Barcelona, Barcelona, Spain,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - P Gassó
- Department of Anatomic Pathology, Pharmacology and Microbiology, University of Barcelona, Barcelona, Spain,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain,Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
| | - L Domènech
- Genomics and Disease Group, Centre for Genomic Regulation, Barcelona, Spain,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Centre for Genomic Regulation, Barcelona, Spain,Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - M Morell
- Genomics and Disease Group, Centre for Genomic Regulation, Barcelona, Spain,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Centre for Genomic Regulation, Barcelona, Spain,Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - I Quintela
- Grupo de Medicina Xenómica, Universidade de Santiago de Compostela, Centro Nacional de Genotipado - Instituto Carlos III, Santiago de Compostela, Spain,Centro de Investigación Biomédica en Red de Enfermedades Raras, Santiago de Compostela, Spain
| | - L Lázaro
- Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain,Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain,Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain,Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental, Carlos III Health Institute, Madrid, Spain,Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - X Estivill
- Genomics and Disease Group, Centre for Genomic Regulation, Barcelona, Spain,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain,Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, Centre for Genomic Regulation, Barcelona, Spain,Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Á Carracedo
- Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde, Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain,Grupo de Medicina Xenómica, Universidade de Santiago de Compostela, Centro Nacional de Genotipado - Instituto Carlos III, Santiago de Compostela, Spain,Centro de Investigación Biomédica en Red de Enfermedades Raras, Santiago de Compostela, Spain
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Real E, Plans G, Alonso P, Aparicio MA, Segalàs C, Cardoner N, Soriano-Mas C, López-Solà C, Menchón JM. Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond): case report. BMC Psychiatry 2016; 16:26. [PMID: 26852116 PMCID: PMC4744631 DOI: 10.1186/s12888-016-0730-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 02/01/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) is emerging as a promising tool in the treatment of refractory obsessive-compulsive disorder (OCD) but the search for the best target still continues. This issue is especially relevant when particularly resistant profiles are observed in some patients, which have been ascribed to individual responses to DBS according to differential patterns of connectivity. As patients have been implanted, new dilemmas have emerged, such as what to do when the patient does not respond to surgery. CASE PRESENTATION Here we describe a 22-year-old male with extremely severe OCD who did not respond to treatment with DBS in the nucleus accumbens, but who did respond after explanting and reimplanting leads targeting the ventral capsule-ventral striatum region. Information regarding the position of the electrodes for both surgeries is provided and possible brain structures affected during stimulation are reviewed. To our knowledge this case is the first in the literature reporting the removal and reimplantation of DBS leads for therapeutical benefits in a patient affected by a mental disorder. CONCLUSION The capability for explantation and reimplantation of leads should be considered as part of the DBS therapy reversibility profile in resistant mental disorders, as it allows application in cases of non-response to the first surgery.
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Affiliation(s)
- Eva Real
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), C/ Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain. .,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Gerard Plans
- Department of Neurosurgery, Bellvitge University Hospital, C/ Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain.
| | - Pino Alonso
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), C/ Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain. .,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
| | - Marco A. Aparicio
- Department of Neurosurgery, Bellvitge University Hospital, C/ Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain
| | - Cinto Segalàs
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), C/ Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain. .,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Narcís Cardoner
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), C/ Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain. .,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. .,Mental Health Department, Corporació Sanitària Parc Taulí, Sabadell, Spain.
| | - Carles Soriano-Mas
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), C/ Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain. .,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Clara López-Solà
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), C/ Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain. .,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - José M. Menchón
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), C/ Feixa Llarga s/n, 08907 Hospitalet del Llobregat, Barcelona, Spain ,Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
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37
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Real E, Jover L, Verdaguer R, Griera A, Segalàs C, Alonso P, Contreras F, Arteman A, Menchón JM. Factors Associated with Long-Term Sickness Absence Due to Mental Disorders: A Cohort Study of 7.112 Patients during the Spanish Economic Crisis. PLoS One 2016; 11:e0146382. [PMID: 26730603 PMCID: PMC4701450 DOI: 10.1371/journal.pone.0146382] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 12/16/2015] [Indexed: 02/02/2023] Open
Abstract
Background Mental health problems are very common and often lead to prolonged sickness absence, having serious economic repercussions for most European countries. Periods of economic crisis are important social phenomena that are assumed to increase sickness absence due to mental disorders, although research on this topic remains scarce. The aim of this study was to gather data on long-term sickness absence (and relapse) due to mental disorders in Spain during a period of considerable socio-economic crisis. Methods Relationships were analyzed (using chi-squared tests and multivariate modelling via binary logistic regression) between clinical, social/employment-related and demographic factors associated and long-term sickness absence (>60 consecutive days) due to mental disorders in a cohort of 7112 Spanish patients during the period 2008–2012. Results Older age, severe mental disorders, being self-employed, having a non-permanent contract, and working in the real estate and construction sector were associated with an increased probability of long-term sickness absence (gender had a mediating role with respect to some of these variables). Relapses were associated with short-term sick leave (return to work due to ‘improvement’) and with working in the transport sector and public administration. Conclusions Aside from medical factors, other social/employment-related and demographic factors have a significant influence on the duration of sickness absence due to mental disorders.
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Affiliation(s)
- Eva Real
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- * E-mail:
| | - Lluís Jover
- Biostatistics Unit, Department of Public Health, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Ricard Verdaguer
- Egarsat, Mutual Society for Work Accidents and Work-Related Illnesses n° 276, Spain
| | - Antoni Griera
- Egarsat, Mutual Society for Work Accidents and Work-Related Illnesses n° 276, Spain
| | - Cinto Segalàs
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Pino Alonso
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Fernando Contreras
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Antoni Arteman
- SSM–Serveis de Salut Mental S.L. Comprehensive Health Services for Sick Doctors, Galatea Foundation, Barcelona, Spain
| | - José M. Menchón
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Goldberg X, Soriano-Mas C, Alonso P, Segalàs C, Real E, López-Solà C, Subirà M, Via E, Jiménez-Murcia S, Menchón JM, Cardoner N. Predictive value of familiality, stressful life events and gender on the course of obsessive-compulsive disorder. J Affect Disord 2015; 185:129-34. [PMID: 26172984 DOI: 10.1016/j.jad.2015.06.047] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/29/2015] [Accepted: 06/29/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Familiality, stressful life events (SLE) and gender significantly affect the onset of obsessive-compulsive disorder (OCD). However, their combined impact on the probability of OCD chronicity is largely unknown. With the objective of clarifying their predictive value, we tested a model of interaction effects between these influences. METHODS A sample of 449 patients with OCD was systematically assessed for familial loading, exposure to stressful life events, gender and course of the disease at the OCD referral unit at Bellvitge University Hospital. Multiple ordinal logistic regression was used to test interaction models. RESULTS Familiality presented a main negative association with chronicity (OR=0.83, CI97.5%=0.70-0.98). This association was additively moderated by both exposure to SLE before onset and gender, and showed a positive slope among female patients not exposed to SLE before onset (Familiality*SLEbo: OR=0.69, CI97.5%=0.47-1; Familiality*gender: OR=1.30, CI97.5%=0.91-1.84). LIMITATIONS The findings are based on cross-sectional data. Assessment of course is based on a retrospective measure, which may imply the possibility of overestimation of chronicity. CONCLUSIONS The predictive value of familiality on the course of OCD is only partially informative as both SLEbo and gender modify the association. When other risk factors are included in the model, familiality may predict decreased chances of chronicity. The mediation effects identified could explain the discrepancies found in previous research on this topic. Increased chances of presenting a chronic course of OCD may be found in association with familial vulnerability among female patients not exposed to SLEbo.
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Affiliation(s)
- Ximena Goldberg
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain.
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain.
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Cinto Segalàs
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain
| | - Eva Real
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain
| | - Clara López-Solà
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Marta Subirà
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Esther Via
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Physiopathology, Obesity and Nutrition CIBER (CIBERobn), Carlos III Health Institute, Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
| | - Narcís Cardoner
- Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain
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39
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Alonso P, Cuadras D, Gabriëls L, Denys D, Goodman W, Greenberg BD, Jimenez-Ponce F, Kuhn J, Lenartz D, Mallet L, Nuttin B, Real E, Segalas C, Schuurman R, Tezenas du Montcel S, Menchon JM. Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Meta-Analysis of Treatment Outcome and Predictors of Response. PLoS One 2015. [PMID: 26208305 PMCID: PMC4514753 DOI: 10.1371/journal.pone.0133591] [Citation(s) in RCA: 195] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Deep brain stimulation (DBS) has been proposed as an alternative to ablative neurosurgery for severe treatment-resistant Obsessive-Compulsive Disorder (OCD), although with partially discrepant results probably related to differences in anatomical targetting and stimulation conditions. We sought to determine the efficacy and tolerability of DBS in OCD and the existence of clinical predictors of response using meta-analysis. Methods We searched the literature on DBS for OCD from 1999 through January 2014 using PubMed/MEDLINE and PsycINFO. We performed fixed and random-effect meta-analysis with score changes (pre-post DBS) on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) as the primary-outcome measure, and the number of responders to treatment, quality of life and acceptability as secondary measures. Findings Thirty-one studies involving 116 subjects were identified. Eighty-three subjects were implanted in striatal areas—anterior limb of the internal capsule, ventral capsule and ventral striatum, nucleus accumbens and ventral caudate—27 in the subthalamic nucleus and six in the inferior thalamic peduncle. Global percentage of Y-BOCS reduction was estimated at 45.1% and global percentage of responders at 60.0%. Better response was associated with older age at OCD onset and presence of sexual/religious obsessions and compulsions. No significant differences were detected in efficacy between targets. Five patients dropped out, but adverse effects were generally reported as mild, transient and reversible. Conclusions Our analysis confirms that DBS constitutes a valid alternative to lesional surgery for severe, therapy-refractory OCD patients. Well-controlled, randomized studies with larger samples are needed to establish the optimal targeting and stimulation conditions and to extend the analysis of clinical predictors of outcome.
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Affiliation(s)
- Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Barcelona, Spain
- Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
- * E-mail:
| | - Daniel Cuadras
- Methodological and Statistical Assessment Unit, Parc Sanitari Sant Joan de Déu—Fundació Sant Joan de Déu, Barcelona, Spain
| | - Loes Gabriëls
- University Centre for OCD, Department of Psychiatry, UPC-KULeuven, Leuven, Belgium
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Brain Imaging Center, Academic Medical Center, University of Amsterdam, and the Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Wayne Goodman
- Department of Psychiatry and Behavioral Health System, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Ben D. Greenberg
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Butler Hospital, Providence, Rhode Island, United States of America
| | - Fiacro Jimenez-Ponce
- Unit of Stereotactic, Functional Neurosurgery and Radiosurgery, General Hospital of Mexico, Mexico City, Mexico
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Doris Lenartz
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Luc Mallet
- UPMC-Inserm U1127-CNRS UMR7225, ICM–Brain & Spine Institute, Paris, France
| | - Bart Nuttin
- Department of Neurosurgery, UZ Leuven, KU Leuven, Belgium
| | - Eva Real
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Barcelona, Spain
| | - Cinto Segalas
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Barcelona, Spain
| | - Rick Schuurman
- Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sophie Tezenas du Montcel
- UPMC Univ Paris 06, ER4, Modelling in Clinical Research, Paris, France
- AP-HP, Hopitaux Universitaires Pitié-Salpétrière Charles-Foix, Department of Biostatistics and Medical Informatics, Paris, France
| | - Jose M. Menchon
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain
- CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Barcelona, Spain
- Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
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Subirà M, Sato JR, Alonso P, do Rosário MC, Segalàs C, Batistuzzo MC, Real E, Lopes AC, Cerrillo E, Diniz JB, Pujol J, Assis RO, Menchón JM, Shavitt RG, Busatto GF, Cardoner N, Miguel EC, Hoexter MQ, Soriano-Mas C. Brain structural correlates of sensory phenomena in patients with obsessive-compulsive disorder. J Psychiatry Neurosci 2015; 40:232-40. [PMID: 25652753 PMCID: PMC4478056 DOI: 10.1503/jpn.140118] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Sensory phenomena (SP) are uncomfortable feelings, including bodily sensations, sense of inner tension, "just-right" perceptions, feelings of incompleteness, or "urge-only" phenomena, which have been described to precede, trigger or accompany repetitive behaviours in individuals with obsessive-compulsive disorder (OCD). Sensory phenomena are also observed in individuals with tic disorders, and previous research suggests that sensorimotor cortex abnormalities underpin the presence of SP in such patients. However, to our knowledge, no studies have assessed the neural correlates of SP in patients with OCD. METHODS We assessed the presence of SP using the University of São Paulo Sensory Phenomena Scale in patients with OCD and healthy controls from specialized units in São Paulo, Brazil, and Barcelona, Spain. All participants underwent a structural magnetic resonance examination, and brain images were examined using DARTEL voxel-based morphometry. We evaluated grey matter volume differences between patients with and without SP and healthy controls within the sensorimotor and premotor cortices. RESULTS We included 106 patients with OCD and 87 controls in our study. Patients with SP (67% of the sample) showed grey matter volume increases in the left sensorimotor cortex in comparison to patients without SP and bilateral sensorimotor cortex grey matter volume increases in comparison to controls. No differences were observed between patients without SP and controls. LIMITATIONS Most patients were medicated. Participant recruitment and image acquisition were performed in 2 different centres. CONCLUSION We have identified a structural correlate of SP in patients with OCD involving grey matter volume increases within the sensorimotor cortex; this finding is in agreement with those of tic disorder studies showing that abnormal activity and volume increases within this region are associated with the urges preceding tic onset.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcelo Q. Hoexter
- Correspondence to: M. Hoexter, Department & Institute of Psychiatry, University of São Paulo Medical School, Rua Ovídio Pires de Campos, 785-3°andar Ala Norte-sala 9, São Paulo, Brazil, , or C. Soriano-Mas, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain;
| | - Carles Soriano-Mas
- Correspondence to: M. Hoexter, Department & Institute of Psychiatry, University of São Paulo Medical School, Rua Ovídio Pires de Campos, 785-3°andar Ala Norte-sala 9, São Paulo, Brazil, , or C. Soriano-Mas, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain;
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Sauvaget A, Jiménez-Murcia S, Fernández-Aranda F, Fagundo AB, Moragas L, Wolz I, Veciana De Las Heras M, Granero R, Del Pino-Gutiérrez A, Baño M, Real E, Aymamí MN, Grall-Bronnec M, Menchón JM. Unexpected online gambling disorder in late-life: a case report. Front Psychol 2015; 6:655. [PMID: 26074835 PMCID: PMC4444736 DOI: 10.3389/fpsyg.2015.00655] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/04/2015] [Indexed: 12/03/2022] Open
Abstract
Background: The lifetime prevalence of problem or Gambling disorder (GD) in the elderly (i.e., those over 60 years old) is reported to range from 0.01 to 10.9%. Research has identified several specific risk factors and vulnerabilities in the elderly. Since the late 1990s, an increase in online GD has been observed in the youth population, whereas casinos, slot machines, and bingo seem to be the activities of choice among the elderly. Interestingly, online GD has not been described in the elderly to date. Case Description: We report an 83-year-old man who started online casino gambling from the age of 80 years, leading to debts that exceeded €30,000. He underwent a full clinical and neuropsychological assessment, without any evidence of cognitive impairment or any associated neurodegenerative disease. However, he had risk factors for GD, including adjustment disorder, stressful life events, previous offline casino GD when 50 years old, and dysfunctional personality traits. The change to online GD may have been due to his isolation, movement difficulties, and his high level of education, which facilitated his access to the Internet. Care management focused on individual cognitive-behavioral therapy. Conclusion: The prevalence of online GD may be underestimated among the elderly, and may increase among isolated old people with movement difficulties and ready access to the Internet. However, late-life GD should be considered a diagnosis of elimination, requiring a full medical, psychiatric (including suicide risk), and cognitive assessment. Specific therapeutic approaches need to be proposed and developed.
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Affiliation(s)
- Anne Sauvaget
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France ; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain ; Department of Clinical Sciences, School of Medicine, University of Barcelona Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain ; Department of Clinical Sciences, School of Medicine, University of Barcelona Barcelona, Spain
| | - Ana B Fagundo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Ines Wolz
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain
| | | | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III Barcelona, Spain ; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Public Health, Mental Health and Perinatal Nursing, University School of Nursing, University of Barcelona Barcelona, Spain
| | - Marta Baño
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Eva Real
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Maria N Aymamí
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain
| | - Marie Grall-Bronnec
- Addictology and Liaison Psychiatry Department, Nantes University Hospital Nantes, France
| | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL Barcelona, Spain ; Department of Clinical Sciences, School of Medicine, University of Barcelona Barcelona, Spain ; CIBER Salud Mental, Instituto de Salud Carlos III Barcelona, Spain
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Abstract
Obsessive-compulsive disorder (OCD) is a disabling and common neuropsychiatric condition of poorly known etiology. Many attempts have been made in the last few years to develop animal models of OCD with the aim of clarifying the genetic, neurochemical, and neuroanatomical basis of the disorder, as well as of developing novel pharmacological and neurosurgical treatments that may help to improve the prognosis of the illness. The latter goal is particularly important given that around 40% of patients with OCD do not respond to currently available therapies. This article summarizes strengths and limitations of the leading animal models of OCD including genetic, pharmacologically induced, behavioral manipulation-based, and neurodevelopmental models according to their face, construct, and predictive validity. On the basis of this evaluation, we discuss that currently labeled "animal models of OCD" should be regarded not as models of OCD but, rather, as animal models of different psychopathological processes, such as compulsivity, stereotypy, or perseverance, that are present not only in OCD but also in other psychiatric or neurological disorders. Animal models might constitute a challenging approach to study the neural and genetic mechanism of these phenomena from a trans-diagnostic perspective. Animal models are also of particular interest as tools for developing new therapeutic options for OCD, with the greatest convergence focusing on the glutamatergic system, the role of ovarian and related hormones, and the exploration of new potential targets for deep brain stimulation. Finally, future research on neurocognitive deficits associated with OCD through the use of analogous animal tasks could also provide a genuine opportunity to disentangle the complex etiology of the disorder.
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Affiliation(s)
- Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain ; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Clara López-Solà
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain
| | - Eva Real
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain
| | - Cinto Segalàs
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain
| | - José Manuel Menchón
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain ; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
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43
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Segalàs C, Alonso P, Orbegozo A, Real E, Subirà M, López-Solà C, Martínez-Zalacaín I, Labad J, Harrison BJ, Pujol J, Menchón JM, Cardoner N, Soriano-Mas C. Brain structural imaging correlates of olfactory dysfunction in obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci 2014; 264:225-33. [PMID: 23995893 DOI: 10.1007/s00406-013-0439-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 08/17/2013] [Indexed: 12/19/2022]
Abstract
Olfactory dysfunction has been described in obsessive-compulsive disorder (OCD). Brain regions involved in smell processing partially overlap with structures included in the neurobiological models of OCD, although no previous studies have analyzed the neuroanatomical correlates of olfactory dysfunction in this disorder. The aim of our study was to examine the association between regional gray matter volume, as assessed by a voxel-based morphometry analysis of magnetic resonance images (MRI), and olfactory function, as assessed by the Sniffin' Sticks test (SST). Olfactory function was assessed in 19 OCD patients and 19 healthy volunteers. All participants were also scanned in a 1.5-T magnet to obtain T1-weighted anatomical MRIs, which were pre-processed and analyzed with SPM8. Three different correlation models were used to study the association between regional gray matter volumes and olfactory function in the domains assessed by the SST: detection threshold, discrimination, and identification. OCD patients showed a significant impairment in all the domains assessed by the SST. Voxel-based mapping revealed a positive association in healthy controls between detection threshold and the gray matter content of a left anterior cingulate cortex cluster. In OCD patients, a positive correlation was observed between identification errors and the gray matter volume of the left medial orbital gyrus. In a post hoc analysis, these two gray matter regions were shown to be enlarged in OCD patients. Our findings support the idea that olfactory dysfunction in OCD is associated with volumetric changes in brain areas typically implicated in the neurobiology of the disorder.
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Affiliation(s)
- Cinto Segalàs
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Bellvitge University Hospital, c/Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain,
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44
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Fullana MA, Cardoner N, Alonso P, Subirà M, López-Solà C, Pujol J, Segalàs C, Real E, Bossa M, Zacur E, Martínez-Zalacaín I, Bulbena A, Menchón JM, Olmos S, Soriano-Mas C. Brain regions related to fear extinction in obsessive-compulsive disorder and its relation to exposure therapy outcome: a morphometric study. Psychol Med 2014; 44:845-856. [PMID: 23773479 DOI: 10.1017/s0033291713001128] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The size of particular sub-regions within the ventromedial prefrontal cortex (vmPFC) has been associated with fear extinction in humans. Exposure therapy is a form of extinction learning widely used in the treatment of obsessive-compulsive disorder (OCD). Here we investigated the relationship between morphometric measurements of different sub-regions of the vmPFC and exposure therapy outcome in OCD. METHOD A total of 74 OCD patients and 86 healthy controls underwent magnetic resonance imaging (MRI). Cortical thickness and volumetric measurements were obtained for the rostral anterior cingulate cortex (rACC), the medial orbital frontal cortex and the subcallosal cortex. After MRI acquisition, patients were enrolled in an exposure therapy protocol, and we assessed the relationship between MRI-derived measurements and treatment outcome. Baseline between-group differences for such measurements were also assessed. RESULTS Compared with healthy controls, OCD patients showed a thinner left rACC (p = 0.008). Also, left rACC thickness was inversely associated with exposure therapy outcome (r - 0.32, p = 0.008), and this region was significantly thinner in OCD patients who responded to exposure therapy than in those who did not (p = 0.006). Analyses based on regional volumetry did not yield any significant results. CONCLUSIONS OCD patients showed cortical thickness reductions in the left rACC, and these alterations were related to exposure therapy outcome. The precise characterization of neuroimaging predictors of treatment response derived from the study of the brain areas involved in fear extinction may optimize exposure therapy planning in OCD and other anxiety disorders.
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Affiliation(s)
- M A Fullana
- Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar and Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain
| | - N Cardoner
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - P Alonso
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - M Subirà
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - C López-Solà
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - J Pujol
- CRC Mar, Hospital del Mar, Barcelona, Spain
| | - C Segalàs
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - E Real
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - M Bossa
- Aragon Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - E Zacur
- Aragon Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - A Bulbena
- Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar and Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain
| | - J M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - S Olmos
- Aragon Institute of Engineering Research, University of Zaragoza, Zaragoza, Spain
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
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45
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López-Solà C, Gutiérrez F, Alonso P, Rosado S, Taberner J, Segalàs C, Real E, Menchón JM, Fullana MA. Spanish version of the Dimensional Obsessive-Compulsive Scale (DOCS): psychometric properties and relation to obsessive beliefs. Compr Psychiatry 2014; 55:206-14. [PMID: 24209609 DOI: 10.1016/j.comppsych.2013.08.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 07/31/2013] [Accepted: 08/08/2013] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Our main goal was to provide the psychometric properties of the Spanish version of the Dimensional Obsessive-Compulsive Scale (DOCS) in a non-clinical sample (n = 237) and in adult patients with Obsessive-Compulsive Disorder (OCD) (n = 110). We also examined the association between OC symptom dimensions and obsessive beliefs. METHODS The psychometric properties involved four steps: reliability, structural validity, convergent and discriminant validity and diagnostic sensitivity. Linear regression analyses were used to assess the associations between OC symptoms and obsessive beliefs. RESULTS Exploratory and confirmatory factor analyses replicated the original four-factor structure in both samples. The DOCS showed good performance in terms of internal consistency, test-retest reliability and convergent validity in both samples. The DOCS showed better diagnostic sensitivity than another self-report instrument of OC symptoms, the Obsessive-Compulsive Inventory Revised. Findings of the relationship between obsessive beliefs and OC symptoms revealed that certain obsessive beliefs predicted specific OC symptom dimensions. CONCLUSIONS The Spanish version of the DOCS has similar psychometric properties than the original English instrument, although its performance is somewhat better in OCD patients than in students. It will be important to ascertain its ability to discriminate OCD from other associated disorders.
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Affiliation(s)
- Clara López-Solà
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
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46
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Via E, Cardoner N, Pujol J, Alonso P, López-Solà M, Real E, Contreras-Rodríguez O, Deus J, Segalàs C, Menchón JM, Soriano-Mas C, Harrison BJ. Amygdala activation and symptom dimensions in obsessive-compulsive disorder. Br J Psychiatry 2014; 204:61-8. [PMID: 24262816 DOI: 10.1192/bjp.bp.112.123364] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Despite knowledge of amygdala involvement in fear and anxiety, its contribution to the pathophysiology of obsessive-compulsive disorder (OCD) remains controversial. In the context of neuroimaging studies, it seems likely that the heterogeneity of the disorder might have contributed to a lack of consistent findings. AIMS To assess the influence of OCD symptom dimensions on amygdala responses to a well-validated emotional face-matching paradigm. METHOD Cross-sectional functional magnetic resonance imaging (fMRI) study of 67 patients with OCD and 67 age-, gender- and education-level matched healthy controls. RESULTS The severity of aggression/checking and sexual/religious symptom dimensions were significantly associated with heightened amygdala activation in those with OCD when responding to fearful faces, whereas no such correlations were seen for other symptom dimensions. CONCLUSIONS Amygdala functional alterations in OCD appear to be specifically modulated by symptom dimensions whose origins may be more closely linked to putative amygdala-centric processes, such as abnormal fear processing.
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Affiliation(s)
- Esther Via
- Esther Via, MD, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain, and Melbourne Neuropsychiatry Centre, Department of Psychiatry & Melbourne Health, The University of Melbourne, National Neuroscience Facility, Melbourne, Australia; Narcís Cardoner, MD, PhD, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain, Carlos III Health Institute, CIBERSAM, Spain and Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain; Jesús Pujol, MD, MRI Research Unit, CRC Mar, Hospital de Mar, Barcelona, Spain; Pino Alonso, MD, PhD, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain, Carlos III Health Institute, CIBERSAM, Spain, and Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain; Marina López-Solà, PhD, MRI Research Unit, CRC Mar, Hospital de Mar, Barcelona, Spain and Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, Colorado, USA; Eva Real, MD, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain and Carlos III Health Institute, CIBERSAM, Spain; Oren Contreras-Rodríguez, PhD, Carlos III Health Institute, CIBERSAM, Spain and MRI Research Unit, CRC Mar, Hospital de Mar, Barcelona, Spain; Joan Deus, PhD, MRI Research Unit, CRC Mar, Hospital de Mar, Barcelona, and Department of Clinical and Health Psychology, Autonomous University of Barcelona, Barcelona, Spain; Cinto Segalàs, MD, PhD, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain, and Carlos III Health Institute, CIBERSAM, Spain; José M. Menchón, MD, PhD, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain, Carlos III Health Institute, CIBERSAM, Spain, and Department of Clini
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Alonso P, Orbegozo A, Pujol J, López-Solà C, Fullana MÀ, Segalàs C, Real E, Subirà M, Martínez-Zalacaín I, Menchón JM, Harrison BJ, Cardoner N, Soriano-Mas C. Neural correlates of obsessive-compulsive related dysfunctional beliefs. Prog Neuropsychopharmacol Biol Psychiatry 2013; 47:25-32. [PMID: 23911440 DOI: 10.1016/j.pnpbp.2013.07.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 07/22/2013] [Accepted: 07/23/2013] [Indexed: 12/30/2022]
Abstract
There have been few attempts to integrate neurobiological and cognitive models of obsessive-compulsive disorder (OCD), although this might constitute a key approach to clarify the complex etiology of the disorder. Our study aimed to explore the neural correlates underlying dysfunctional beliefs hypothesized by cognitive models to be involved in the development and maintenance of OCD. We obtained a high-resolution magnetic resonance image from fifty OCD patients and 30 healthy controls, and correlated them, voxel-wise, with the severity of OC-related dysfunctional beliefs assessed by the Obsessive Beliefs Questionnaire-44. In healthy controls, significant negative correlations were observed between anterior temporal lobe (ATL) volume and scores on perfectionism/intolerance of uncertainty and overimportance/need to control thoughts. No significant correlations between OBQ-44 domains and regional gray matter volumes were observed in OCD patients. A post-hoc region-of-interest analysis detected that the ATLs was bilaterally smaller in OCD patients. On splitting subjects into high- and low-belief subgroups, we observed that such brain structural differences between OCD patients and healthy controls were explained by significantly larger ATL volumes among healthy subjects from the low-belief subgroup. Our results suggest a significant correlation between OC-related dysfunctional beliefs and morphometric variability in the anterior temporal lobe, a brain structure related to socio-emotional processing. Future studies should address the interaction of these correlations with environmental factors to fully characterize the bases of OC-related dysfunctional beliefs and to advance in the integration of biological and cognitive models of OCD.
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Affiliation(s)
- Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Spain; CRC-Hospital del Mar, Barcelona, Spain.
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Subirà M, Alonso P, Segalàs C, Real E, López-Solà C, Pujol J, Martínez-Zalacaín I, Harrison BJ, Menchón JM, Cardoner N, Soriano-Mas C. Brain structural alterations in obsessive-compulsive disorder patients with autogenous and reactive obsessions. PLoS One 2013; 8:e75273. [PMID: 24098688 PMCID: PMC3787080 DOI: 10.1371/journal.pone.0075273] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 08/15/2013] [Indexed: 11/19/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. Although structural brain alterations have been consistently reported in OCD, their interaction with particular clinical subtypes deserves further examination. Among other approaches, a two-group classification in patients with autogenous and reactive obsessions has been proposed. The purpose of the present study was to assess, by means of a voxel-based morphometry analysis, the putative brain structural correlates of this classification scheme in OCD patients. Ninety-five OCD patients and 95 healthy controls were recruited. Patients were divided into autogenous (n = 30) and reactive (n = 65) sub-groups. A structural magnetic resonance image was acquired for each participant and pre-processed with SPM8 software to obtain a volume-modulated gray matter map. Whole-brain and voxel-wise comparisons between the study groups were then performed. In comparison to the autogenous group, reactive patients showed larger gray matter volumes in the right Rolandic operculum. When compared to healthy controls, reactive patients showed larger volumes in the putamen (bilaterally), while autogenous patients showed a smaller left anterior temporal lobe. Also in comparison to healthy controls, the right middle temporal gyrus was smaller in both patient subgroups. Our results suggest that autogenous and reactive obsessions depend on partially dissimilar neural substrates. Our findings provide some neurobiological support for this classification scheme and contribute to unraveling the neurobiological basis of clinical heterogeneity in OCD.
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Affiliation(s)
- Marta Subirà
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Pino Alonso
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Cinto Segalàs
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Eva Real
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Clara López-Solà
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Jesús Pujol
- Magnetic Resonance Unit, CRC-Hospital del Mar, Barcelona, Spain
| | - Ignacio Martínez-Zalacaín
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Ben J. Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - José M. Menchón
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Narcís Cardoner
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Carles Soriano-Mas
- Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- * E-mail:
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49
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Alonso P, López-Solà C, Gratacós M, Fullana MA, Segalàs C, Real E, Cardoner N, Soriano-Mas C, Harrison BJ, Estivill X, Menchón JM. The interaction between Comt and Bdnf variants influences obsessive-compulsive-related dysfunctional beliefs. J Anxiety Disord 2013; 27:321-7. [PMID: 23602946 DOI: 10.1016/j.janxdis.2013.02.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 02/26/2013] [Accepted: 02/27/2013] [Indexed: 01/29/2023]
Abstract
Cognitive models emphasize the importance of dysfunctional beliefs as overimportance/need to control thoughts, perfectionism, intolerance of uncertainty, responsibility, and overestimation of threat in obsessive-compulsive disorder (OCD). Twin studies suggest that these beliefs are significantly heritable, but candidate genes associated with them have not been analyzed. We genotyped the Val158Met in the COMT gene and Val66Met variant in the BDNF gene in 141 OCD patients and analyzed their single and interactive effects on the obsessive beliefs questionnaire (OBQ-44). Variability in dysfunctional beliefs was not affected by the COMT or BDNF genotype in isolation, but we detected a significant COMT×BDNF interaction effect on responsibility/overestimation of threat and overimportance/need to control thoughts scores. Subjects with the BDNF Met-present and the COMT Met-present genotype showed higher scores on responsibility/overestimation of threat. An interaction between dopaminergic and neurotrophic functional gene variants may influence dysfunctional beliefs hypothesized to contribute to the development of OCD.
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Affiliation(s)
- Pino Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital de Bellvitge, Barcelona, Spain.
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50
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Harrison BJ, Pujol J, Cardoner N, Deus J, Alonso P, López-Solà M, Contreras-Rodríguez O, Real E, Segalàs C, Blanco-Hinojo L, Menchon JM, Soriano-Mas C. Brain corticostriatal systems and the major clinical symptom dimensions of obsessive-compulsive disorder. Biol Psychiatry 2013. [PMID: 23200527 DOI: 10.1016/j.biopsych.2012.10.006] [Citation(s) in RCA: 162] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Functional neuroimaging studies have provided consistent support for the idea that obsessive-compulsive disorder (OCD) is associated with disturbances of brain corticostriatal systems. However, in general, these studies have not sought to account for the disorder's prominent clinical heterogeneity. METHODS To address these concerns, we investigated the influence of major OCD symptom dimensions on brain corticostriatal functional systems in a large sample of OCD patients (n = 74) and control participants (n = 74) examined with resting-state functional magnetic resonance imaging. We employed a valid method for mapping ventral and dorsal striatal functional connectivity, which supported both standard group comparisons and linear regression analyses with patients' scores on the Dimensional Yale-Brown Obsessive-Compulsive Scale. RESULTS Consistent with past findings, patients demonstrated a common connectivity alteration involving the ventral striatum and orbitofrontal cortex that predicted overall illness severity levels. This common alteration was independent of the effect of particular symptom dimensions. Instead, we observed distinct anatomical relationships between the severity of symptom dimensions and striatal functional connectivity. Aggression symptoms modulated connectivity between the ventral striatum, amygdala, and ventromedial frontal cortex, while sexual/religious symptoms had a specific influence on ventral striatal-insular connectivity. Hoarding modulated the strength of ventral and dorsal striatal connectivity with distributed frontal regions. CONCLUSIONS Taken together, these results suggest that pathophysiological changes among orbitofrontal-striatal regions may be common to all forms of OCD. They suggest that a further examination of certain dimensional relationships will also be relevant for advancing current neurobiological models of the disorder.
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Affiliation(s)
- Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia.
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