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Pan X, Wang Z. Cortical and subcortical contributions to non-motor inhibitory control: an fMRI study. Cereb Cortex 2023; 33:10909-10917. [PMID: 37724423 DOI: 10.1093/cercor/bhad336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023] Open
Abstract
Inhibition is a core executive cognitive function. However, the neural correlates of non-motor inhibitory control are not well understood. We investigated this question using functional Magnetic Resonance Imaging (fMRI) and a simple Count Go/NoGo task (n = 23), and further explored the causal relationships between activated brain regions. We found that the Count NoGo task activated a distinct pattern in the subcortical basal ganglia, including bilateral ventral anterior/lateral nucleus of thalamus (VA/VL), globus pallidus/putamen (GP/putamen), and subthalamic nucleus (STN). Stepwise regressions and mediation analyses revealed that activations in these region(s) were modulated differently by only 3 cortical regions i.e. the right inferior frontal gyrus/insula (rIFG/insula), along with left IFG/insula, and anterior cingulate cortex/supplementary motor area (ACC/SMA). The activations of bilateral VA/VL were modulated by both rSTN and rIFG/insula (with rGP/putamen as a mediator) independently, and the activation of rGP/putamen was modulated by ACC/SMA, with rIFG/insula as a mediator. Our findings provide the neural correlates of inhibitory control of counting and causal relationships between them, and strongly suggest that both indirect and hyperdirect pathways of the basal ganglia are involved in the Count NoGo condition.
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Affiliation(s)
- Xin Pan
- Key Laboratory of Brain Functional Genomics (Ministry of Education and Shanghai), Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Psychological Counseling Center, Shanghai University, Shanghai, China
| | - Zhaoxin Wang
- Key Laboratory of Brain Functional Genomics (Ministry of Education and Shanghai), Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Shanghai Changning Mental Health Center, Shanghai, China
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2
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Li H, Wang Y, Xi H, Zhang J, Zhao M, Jia X. Alterations of regional spontaneous brain activity in obsessive-compulsive disorders: A meta-analysis. J Psychiatr Res 2023; 165:325-335. [PMID: 37573797 DOI: 10.1016/j.jpsychires.2023.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/04/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Recent studies using resting-state functional magnetic resonance imaging (rs-fMRI) demonstrate that there is aberrant regional spontaneous brain activity in obsessive-compulsive disorders (OCD). Nevertheless, the results of previous studies are contradictory, especially in the abnormal brain regions and the directions of their activities. It is necessary to perform a meta-analysis to identify the common pattern of altered regional spontaneous brain activity in patients with OCD. METHODS The present study conducted a systematic search for studies in English published up to May 2023 in PubMed, Web of Science, and Embase. These studies measured differences in regional spontaneous brain activity at the whole brain level using regional homogeneity (ReHo), the amplitude of low-frequency fluctuations (ALFF) and the fractional amplitude of low-frequency fluctuations (fALFF). Then the Anisotropic effect-size version of seed-based d mapping (AES-SDM) was used to investigate the consistent abnormality of regional spontaneous brain activity in patients with OCD. RESULTS 27 studies (33 datasets) were included with 1256 OCD patients (650 males, 606 females) and 1176 healthy controls (HCs) (588 males, 588 females). Compared to HCs, patients with OCD showed increased spontaneous brain activity in the right inferior parietal gyrus (Brodmann Area 39), left median cingulate and paracingulate gyri (Brodmann Area 24), bilateral inferior cerebellum, right middle frontal gyrus (Brodmann Area 46), left inferior frontal gyrus in triangular part (Brodmann Area 45) and left middle frontal gyrus in orbital part (Brodmann Area 11). Meanwhile, decreased spontaneous brain activity was identified in the right precentral gyrus (Brodmann Area 4), right insula (Brodmann Area 48), left postcentral gyrus (Brodmann Area 43), bilateral superior cerebellum and left caudate (Brodmann Area 25). CONCLUSIONS This meta-analysis provided a quantitative review of spontaneous brain activity in OCD. The results demonstrated that the brain regions in the frontal lobe, sensorimotor cortex, cerebellum, caudate and insula are crucially involved in the pathophysiology of OCD. This research contributes to the understanding of the pathophysiologic mechanism underlying OCD and could provide a new perspective on future diagnosis and treatment of OCD.
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Affiliation(s)
- Huayun Li
- School of Psychology, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China; Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Jinhua, China.
| | - Yihe Wang
- School of Psychology, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China; Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Jinhua, China
| | - Hongyu Xi
- School of Western Language, Heilongjiang University, Harbin, China
| | - Jianxin Zhang
- School of Foreign Studies, China University of Petroleum (East China), Qingdao, China
| | - Mengqi Zhao
- School of Psychology, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China
| | - Xize Jia
- School of Psychology, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China.
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3
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Lv Q, Zeljic K, Zhao S, Zhang J, Zhang J, Wang Z. Dissecting Psychiatric Heterogeneity and Comorbidity with Core Region-Based Machine Learning. Neurosci Bull 2023; 39:1309-1326. [PMID: 37093448 PMCID: PMC10387015 DOI: 10.1007/s12264-023-01057-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/17/2023] [Indexed: 04/25/2023] Open
Abstract
Machine learning approaches are increasingly being applied to neuroimaging data from patients with psychiatric disorders to extract brain-based features for diagnosis and prognosis. The goal of this review is to discuss recent practices for evaluating machine learning applications to obsessive-compulsive and related disorders and to advance a novel strategy of building machine learning models based on a set of core brain regions for better performance, interpretability, and generalizability. Specifically, we argue that a core set of co-altered brain regions (namely 'core regions') comprising areas central to the underlying psychopathology enables the efficient construction of a predictive model to identify distinct symptom dimensions/clusters in individual patients. Hypothesis-driven and data-driven approaches are further introduced showing how core regions are identified from the entire brain. We demonstrate a broadly applicable roadmap for leveraging this core set-based strategy to accelerate the pursuit of neuroimaging-based markers for diagnosis and prognosis in a variety of psychiatric disorders.
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Affiliation(s)
- Qian Lv
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, 100871, China.
| | - Kristina Zeljic
- School of Health and Psychological Sciences, City, University of London, London, EC1V 0HB, UK
| | - Shaoling Zhao
- Institute of Neuroscience, State Key Laboratory of Neuroscience, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Jiangtao Zhang
- Tongde Hospital of Zhejiang Province (Zhejiang Mental Health Center), Zhejiang Office of Mental Health, Hangzhou, 310012, China
| | - Jianmin Zhang
- Tongde Hospital of Zhejiang Province (Zhejiang Mental Health Center), Zhejiang Office of Mental Health, Hangzhou, 310012, China
| | - Zheng Wang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, 100871, China.
- School of Biomedical Engineering, Hainan University, Haikou, 570228, China.
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4
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Ruan Z, Seger CA, Yang Q, Kim D, Lee SW, Chen Q, Peng Z. Impairment of arbitration between model-based and model-free reinforcement learning in obsessive-compulsive disorder. Front Psychiatry 2023; 14:1162800. [PMID: 37304449 PMCID: PMC10250695 DOI: 10.3389/fpsyt.2023.1162800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Obsessive-compulsive disorder (OCD) is characterized by an imbalance between goal-directed and habitual learning systems in behavioral control, but it is unclear whether these impairments are due to a single system abnormality of the goal-directed system or due to an impairment in a separate arbitration mechanism that selects which system controls behavior at each point in time. Methods A total of 30 OCD patients and 120 healthy controls performed a 2-choice, 3-stage Markov decision-making paradigm. Reinforcement learning models were used to estimate goal-directed learning (as model-based reinforcement learning) and habitual learning (as model-free reinforcement learning). In general, 29 high Obsessive-Compulsive Inventory-Revised (OCI-R) score controls, 31 low OCI-R score controls, and all 30 OCD patients were selected for the analysis. Results Obsessive-compulsive disorder (OCD) patients showed less appropriate strategy choices than controls regardless of whether the OCI-R scores in the control subjects were high (p = 0.012) or low (p < 0.001), specifically showing a greater model-free strategy use in task conditions where the model-based strategy was optimal. Furthermore, OCD patients (p = 0.001) and control subjects with high OCI-R scores (H-OCI-R; p = 0.009) both showed greater system switching rather than consistent strategy use in task conditions where model-free use was optimal. Conclusion These findings indicated an impaired arbitration mechanism for flexible adaptation to environmental demands in both OCD patients and healthy individuals reporting high OCI-R scores.
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Affiliation(s)
- Zhongqiang Ruan
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Carol A. Seger
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Qiong Yang
- Affective Disorder Center, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Dongjae Kim
- Department of AI-based Convergence, College of Engineering, Dankook University, Yongin, Republic of Korea
| | - Sang Wan Lee
- Department of Bio and Brain Engineering, Program of Brain and Cognitive Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Qi Chen
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Ziwen Peng
- Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen University School of Medicine, Shenzhen, China
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5
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Tan V, Dockstader C, Moxon-Emre I, Mendlowitz S, Schacter R, Colasanto M, Voineskos AN, Akingbade A, Nishat E, Mabbott DJ, Arnold PD, Ameis SH. Preliminary Observations of Resting-State Magnetoencephalography in Nonmedicated Children with Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol 2022; 32:522-532. [PMID: 36548364 PMCID: PMC9917323 DOI: 10.1089/cap.2022.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Cortico-striato-thalamo-cortical (CSTC) network alterations are hypothesized to contribute to symptoms of obsessive-compulsive disorder (OCD). To date, very few studies have examined whether CSTC network alterations are present in children with OCD, who are medication naive. Medication-naive pediatric imaging samples may be optimal to study neural correlates of illness and identify brain-based markers, given the proximity to illness onset. Methods: Magnetoencephalography (MEG) data were analyzed at rest, in 18 medication-naive children with OCD (M = 12.1 years ±2.0 standard deviation [SD]; 10 M/8 F) and 13 typically developing children (M = 12.3 years ±2.2 SD; 6 M/7 F). Whole-brain MEG-derived resting-state functional connectivity (rs-fc), for alpha- and gamma-band frequencies were compared between OCD and typically developing (control) groups. Results: Increased MEG-derived rs-fc across alpha- and gamma-band frequencies was found in the OCD group compared to the control group. Increased MEG-derived rs-fc at alpha-band frequencies was evident across a number of regions within the CSTC circuitry and beyond, including the cerebellum and limbic regions. Increased MEG-derived rs-fc at gamma-band frequencies was restricted to the frontal and temporal cortices. Conclusions: This MEG study provides preliminary evidence of altered alpha and gamma networks, at rest, in medication-naive children with OCD. These results support prior findings pointing to the relevance of CSTC circuitry in pediatric OCD and further support accumulating evidence of altered connectivity between regions that extend beyond this network, including the cerebellum and limbic regions. Given the substantial portion of children and youth whose OCD symptoms do not respond to conventional treatments, our findings have implications for future treatment innovation research aiming to target and track whether brain patterns associated with having OCD may change with treatment and/or predict treatment response.
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Affiliation(s)
- Vinh Tan
- Human Biology Program, Faculty of Arts and Science, University of Toronto, Toronto, Canada
- Kimel Family Translational Imaging Genetics Research Laboratory, Centre for Addiction and Mental Health, Toronto, Canada
| | - Colleen Dockstader
- Human Biology Program, Faculty of Arts and Science, University of Toronto, Toronto, Canada
| | - Iska Moxon-Emre
- Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sandra Mendlowitz
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Reva Schacter
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
| | - Marlena Colasanto
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada
| | - Aristotle N. Voineskos
- Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Aquila Akingbade
- Human Biology Program, Faculty of Arts and Science, University of Toronto, Toronto, Canada
| | - Eman Nishat
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, Canada
- Department of Physiology, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Donald J. Mabbott
- Department of Physiology, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Paul D. Arnold
- Department of Psychiatry, Cumming School of Medicine, The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Stephanie H. Ameis
- Cundill Centre for Child and Youth Depression, Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, Canada
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6
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Raposo-Lima C, Moreira P, Magalhães R, Ferreira S, Sousa N, Picó-Pérez M, Morgado P. Differential patterns of association between resting-state functional connectivity networks and stress in OCD patients. Prog Neuropsychopharmacol Biol Psychiatry 2022; 118:110563. [PMID: 35569618 DOI: 10.1016/j.pnpbp.2022.110563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 04/11/2022] [Accepted: 05/02/2022] [Indexed: 10/18/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a highly prevalent psychiatric disorder that is characterized by its complex pathophysiology and heterogenous presentation. Multiple studies to date have identified a variety of factors that are involved in the development of symptoms, but little is known about how these affect brain function. In this study, we have tried to understand how stress, one of the most studied risk factors for OCD, may influence resting-state functional connectivity (rsFC) by comparing resting brain activity of OCD patients with healthy control subjects, while assessing self-reported levels of perceived stress using the Perceived Stress Scale-10 (PSS-10). Seventy-five OCD patients and seventy-one healthy matched control subjects were enrolled in this study, where we used a data-driven, independent component analysis approach. Our results show differences in connectivity between patients and healthy controls involving the dorsal attention (DAN) and lateral visual networks, with patients presenting increased rsFC within the DAN and decreased rsFC within the lateral visual network. Moreover, connectivity in the anterior default mode (aDMN), dorsal attention and basal ganglia networks was associated with PSS scores in OCD patients. Specifically, rsFC within the DAN and aDMN was positively correlated with PSS scores, while the opposite was observed for the basal ganglia network. This study is the first to report such association between rsFC alterations and self-reported stress levels. Our findings are relevant in the context of OCD pathophysiology given evidence of functional dysconnectivity involving the same networks in previous OCD studies and the possible involvement of these changes in the generation of obsessions.
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Affiliation(s)
- Catarina Raposo-Lima
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Pedro Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal; Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS-3Bs PT Government Associate Laboratory, Braga, Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal; Hospital de Braga, Braga, Portugal.
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7
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Kalmady SV, Paul AK, Narayanaswamy JC, Agrawal R, Shivakumar V, Greenshaw AJ, Dursun SM, Greiner R, Venkatasubramanian G, Reddy YCJ. Prediction of Obsessive-Compulsive Disorder: Importance of Neurobiology-Aided Feature Design and Cross-Diagnosis Transfer Learning. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:735-746. [PMID: 34929344 DOI: 10.1016/j.bpsc.2021.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/25/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Machine learning applications using neuroimaging provide a multidimensional, data-driven approach that captures the level of complexity necessary for objectively aiding diagnosis and prognosis in psychiatry. However, models learned from small training samples often have limited generalizability, which continues to be a problem with automated diagnosis of mental illnesses such as obsessive-compulsive disorder (OCD). Earlier studies have shown that features incorporating prior neurobiological knowledge of brain function and combining brain parcellations from various sources can potentially improve the overall prediction. However, it is unknown whether such knowledge-driven methods can provide a performance that is comparable to state-of-the-art approaches based on neural networks. METHODS In this study, we apply a transparent and explainable multiparcellation ensemble learning framework EMPaSchiz (Ensemble algorithm with Multiple Parcellations for Schizophrenia prediction) to the task of predicting OCD, based on a resting-state functional magnetic resonance imaging dataset of 350 subjects. Furthermore, we apply transfer learning using the features found effective for schizophrenia to OCD to leverage the commonality in brain alterations across these psychiatric diagnoses. RESULTS We show that our knowledge-based approach leads to a prediction performance of 80.3% accuracy for OCD diagnosis that is better than domain-agnostic and automated feature design using neural networks. Furthermore, we show that a selection of reduced feature sets can be transferred from schizophrenia to the OCD prediction model without significant loss in prediction performance. CONCLUSIONS This study presents a machine learning framework for OCD prediction with neurobiology-aided feature design using resting-state functional magnetic resonance imaging that is generalizable and reasonably interpretable.
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Affiliation(s)
- Sunil Vasu Kalmady
- Alberta Machine Intelligence Institute, Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada; Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada.
| | - Animesh Kumar Paul
- Alberta Machine Intelligence Institute, Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada
| | - Janardhanan C Narayanaswamy
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Rimjhim Agrawal
- Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Venkataram Shivakumar
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Andrew J Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Serdar M Dursun
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Russell Greiner
- Alberta Machine Intelligence Institute, Department of Computing Science, University of Alberta, Edmonton, Alberta, Canada; Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ganesan Venkatasubramanian
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
| | - Y C Janardhan Reddy
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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8
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Li N, Hollunder B, Baldermann JC, Kibleur A, Treu S, Akram H, Al-Fatly B, Strange BA, Barcia JA, Zrinzo L, Joyce EM, Chabardes S, Visser-Vandewalle V, Polosan M, Kuhn J, Kühn AA, Horn A. A Unified Functional Network Target for Deep Brain Stimulation in Obsessive-Compulsive Disorder. Biol Psychiatry 2021; 90:701-713. [PMID: 34134839 DOI: 10.1016/j.biopsych.2021.04.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Multiple deep brain stimulation (DBS) targets have been proposed for treating intractable obsessive-compulsive disorder (OCD). Here, we investigated whether stimulation effects of different target sites would be mediated by one common or several segregated functional brain networks. METHODS First, seeding from active electrodes of 4 OCD patient cohorts (N = 50) receiving DBS to anterior limb of the internal capsule or subthalamic nucleus zones, optimal functional connectivity profiles for maximal Yale-Brown Obsessive Compulsive Scale improvements were calculated and cross-validated in leave-one-cohort-out and leave-one-patient-out designs. Second, we derived optimal target-specific connectivity patterns to determine brain regions mutually predictive of clinical outcome for both targets and others predictive for either target alone. Functional connectivity was defined using resting-state functional magnetic resonance imaging data acquired in 1000 healthy participants. RESULTS While optimal functional connectivity profiles showed both commonalities and differences between target sites, robust cross-predictions of clinical improvements across OCD cohorts and targets suggested a shared network. Connectivity to the anterior cingulate cortex, insula, and precuneus, among other regions, was predictive regardless of stimulation target. Regions with maximal connectivity to these commonly predictive areas included the insula, superior frontal gyrus, anterior cingulate cortex, and anterior thalamus, as well as the original stereotactic targets. CONCLUSIONS Pinpointing the network modulated by DBS for OCD from different target sites identified a set of brain regions to which DBS electrodes associated with optimal outcomes were functionally connected-regardless of target choice. On these grounds, we establish potential brain areas that could prospectively inform additional or alternative neuromodulation targets for obsessive-compulsive disorder.
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Affiliation(s)
- Ningfei Li
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany.
| | - Barbara Hollunder
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany; Charité - Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany; Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Juan Carlos Baldermann
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne; Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Astrid Kibleur
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut des Neurosciences (AK, SC, MP), Grenoble; and OpenMind Innovation (AK), Paris, France; OpenMind Innovation, Paris, France
| | - Svenja Treu
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
| | - Harith Akram
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust (UCLH), London, United Kingdom
| | - Bassam Al-Fatly
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany
| | - Bryan A Strange
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Madrid, Spain
| | - Juan A Barcia
- Neurosurgery Department, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - Ludvic Zrinzo
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust (UCLH), London, United Kingdom
| | - Eileen M Joyce
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom; National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust (UCLH), London, United Kingdom
| | - Stephan Chabardes
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut des Neurosciences (AK, SC, MP), Grenoble; and OpenMind Innovation (AK), Paris, France
| | | | - Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut des Neurosciences (AK, SC, MP), Grenoble; and OpenMind Innovation (AK), Paris, France
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, Cologne, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Johanniter Hospital Oberhausen, Evangelisches Klinikum Niederrhein, Oberhausen, Germany
| | - Andrea A Kühn
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany; Charité - Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany; Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Horn
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Movement Disorders and Neuromodulation Unit, Department of Neurology, Berlin, Germany; Charité - Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, Berlin, Germany
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9
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Luo Q, Liu W, Jin L, Chang C, Peng Z. Classification of Obsessive-Compulsive Disorder Using Distance Correlation on Resting-State Functional MRI Images. Front Neuroinform 2021; 15:676491. [PMID: 34744676 PMCID: PMC8564498 DOI: 10.3389/fninf.2021.676491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
Both the Pearson correlation and partial correlation methods have been widely used in the resting-state functional MRI (rs-fMRI) studies. However, they can only measure linear relationship, although partial correlation excludes some indirect effects. Recent distance correlation can discover both the linear and non-linear dependencies. Our goal was to use the multivariate pattern analysis to compare the ability of such three correlation methods to distinguish between the patients with obsessive-compulsive disorder (OCD) and healthy control subjects (HCSs), so as to find optimal correlation method. The main process includes four steps. First, the regions of interest are defined by automated anatomical labeling (AAL). Second, functional connectivity (FC) matrices are constructed by the three correlation methods. Third, the best discriminative features are selected by support vector machine recursive feature elimination (SVM-RFE) with a stratified N-fold cross-validation strategy. Finally, these discriminative features are used to train a classifier. We had a total of 128 subjects out of which 61 subjects had OCD and 67 subjects were normal. All the three correlation methods with SVM have achieved good results, among which distance correlation is the best [accuracy = 93.01%, specificity = 89.71%, sensitivity = 95.08%, and area under the receiver-operating characteristic curve (AUC) = 0.94], followed by Pearson correlation and partial correlation is the last. The most discriminative regions of the brain for distance correlation are right dorsolateral superior frontal gyrus, orbital part of left superior frontal gyrus, orbital part of right middle frontal gyrus, right anterior cingulate and paracingulate gyri, left the supplementary motor area, and right precuneus, which are the promising biomarkers of OCD.
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Affiliation(s)
- Qian Luo
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen University, Shenzhen, China.,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen University, Shenzhen, China
| | - Weixiang Liu
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen University, Shenzhen, China.,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen University, Shenzhen, China
| | - Lili Jin
- Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.,Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Chunqi Chang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, Shenzhen University, Shenzhen, China.,National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen University, Shenzhen, China.,Peng Cheng Laboratory, Shenzhen, China
| | - Ziwen Peng
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China.,Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen University School of Medicine, Shenzhen, China
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10
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Gilbert KE, Wheelock MD, Kandala S, Eggebrecht AT, Luby JL, Barch DM. Associations of observed preschool performance monitoring with brain functional connectivity in adolescence. Cortex 2021; 142:15-27. [PMID: 34174721 PMCID: PMC8405590 DOI: 10.1016/j.cortex.2021.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/12/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
Monitoring one's performance helps detect errors and adapt to prevent future mistakes. However, elevated performance monitoring is associated with increased checking behaviors and perfectionism and is characteristic of multiple psychiatric disorders. Understanding how heightened performance monitoring in early childhood relates to subsequent brain connectivity may elucidate mechanistic risk factors that influence brain and psychiatric outcomes. The aim of this study was to examine the association between performance monitoring in preschool-aged children and functional connectivity during adolescence. In the current prospective longitudinal study, we performed seed-based functional connectivity analysis using a dorsal anterior cingulate cortex (dACC) seed to assess brain-behavior relationships between observationally coded performance monitoring in preschool-aged children and adolescent functional connectivity (n = 79). We also utilized enrichment analysis to investigate network-level connectome-wide associations. Seed-based analysis revealed negative correlations between preschool performance monitoring and adolescent fc between dACC and orbitofrontal and dorsolateral prefrontal cortex while a positive correlation was observed between dACC-occipital cortex connectivity. Enrichment analysis revealed a negative correlation between preschool performance monitoring and connectivity between motor (MOT) - cingulo-opercular (CO) and salience (SN) - Reward (REW) and a positive correlation with MOT-DMN, and cerebellum (CB) - motor connectivity. Elevated performance monitoring in early childhood is associated with functional connectivity during adolescence in regions and networks associated with cognitive control, sensorimotor processing and cortico-striatal-thalamic-cortico (CTSC) aberrations. These regions and networks are implicated in psychiatric disorders characterized by elevated performance monitoring. Findings shed light on a mechanistic risk factor in early childhood with long-term associations with neural functioning.
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Affiliation(s)
- Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
| | - Muriah D Wheelock
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sridhar Kandala
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Adam T Eggebrecht
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
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11
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Cyr M, Pagliaccio D, Yanes-Lukin P, Goldberg P, Fontaine M, Rynn MA, Marsh R. Altered fronto-amygdalar functional connectivity predicts response to cognitive behavioral therapy in pediatric obsessive-compulsive disorder. Depress Anxiety 2021; 38:836-845. [PMID: 34157177 PMCID: PMC8328961 DOI: 10.1002/da.23187] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/29/2021] [Accepted: 05/22/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Based on findings from adults with obsessive-compulsive disorder (OCD), this study examined alterations in resting-state functional connectivity (rs-fc) between the basolateral amygdala (BLA) and the ventromedial prefrontal cortex (vmPFC) in children and adolescents with OCD. We also assessed whether such BLA-vmPFC connectivity changed with or predicted response to exposure and response prevention (E/RP), the first-line treatment for pediatric OCD, given the involvement of these regions in fear processing, regulation, and extinction learning-a probable mechanism of action of E/RP. METHODS Resting state functional magnetic resonance imaging scans were acquired from 25 unmedicated, treatment-naïve pediatric patients with OCD (12.8 ± 2.9 years) and 23 age- and sex-matched healthy controls (HCs; 11.0 ± 3.3 years). Patients completed a 12-16-week E/RP intervention for OCD. Participants were rescanned after the 12-16-week period. ANCOVAs tested group differences in baseline rs-fc. Cross-lagged panel models examined relationships between BLA-vmPFC rs-fc and OCD symptoms pre- and posttreatment. All tests were adjusted for participants' age, sex, and head motion. RESULTS Right BLA-vmPFC rs-fc was significantly reduced (more negative) in patients with OCD relative to HCs at baseline, and increased following treatment. In patients, more positive (less negative) right BLA-vmPFC rs-fc pretreatment predicted greater OCD symptoms reduction posttreatment. Changes in BLA-vmPFC rs-fc was unassociated with change in OCD symptoms pre- to posttreatment. CONCLUSIONS These results provide further evidence of the BLA-vmPFC pathway as a potential target for novel treatments or prevention strategies aimed at facilitating adaptive learning and fear extinction in children with OCD or subclinical OCD symptoms.
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Affiliation(s)
- Marilyn Cyr
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - David Pagliaccio
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Paula Yanes-Lukin
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Pablo Goldberg
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Martine Fontaine
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Moira A. Rynn
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Rachel Marsh
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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12
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Shi G, Li X, Zhu Y, Shang R, Sun Y, Guo H, Sui J. The divided brain: Functional brain asymmetry underlying self-construal. Neuroimage 2021; 240:118382. [PMID: 34252524 DOI: 10.1016/j.neuroimage.2021.118382] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/26/2021] [Accepted: 07/08/2021] [Indexed: 12/29/2022] Open
Abstract
Self-construal (orientations of independence and interdependence) is a fundamental concept that guides human behaviour, and it is linked to a large number of brain regions. However, understanding the connectivity of these regions and the critical principles underlying these self-functions are lacking. Because brain activity linked to self-related processes are intrinsic, the resting-state method has received substantial attention. Here, we focused on resting-state functional connectivity matrices based on brain asymmetry as indexed by the differential partition of the connectivity located in mirrored positions of the two hemispheres, hemispheric specialization measured using the intra-hemispheric (left or right) connectivity, brain communication via inter-hemispheric interactions, and global connectivity as the sum of the two intra-hemispheric connectivity. Combining machine learning techniques with hypothesis-driven network mapping approaches, we demonstrated that orientations of independence and interdependence were best predicted by the asymmetric matrix compared to brain communication, hemispheric specialization, and global connectivity matrices. The network results revealed that there were distinct asymmetric connections between the default mode network, the salience network and the executive control network which characterise independence and interdependence. These analyses shed light on the importance of brain asymmetry in understanding how complex self-functions are optimally represented in the brain networks.
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Affiliation(s)
- Gen Shi
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, PR China
| | - Xuesong Li
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, PR China.
| | - Yifan Zhu
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, PR China
| | - Ruihong Shang
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, PR China
| | - Yang Sun
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, PR China
| | - Hua Guo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, PR China
| | - Jie Sui
- School of Psychology, University of Aberdeen, Aberdeen, UK.
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13
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Kwak S, Kim M, Kim T, Kwak Y, Oh S, Lho SK, Moon SY, Lee TY, Kwon JS. Defining data-driven subgroups of obsessive-compulsive disorder with different treatment responses based on resting-state functional connectivity. Transl Psychiatry 2020; 10:359. [PMID: 33106472 PMCID: PMC7589530 DOI: 10.1038/s41398-020-01045-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022] Open
Abstract
Characterization of obsessive-compulsive disorder (OCD), like other psychiatric disorders, suffers from heterogeneities in its symptoms and therapeutic responses, and identification of more homogeneous subgroups may help to resolve the heterogeneity. We aimed to identify the OCD subgroups based on resting-state functional connectivity (rsFC) and to explore their differences in treatment responses via a multivariate approach. From the resting-state functional MRI data of 107 medication-free OCD patients and 110 healthy controls (HCs), we selected rsFC features, which discriminated OCD patients from HCs via support vector machine (SVM) analyses. With the selected brain features, we subdivided OCD patients into subgroups using hierarchical clustering analyses. We identified 35 rsFC features that achieved a high sensitivity (82.74%) and specificity (76.29%) in SVM analyses. The OCD patients were subdivided into two subgroups, which did not show significant differences in their demographic and clinical backgrounds. However, one of the OCD subgroups demonstrated more impaired rsFC that was involved either within the default mode network (DMN) or between DMN brain regions and other network regions. This subgroup also showed both lower improvements in symptom severity in the 16-week follow-up visit and lower responder percentage than the other subgroup. Our results highlight that not only abnormalities within the DMN but also aberrant rsFC between the DMN and other networks may contribute to the treatment response and support the importance of these neurobiological alterations in OCD patients. We suggest that abnormalities in these connectivity may play predictive biomarkers of treatment response, and aid to build more optimal treatment strategies.
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Affiliation(s)
- Seoyeon Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Taekwan Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Yoobin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Sanghoon Oh
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Silvia Kyungjin Lho
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun-Young Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Young Lee
- Department of Neuropsychiatry, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea.
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14
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Resting-state functional connectivity in drug-naive pediatric patients with Tourette syndrome and obsessive-compulsive disorder. J Psychiatr Res 2020; 129:129-140. [PMID: 32912593 DOI: 10.1016/j.jpsychires.2020.06.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/11/2020] [Accepted: 06/24/2020] [Indexed: 12/16/2022]
Abstract
Previous studies in cohorts of Tourette syndrome (TS) or obsessive-compulsive disorder (OCD) patients have not clarified whether these two disorders represent two clinical conditions or they are distinct clinical phenotypes of a common disease spectrum. The study aimed to compare functional connectivity (FC) patterns in a pediatric drug-naive cohort of 16 TS patients without any comorbidity (TS), 14 TS patients with OCD (TS + OCD), and 10 pure OCD patients as well as 11 matched controls that underwent resting state fMRI. Via independent component analysis, we examined FC in the basal ganglia (BGN), sensorimotor (SMN), cerebellum (CBN), frontoparietal (FPN), default-mode (DMN), orbitofrontal (OBFN), and salience (SAN) networks among the above cohorts and their association with clinical measures. Compared to controls, TS and TS + OCD patients showed higher FC in the BGN, SMN, CBN and DMN and lower FC in the FPN and SAN. The TS and TS + OCD groups showed comparable FC in all networks. In contrast to controls, OCD patients exhibited increased FC in the BGN, SMN, CBN, DMN, FPN, and SAN. OCD patients also showed higher FC in CBN and FPN when compared with TS and TS + OCD patients both separately and as one group. Tic severity negatively correlated with FC in CBN and FPN in the TS group, while the compulsiveness scores positively correlated with the same two networks in OCD patients. Our findings suggest common FC changes in TS and TS + OCD patients. In contrast, OCD is characterized by a distinctive pattern of FC changes prominently involving the CBN and FPN.
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15
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Rashid B, Calhoun V. Towards a brain-based predictome of mental illness. Hum Brain Mapp 2020; 41:3468-3535. [PMID: 32374075 PMCID: PMC7375108 DOI: 10.1002/hbm.25013] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 01/10/2023] Open
Abstract
Neuroimaging-based approaches have been extensively applied to study mental illness in recent years and have deepened our understanding of both cognitively healthy and disordered brain structure and function. Recent advancements in machine learning techniques have shown promising outcomes for individualized prediction and characterization of patients with psychiatric disorders. Studies have utilized features from a variety of neuroimaging modalities, including structural, functional, and diffusion magnetic resonance imaging data, as well as jointly estimated features from multiple modalities, to assess patients with heterogeneous mental disorders, such as schizophrenia and autism. We use the term "predictome" to describe the use of multivariate brain network features from one or more neuroimaging modalities to predict mental illness. In the predictome, multiple brain network-based features (either from the same modality or multiple modalities) are incorporated into a predictive model to jointly estimate features that are unique to a disorder and predict subjects accordingly. To date, more than 650 studies have been published on subject-level prediction focusing on psychiatric disorders. We have surveyed about 250 studies including schizophrenia, major depression, bipolar disorder, autism spectrum disorder, attention-deficit hyperactivity disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder, and substance dependence. In this review, we present a comprehensive review of recent neuroimaging-based predictomic approaches, current trends, and common shortcomings and share our vision for future directions.
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Affiliation(s)
- Barnaly Rashid
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
| | - Vince Calhoun
- Tri‐Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS)Georgia State University, Georgia Institute of Technology, and Emory UniversityAtlantaGeorgiaUSA
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16
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Drăgoi AM, Pecie LG, Patrichi BE, Ladea M. Morphopathological changes in obsessive-compulsive disorder. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2020; 61:51-60. [PMID: 32747895 PMCID: PMC7728136 DOI: 10.47162/rjme.61.1.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
The pathophysiology of the obsessive-compulsive disorder (OCD) has been studied for many years using several structural magnetic resonance imaging, discovering that the anomalies of function and structure of the brain are widespread, they involve different areas, structures and circuits with a complex interconnectivity. More than that, these anomalies cover all the life of a patient, from early childhood, due to variations of developmental stages until adult life. The research is highly important also because OCD has a major hereditary factor, with the phenotype variance between 27–47% due to hereditary factors. Under this paper, that follows last 10 years studies in this area, we will find some relevant findings consisting on neuroanatomic changes, the morphology findings of striatum, globus pallidus and thalamus, the blood flow circuit changes in various regions of the brain, brain connectivity and various correlations of them. Not to forget that OCD must be understand as an emotional disorder but in the same time as a cognitive disorder too. This approach highlights the abnormalities that have been found in brain regions involved in the cognitive and emotional behavior, as for example: extended temporal, parietal, and occipital regions, anterior cingulate, frontal gyrus, amygdala.
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Affiliation(s)
- Ana Miruna Drăgoi
- Department of Psychiatry, Prof. Dr. Alexandru Obregia Clinical Hospital for Psychiatry, Bucharest, Romania;
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17
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Tymofiyeva O, Zhou VX, Lee CM, Xu D, Hess CP, Yang TT. MRI Insights Into Adolescent Neurocircuitry-A Vision for the Future. Front Hum Neurosci 2020; 14:237. [PMID: 32733218 PMCID: PMC7359264 DOI: 10.3389/fnhum.2020.00237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/29/2020] [Indexed: 11/13/2022] Open
Abstract
Adolescence is the time of onset of many psychiatric disorders. Half of pediatric patients present with comorbid psychiatric disorders that complicate both their medical and psychiatric care. Currently, diagnosis and treatment decisions are based on symptoms. The field urgently needs brain-based diagnosis and personalized care. Neuroimaging can shed light on how aberrations in brain circuits might underlie psychiatric disorders and their development in adolescents. In this perspective article, we summarize recent MRI literature that provides insights into development of psychiatric disorders in adolescents. We specifically focus on studies of brain structural and functional connectivity. Ninety-six included studies demonstrate the potential of MRI to assess psychiatrically relevant constructs, diagnose psychiatric disorders, predict their development or predict response to treatment. Limitations of the included studies are discussed, and recommendations for future research are offered. We also present a vision for the role that neuroimaging may play in pediatrics and primary care in the future: a routine neuropsychological and neuropsychiatric imaging (NPPI) protocol for adolescent patients, which would include a 30-min brain scan, a quality control and safety read of the scan, followed by computer-based calculation of the structural and functional brain network metrics that can be compared to the normative data by the pediatrician. We also perform a cost-benefit analysis to support this vision and provide a roadmap of the steps required for this vision to be implemented.
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Affiliation(s)
- Olga Tymofiyeva
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Vivian X Zhou
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Chuan-Mei Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.,Clinical Excellence Research Center, Stanford University, Stanford, CA, United States
| | - Duan Xu
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Christopher P Hess
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Tony T Yang
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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18
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Cyr M, Pagliaccio D, Yanes-Lukin P, Fontaine M, Rynn MA, Marsh R. Altered network connectivity predicts response to cognitive-behavioral therapy in pediatric obsessive-compulsive disorder. Neuropsychopharmacology 2020; 45:1232-1240. [PMID: 31952071 PMCID: PMC7235012 DOI: 10.1038/s41386-020-0613-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/21/2019] [Accepted: 01/08/2020] [Indexed: 12/12/2022]
Abstract
Obsessive-compulsive disorder (OCD) is commonly associated with alterations in cortico-striato-thalamo-cortical brain networks. Yet, recent investigations of large-scale brain networks suggest that more diffuse alterations in brain connectivity may underlie its pathophysiology. Few studies have assessed functional connectivity within or between networks across the whole brain in pediatric OCD or how patterns of connectivity associate with treatment response. Resting-state functional magnetic resonance imaging scans were acquired from 25 unmedicated, treatment-naive children and adolescents with OCD (12.8 ± 2.9 years) and 23 matched healthy control (HC) participants (11.0 ± 3.3 years) before participants with OCD completed a course of cognitive-behavioral therapy (CBT). Participants were re-scanned after 12-16 weeks. Whole-brain connectomic analyses were conducted to assess baseline group differences and group-by-time interactions, corrected for multiple comparisons. Relationships between functional connectivity and OCD symptoms pre- and post-CBT were examined using longitudinal cross-lagged panel modeling. Reduced connectivity in OCD relative to HC participants was detected between default mode and task-positive network regions. Greater (less altered) connectivity between left angular gyrus and left frontal pole predicted better response to CBT in the OCD group. Altered connectivity between task-positive and task-negative networks in pediatric OCD may contribute to the impaired control over intrusive thoughts early in the illness. This is the first study to show that altered connectivity between large-scale network regions may predict response to CBT in pediatric OCD, highlighting the clinical relevance of these networks as potential circuit-based targets for the development of novel treatments.
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Affiliation(s)
- Marilyn Cyr
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA. .,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA.
| | - David Pagliaccio
- grid.413734.60000 0000 8499 1112Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Paula Yanes-Lukin
- grid.413734.60000 0000 8499 1112Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Martine Fontaine
- grid.413734.60000 0000 8499 1112Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
| | - Moira A. Rynn
- grid.26009.3d0000 0004 1936 7961Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC USA
| | - Rachel Marsh
- grid.413734.60000 0000 8499 1112Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY USA
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Gürsel DA, Reinholz L, Bremer B, Schmitz-Koep B, Franzmeier N, Avram M, Koch K. Frontoparietal and salience network alterations in obsessive–compulsive disorder: insights from independent component and sliding time window analyses. J Psychiatry Neurosci 2020; 45:214-221. [PMID: 32167267 PMCID: PMC7828976 DOI: 10.1503/jpn.190038] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Resting-state functional MRI (fMRI) studies commonly report alterations in 3 core networks in obsessive–compulsive disorder (OCD) — the frontoparietal network, the default mode network and the salience network — defined by functionally connected infraslow oscillations in ongoing brain activity. However, most of these studies observed static functional connectivity in the brains of patients with OCD. METHODS To investigate dynamic functional connectivity alterations and widen the evidence base toward the triple network model in OCD, we performed group-based independent component and sliding time window analyses in 49 patients with OCD and 41 healthy controls. RESULTS The traditional independent component analysis showed alterations in the left frontoparietal network as well as between the left and right frontoparietal networks in patients with OCD compared with healthy controls. For dynamic functional connectivity, the sliding time window approach revealed peak dysconnectivity between the left and right frontoparietal networks and between the left frontoparietal network and the salience network. LIMITATIONS The number of independent components, noise in the resting-state fMRI images, the heterogeneity of the OCD sample, and comorbidities and medication status in the patients could have biased the results. CONCLUSION Disrupted modulation of these intrinsic brain networks may contribute to the pathophysiology of OCD.
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Affiliation(s)
- Deniz A. Gürsel
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Lena Reinholz
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Benno Bremer
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Benita Schmitz-Koep
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Nicolai Franzmeier
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Mihai Avram
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
| | - Kathrin Koch
- From the Department of Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675 Munich, Germany (Gürsel, Bremer, Schmitz-Koep, Avram, Koch); the TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Einsteinstr. 1, 81675 Munich, Germany (Gürsel, Avram); the Department of Psychology, Ludwig-Maximilians-Universität München, Munich, 80802, Germany (Reinholz); and the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Feodor-Lynen Straße 17, 81377, Munich, Germany (Franzmeier)
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Simpson HB, van den Heuvel OA, Miguel EC, Reddy YCJ, Stein DJ, Lewis-Fernández R, Shavitt RG, Lochner C, Pouwels PJW, Narayanawamy JC, Venkatasubramanian G, Hezel DM, Vriend C, Batistuzzo MC, Hoexter MQ, de Joode NT, Costa DL, de Mathis MA, Sheshachala K, Narayan M, van Balkom AJLM, Batelaan NM, Venkataram S, Cherian A, Marincowitz C, Pannekoek N, Stovezky YR, Mare K, Liu F, Otaduy MCG, Pastorello B, Rao R, Katechis M, Van Meter P, Wall M. Toward identifying reproducible brain signatures of obsessive-compulsive profiles: rationale and methods for a new global initiative. BMC Psychiatry 2020; 20:68. [PMID: 32059696 PMCID: PMC7023814 DOI: 10.1186/s12888-020-2439-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/10/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has a lifetime prevalence of 2-3% and is a leading cause of global disability. Brain circuit abnormalities in individuals with OCD have been identified, but important knowledge gaps remain. The goal of the new global initiative described in this paper is to identify robust and reproducible brain signatures of measurable behaviors and clinical symptoms that are common in individuals with OCD. A global approach was chosen to accelerate discovery, to increase rigor and transparency, and to ensure generalizability of results. METHODS We will study 250 medication-free adults with OCD, 100 unaffected adult siblings of individuals with OCD, and 250 healthy control subjects at five expert research sites across five countries (Brazil, India, Netherlands, South Africa, and the U.S.). All participants will receive clinical evaluation, neurocognitive assessment, and magnetic resonance imaging (MRI). The imaging will examine multiple brain circuits hypothesized to underlie OCD behaviors, focusing on morphometry (T1-weighted MRI), structural connectivity (Diffusion Tensor Imaging), and functional connectivity (resting-state fMRI). In addition to analyzing each imaging modality separately, we will also use multi-modal fusion with machine learning statistical methods in an attempt to derive imaging signatures that distinguish individuals with OCD from unaffected siblings and healthy controls (Aim #1). Then we will examine how these imaging signatures link to behavioral performance on neurocognitive tasks that probe these same circuits as well as to clinical profiles (Aim #2). Finally, we will explore how specific environmental features (childhood trauma, socioeconomic status, and religiosity) moderate these brain-behavior associations. DISCUSSION Using harmonized methods for data collection and analysis, we will conduct the largest neurocognitive and multimodal-imaging study in medication-free subjects with OCD to date. By recruiting a large, ethno-culturally diverse sample, we will test whether there are robust biosignatures of core OCD features that transcend countries and cultures. If so, future studies can use these brain signatures to reveal trans-diagnostic disease dimensions, chart when these signatures arise during development, and identify treatments that target these circuit abnormalities directly. The long-term goal of this research is to change not only how we conceptualize OCD but also how we diagnose and treat it.
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Affiliation(s)
- Helen Blair Simpson
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Odile A. van den Heuvel
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Euripedes C. Miguel
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Y. C. Janardhan Reddy
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Dan J. Stein
- grid.7836.a0000 0004 1937 1151SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Roberto Lewis-Fernández
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Roseli Gedanke Shavitt
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Christine Lochner
- grid.11956.3a0000 0001 2214 904XSAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Petra J. W. Pouwels
- grid.12380.380000 0004 1754 9227Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Janardhanan C. Narayanawamy
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Ganesan Venkatasubramanian
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Dianne M. Hezel
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Chris Vriend
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Marcelo C. Batistuzzo
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Marcelo Q. Hoexter
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Niels T. de Joode
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Daniel Lucas Costa
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Maria Alice de Mathis
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Karthik Sheshachala
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Madhuri Narayan
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Anton J. L. M. van Balkom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest, Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M. Batelaan
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest, Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Shivakumar Venkataram
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Anish Cherian
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Clara Marincowitz
- grid.11956.3a0000 0001 2214 904XSAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Nienke Pannekoek
- grid.11956.3a0000 0001 2214 904XSAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Yael R. Stovezky
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Karen Mare
- grid.7836.a0000 0004 1937 1151SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Feng Liu
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Maria Concepcion Garcia Otaduy
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Bruno Pastorello
- grid.11899.380000 0004 1937 0722Institute of Radiology, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Rashmi Rao
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Martha Katechis
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Page Van Meter
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Melanie Wall
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
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Moreira PS, Marques P, Magalhães R, Esteves M, Sousa N, Soares JM, Morgado P. The resting-brain of obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2019; 290:38-41. [PMID: 31279239 DOI: 10.1016/j.pscychresns.2019.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/26/2019] [Accepted: 06/30/2019] [Indexed: 01/03/2023]
Abstract
Obsessive-compulsive disorder (OCD) is one of the most debilitating psychiatric conditions, having a dramatic impact on patients' daily living. In this work, we aimed to explore resting-state functional connectivity in OCD patients, using an independent component analysis. Eighty individuals (40 patients and 40 healthy controls) performed a resting state fMRI protocol. OCD patients displayed reduced functional connectivity (FC) in visual and sensorimotor networks. In addition, patients displayed decreased FC between sensory networks and increased FC between default-mode and cerebellar networks.
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Affiliation(s)
- Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal.
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - Madalena Esteves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - José Miguel Soares
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, 4710-057 Braga/Guimarães, Portugal; Clinical Academic Center - Braga, 4710-057 Braga, Portugal
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Sertraline Effects on Striatal Resting-State Functional Connectivity in Youth With Obsessive-Compulsive Disorder: A Pilot Study. J Am Acad Child Adolesc Psychiatry 2019; 58:486-495. [PMID: 30768407 PMCID: PMC6487209 DOI: 10.1016/j.jaac.2018.07.897] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/23/2018] [Accepted: 08/15/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Foundational knowledge on neural circuitry underlying pediatric obsessive-compulsive disorder (OCD) and how it changes during standard treatment is needed to provide the basis for conceptualization and development of novel targeted treatments. This study explored the effects of sertraline, a selective serotonin reuptake inhibitor, on resting-state functional connectivity in cortico-striatal-thalamic-cortical circuits in pediatric OCD. METHOD Medication-free youths with OCD (n = 14) and healthy controls (n = 14) were examined at baseline and 12 weeks with resting-state functional magnetic resonance imaging. Between scan sessions, participants with OCD received 12 weeks of sertraline. For each scan, seed-based whole-brain resting-state functional connectivity analyses were conducted with 6 striatal seeds. Analysis of variance examined the interaction between group and time on striatal connectivity, including cluster-based thresholding to correct for multiple tests. Connectivity changes within circuits identified in group analyses were correlated with clinical change. RESULTS Two significant group-by-time effects in the OCD group showed increased striatal connectivity from baseline to 12 weeks compared with controls. Circuits demonstrating this pattern included the right putamen with the left frontal cortex and insula and the left putamen with the left frontal cortex and pre- and post-central cortices. Increase in connectivity in the left putamen circuit was significantly correlated with clinical improvement on the Children's Yale-Brown Obsessive-Compulsive Scale score (r = -0.58, p = .03). CONCLUSION Sertraline appears to affect specific striatal-based circuits in pediatric OCD, and these changes in part could account for clinical improvement. Future work is needed to confirm these preliminary findings, which would facilitate identification of circuit-based targets for novel treatment development. CLINICAL TRIAL REGISTRATION INFORMATION Effects of Sertraline on Brain Connectivity in Adolescents with OCD; https://clinicaltrials.gov/; NCT02797808.
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Bruin W, Denys D, van Wingen G. Diagnostic neuroimaging markers of obsessive-compulsive disorder: Initial evidence from structural and functional MRI studies. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:49-59. [PMID: 30107192 DOI: 10.1016/j.pnpbp.2018.08.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/30/2018] [Accepted: 08/09/2018] [Indexed: 01/09/2023]
Abstract
As of yet, no diagnostic biomarkers are available for obsessive-compulsive disorder (OCD), and its diagnosis relies entirely upon the recognition of behavioural features assessed through clinical interview. Neuroimaging studies have shown that various brain structures are abnormal in OCD patients compared to healthy controls. However, the majority of these results are based on average differences between groups, which limits diagnostic usage in clinical practice. In recent years, a growing number of studies have applied multivariate pattern analysis (MVPA) techniques on neuroimaging data to extract patterns of altered brain structure, function and connectivity typical for OCD. MVPA techniques can be used to develop predictive models that extract regularities in data to classify individual subjects based on their diagnosis. In the present paper, we reviewed the literature of MVPA studies using data from different imaging modalities to distinguish OCD patients from controls. A systematic search retrieved twelve articles that fulfilled the inclusion and exclusion criteria. Reviewed studies have been able to classify OCD diagnosis with accuracies ranging from 66% up to 100%. Features important for classification were different across imaging modalities and widespread throughout the brain. Although studies have shown promising results, sample sizes used are typically small which can lead to high variance of the estimated model accuracy, cohort-specific solutions and lack of generalizability of findings. Some of the challenges are discussed that need to be overcome in order to move forward toward clinical applications.
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Affiliation(s)
- Willem Bruin
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands.
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
| | - Guido van Wingen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, the Netherlands
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Xie C, Ma L, Jiang N, Huang R, Li L, Gong L, He C, Xiao C, Liu W, Xu S, Zhang Z. Imbalanced functional link between reward circuits and the cognitive control system in patients with obsessive-compulsive disorder. Brain Imaging Behav 2018; 11:1099-1109. [PMID: 27553440 DOI: 10.1007/s11682-016-9585-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Altered reward processing and cognitive deficits are often observed in patients with obsessive-compulsive disorder (OCD); however, whether the imbalance in activity between reward circuits and the cognitive control (CC) system is associated with compulsive behavior remains unknown. Sixty-eight OCD patients and 33 cognitively normal (CN) healthy subjects participated in this resting-state functional magnetic resonance imaging study. Alterations in the functional connectivity between reward circuits and the CC system were quantitatively assessed and compared between the groups. A Granger causality analysis was used to determine the causal informational influence between and within reward circuits and the CC system across all subjects. OCD patients showed a dichotomous pattern of enhanced functional coupling in their reward circuits and a weakened functional coupling in their CC system when compared to CN subjects. Neural correlates of compulsive behavior were primarily located in the reward circuits and CC system in OCD patients. Importantly, the CC system exerted a reduced interregional causal influence over the reward system in OCD patients relative to its effect in CN subjects. The limitations of this study are that it was a cross-sectional study and the potential effects of environmental and genetic factors were not explored. OCD patients showed an imbalance in the functional link between reward circuits and the CC system at rest. This bias toward a loss of control may define a pathological state in which subjects are more vulnerable to engaging in compulsive behaviors.
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Affiliation(s)
- Chunming Xie
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute, Medical School, Southeast University, No. 87 DingJiaQiao Road, Nanjing, People's Republic of China, 210009.
| | - Lisha Ma
- Department of Psychology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, People's Republic of China, 210029
| | - Nan Jiang
- Department of Pharmacy, PLA Army General Hospital, Beijing, People's Republic of China
| | - Ruyan Huang
- Department of Psychology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, People's Republic of China, 210029
| | - Li Li
- Advanced Health Center, Affiliated Zhangda Hospital, Medical School, Southeast University, Nanjing, People's Republic of China
| | - Liang Gong
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute, Medical School, Southeast University, No. 87 DingJiaQiao Road, Nanjing, People's Republic of China, 210009
| | - Cancan He
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute, Medical School, Southeast University, No. 87 DingJiaQiao Road, Nanjing, People's Republic of China, 210009
| | - Chaoyong Xiao
- Department of Psychology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, People's Republic of China, 210029
| | - Wen Liu
- Department of Radiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Shu Xu
- Department of Psychology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, No. 264 Guangzhou Road, Nanjing, People's Republic of China, 210029.
| | - Zhijun Zhang
- Department of Neurology, Affiliated ZhongDa Hospital, Neuropsychiatric Institute, Medical School, Southeast University, No. 87 DingJiaQiao Road, Nanjing, People's Republic of China, 210009
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Hong JS, Kim SM, Aboujaoude E, Han DH. Investigation of a Mobile "Serious Game" in the Treatment of Obsessive-Compulsive Disorder: A Pilot Study. Games Health J 2018; 7:317-326. [PMID: 30129775 DOI: 10.1089/g4h.2017.0158] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Exposure and response prevention (ERP) therapy is considered a first-line treatment for obsessive-compulsive disorder (OCD). Dysregulation in the cortico-striato-thalamo-cortical (CSTC) circuit has been implicated in the pathophysiology of OCD, as have decreased functional connectivity (FC) between the dorsal anterior cingulate cortex (dACC) and the prefrontal cortex and increased FC between the dACC and the basal ganglia. We hypothesized that a new ERP-inspired mobile "serious game" would improve clinical symptoms in OCD and that symptom improvement would be associated with altered FC within CSTC. MATERIALS AND METHODS Fifteen OCD subjects and 15 healthy controls were recruited. All subjects completed questionnaires covering demographic data, the Yale-Brown Obsessive-Compulsive Scale, the Beck Depressive Inventory, and the Beck Anxiety Inventory. In addition, all subjects were scanned at baseline to assess brain FC using resting-state functional magnetic resonance imaging. RESULTS After 3 weeks of gameplay, FC from the left dACC seed to the right frontal precentral gyrus and from the right dACC seed to the left inferior frontal gyrus and the right middle frontal gyrus, increased in the OCD group. Responders showed increased brain connectivity from the left dACC seed to the right superior frontal gyrus compared with nonresponders. CONCLUSION Our results suggest that serious games may improve symptoms in OCD and that this improvement may be related to increased brain connectivity between the dACC and the prefrontal cortex. Further exploration is needed to assess the potential role of serious games in OCD treatment.
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Affiliation(s)
- Ji Sun Hong
- 1 Department of Psychiatry, Chung Ang University Hospital , Seoul, South Korea
| | - Sun Mi Kim
- 1 Department of Psychiatry, Chung Ang University Hospital , Seoul, South Korea
| | - Elias Aboujaoude
- 2 Department of Psychiatry, Stanford University School of Medicine , Stanford, California
| | - Doug Hyun Han
- 1 Department of Psychiatry, Chung Ang University Hospital , Seoul, South Korea
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A common brain network among state, trait, and pathological anxiety from whole-brain functional connectivity. Neuroimage 2018; 172:506-516. [DOI: 10.1016/j.neuroimage.2018.01.080] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/27/2018] [Accepted: 01/30/2018] [Indexed: 01/18/2023] Open
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Adams TG, Kelmendi B, Brake CA, Gruner P, Badour CL, Pittenger C. The role of stress in the pathogenesis and maintenance of obsessive-compulsive disorder. ACTA ACUST UNITED AC 2018. [PMID: 29527593 PMCID: PMC5841259 DOI: 10.1177/2470547018758043] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Individuals with obsessive-compulsive disorder often identify psychosocial stress
as a factor that exacerbates their symptoms, and many trace the onset of
symptoms to a stressful period of life or a discrete traumatic incident.
However, the pathophysiological relationship between stress and
obsessive-compulsive disorder remains poorly characterized: it is unclear
whether trauma or stress is an independent cause of obsessive-compulsive
disorder symptoms, a triggering factor that interacts with a preexisting
diathesis, or simply a nonspecific factor that can exacerbate
obsessive-compulsive disorder along with other aspects of psychiatric
symptomatology. Nonetheless, preclinical research has demonstrated that stress
has conspicuous effects on corticostriatal and limbic circuitry. Specifically,
stress can lead to neuronal atrophy in frontal cortices (particularly the medial
prefrontal cortex), the dorsomedial striatum (caudate), and the hippocampus.
Stress can also result in neuronal hypertrophy in the dorsolateral striatum
(putamen) and amygdala. These neurobiological effects mirror reported neural
abnormalities in obsessive-compulsive disorder and may contribute to an
imbalance between goal-directed and habitual behavior, an imbalance that is
implicated in the pathogenesis and expression of obsessive-compulsive disorder
symptomatology. The modulation of corticostriatal and limbic circuits by stress
and the resultant imbalance between habit and goal-directed learning and
behavior offers a framework for investigating how stress may exacerbate or
trigger obsessive-compulsive disorder symptomatology.
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Affiliation(s)
- T G Adams
- School of Medicine - Department of Psychiatry, Yale University.,Clinical Neuroscience Division of the VA National Center for PTSD
| | - B Kelmendi
- School of Medicine - Department of Psychiatry, Yale University.,Clinical Neuroscience Division of the VA National Center for PTSD
| | - C A Brake
- University of Kentucky, Department of Psychology
| | - P Gruner
- School of Medicine - Department of Psychiatry, Yale University
| | - C L Badour
- University of Kentucky, Department of Psychology
| | - C Pittenger
- School of Medicine - Department of Psychiatry, Yale University.,Clinical Neuroscience Division of the VA National Center for PTSD.,Child Study Center, Yale University.,Department of Psychology, Yale University
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Low frequency fluctuation of brain spontaneous activity and obsessive-compulsive symptoms in a large school-age sample. J Psychiatr Res 2018; 96:224-230. [PMID: 29102817 DOI: 10.1016/j.jpsychires.2017.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/06/2017] [Accepted: 10/13/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND The present study was designed to explore alterations in brain dynamics at rest that are associated with Obsessive Compulsive Symptoms (OCS) in childhood by measuring low frequency fluctuation of spontaneous brain activity in a large school community sample from a developing country. METHOD Resting state functional magnetic resonance imaging data were collected in a sample of 655 children and adolescents (6-15 years old) from the brazilian 'High Risk Cohort Study for Psychiatric Disorders (HRC)'. OCS were assessed using items from the Compulsion and Obsessions section of the Development and Well-Being Assessment (DAWBA). The correlation between the fractional amplitude of low frequency fluctuations (fALFF) and the number of OCS were explored by using a general linear model, considering fALFF as response variable, OCS score as regressor and age, gender and site as nuisance variables. RESULTS The number of OCS was positively correlated with the fALFF coefficients at the right sensorimotor cortex (pre-motor, primary motor cortex and post-central gyrus) and negatively correlated with the fALFF coefficients at the insula/superior temporal gyrus of both hemispheres. Our results were specific to OCS and not due to associations with overall psychopathology. CONCLUSIONS Our results suggest that brain spontaneous activity at rest in the sensorimotor and insular/superior-temporal cortices may be involved in OCS in children. These findings need independent replication and future studies should determine whether brain spontaneous activity changes within these regions might be predictors of risk for obsessive-compulsive disorder latter in life.
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Altered connectivity within and between the default mode, central executive, and salience networks in obsessive-compulsive disorder. J Affect Disord 2017; 223:106-114. [PMID: 28743059 DOI: 10.1016/j.jad.2017.07.041] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/25/2017] [Accepted: 07/19/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Default mode network (DMN), central executive network (CEN) and salience network (SN) are the three most important intrinsic networks of the human brain. Recent studies emphasized the importance of the "triple-network model" which illustrated the interactions within and between DMN, CEN and SN in the pathophysiology of psychiatric disorders. However, previous studies of obsessive-compulsive disorder (OCD) just explored the altered connectivity within these networks while neglected the coupling between them. Hence, the present study was designed to fill this research gap. METHODS Resting-state functional magnetic resonance imaging (fMRI) data from 35 OCD patients and 32 healthy controls (HCs) were acquired. Independent component analysis (ICA) was used to extract sub-networks of the DMN, CEN, and SN. Functional connectivity (FC) values within and between these networks were measured. RESULTS OCD patients had increased FC within several DMN, CEN, and SN subsystems. In addition, OCD patients demonstrated aberrant functional interactions between the SN and anterior DMN (aDMN) as well as between the SN and the dorsal CEN (dCEN), and the interaction between the SN and dCEN significantly correlated with trait anxiety level in the OCD group. LIMITATION Lack of the assessments of cognitive functions is the main limitation of the present study. CONCLUSIONS Not only impaired coupling within the brain core intrinsic large-scale networks, but also coupling between large-scale neurocognitive networks, which reflect the difficulties in switching between task-negative and task-positive processing modes are involved in the neurobiological mechanism of OCD.
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A Neural Marker of Obsessive-Compulsive Disorder from Whole-Brain Functional Connectivity. Sci Rep 2017; 7:7538. [PMID: 28790433 PMCID: PMC5548868 DOI: 10.1038/s41598-017-07792-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a common psychiatric disorder with a lifetime prevalence of 2–3%. Recently, brain activity in the resting state is gathering attention for exploring altered functional connectivity in psychiatric disorders. Although previous resting-state functional magnetic resonance imaging studies investigated the neurobiological abnormalities of patients with OCD, there are concerns that should be addressed. One concern is the validity of the hypothesis employed. Most studies used seed-based analysis of the fronto-striatal circuit, despite the potential for abnormalities in other regions. A hypothesis-free study is a promising approach in such a case, while it requires researchers to handle a dataset with large dimensions. Another concern is the reliability of biomarkers derived from a single dataset, which may be influenced by cohort-specific features. Here, our machine learning algorithm identified an OCD biomarker that achieves high accuracy for an internal dataset (AUC = 0.81; N = 108) and demonstrates generalizability to an external dataset (AUC = 0.70; N = 28). Our biomarker was unaffected by medication status, and the functional networks contributing to the biomarker were distributed widely, including the frontoparietal and default mode networks. Our biomarker has the potential to deepen our understanding of OCD and to be applied clinically.
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Hu X, Du M, Chen L, Li L, Zhou M, Zhang L, Liu Q, Lu L, Mreedha K, Huang X, Gong Q. Meta-analytic investigations of common and distinct grey matter alterations in youths and adults with obsessive-compulsive disorder. Neurosci Biobehav Rev 2017; 78:91-103. [PMID: 28442404 DOI: 10.1016/j.neubiorev.2017.04.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 04/15/2017] [Accepted: 04/15/2017] [Indexed: 02/05/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a disabling illness with onset generally in childhood. OCD-youths differ from OCD-adults with regard to gender distribution, comorbidity patterns and treatment options. However, little is known about the neural correlate differences underpin those two populations. The current meta-analysis summarizes voxel based morphometry findings to elucidate whether differences of neural correlates exist between these two populations. Both OCD-youths and OCD-adults demonstrated greater striatal volume and smaller prefrontal grey matter volume (GMV). However, smaller GMV in left visual cortex was observed in OCD-youths only, while smaller GMV in anterior cingulate gyrus and greater GMV in cerebellum were demonstrated only in OCD-adults. Meta-regression showed greater GMV in left putamen was most prominent in samples with higher percentages of medicated OCD-adults. Our findings confirmed the most consistent GMV alterations in OCD were in prefrontal-striatal circuitry. Besides, other regions may involve at different developmental stages including deficits of visual cortex in OCD-youths and abnormalities of limbic-cerebellar circuit in OCD-adults. Medication effect may be more pronounced in the striatum, especially the putamen.
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Affiliation(s)
- Xinyu Hu
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Mingying Du
- Department of Radiology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lizhou Chen
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lei Li
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Ming Zhou
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lianqing Zhang
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Qi Liu
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Lu
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Kunal Mreedha
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoqi Huang
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
| | - Qiyong Gong
- Huaxi MR Research Centre(HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
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Frydman I, de Salles Andrade JB, Vigne P, Fontenelle LF. Can Neuroimaging Provide Reliable Biomarkers for Obsessive-Compulsive Disorder? A Narrative Review. Curr Psychiatry Rep 2016; 18:90. [PMID: 27549605 DOI: 10.1007/s11920-016-0729-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In this integrative review, we discuss findings supporting the use neuroimaging biomarkers in the diagnosis and treatment of obsessive-compulsive disorder (OCD). To do so, we have selected the most recent studies that attempted to identify the underlying pathogenic process associated with OCD and whether they provide useful information to predict clinical features, natural history or treatment responses. Studies using functional magnetic resonance (fMRI), voxel-based morphometry (VBM), diffusion tensor imaging (DTI) and proton magnetic resonance spectroscopy (1H MRS) in OCD patients are generally supportive of an expanded version of the earlier cortico-striatal-thalamus-cortical (CSTC) model of OCD. Although it is still unclear whether this information will be incorporated into the daily clinical practice (due to current conceptual approaches to mental illness), statistical techniques, such as pattern recognition methods, appear promising in identifying OCD patients and predicting their outcomes.
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Affiliation(s)
- Ilana Frydman
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Juliana B de Salles Andrade
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paula Vigne
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia.
- , Rua Visconde de Pirajá, 547, 617, Ipanema, Rio de Janeiro, RJ, 22410-003, Brazil.
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Zhu Y, Fan Q, Zhang Z, Zhang H, Tong S, Li Y. Spontaneous neuronal activity in insula predicts symptom severity of unmedicated obsessive compulsive disorder adults. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:5445-8. [PMID: 26737523 DOI: 10.1109/embc.2015.7319623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Emerging evidence has suggested that the pathophysiology of obsessive compulsive disorder (OCD) might involve widely distributed large-scale brain systems. The dysfunction within salience network, which is comprised of dorsal anterior cingulated cortex (dACC) and bilateral insular areas, has been proposed to contribute to OCD onset. The mechanism underlying salience network abnormality remains unclear and it is worthwhile to investigate its clinical relevance using functional neuroimaging approaches. In this study, we performed the spontaneous brain activity measurement using resting-state functional magnetic resonance imaging (fMRI) on unmedicated OCD patients (n=23). Specifically, the amplitude of low frequency (0.01-0.08 Hz) fluctuations (ALFF) was calculated for regions in salience network. The voxel-based Pearson's correlative analysis was conducted to explore the relationship beween ALFF measures and symptom severity for OCD patients. The results showed that the spontaneous neuronal activity in insula was significantly correlated to OCD clinical symptoms, especially compulsive behaviors. Our findings consolidated that the salience network played an important role in the pathogenesis of OCD and the intensity of intrinsic brain activity in insula provided a predictive biomarker for OCD symptom severity.
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McGovern RA, Sheth SA. Role of the dorsal anterior cingulate cortex in obsessive-compulsive disorder: converging evidence from cognitive neuroscience and psychiatric neurosurgery. J Neurosurg 2016; 126:132-147. [PMID: 27035167 DOI: 10.3171/2016.1.jns15601] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Advances in understanding the neurobiological basis of psychiatric disorders will improve the ability to refine neuromodulatory procedures for treatment-refractory patients. One of the core dysfunctions in obsessive-compulsive disorder (OCD) is a deficit in cognitive control, especially involving the dorsal anterior cingulate cortex (dACC). The authors' aim was to derive a neurobiological understanding of the successful treatment of refractory OCD with psychiatric neurosurgical procedures targeting the dACC. METHODS First, the authors systematically conducted a review of the literature on the role of the dACC in OCD by using the search terms "obsessive compulsive disorder" and "anterior cingulate." The neuroscience literature on cognitive control mechanisms in the dACC was then combined with the literature on psychiatric neurosurgical procedures targeting the dACC for the treatment of refractory OCD. RESULTS The authors reviewed 89 studies covering topics that included structural and functional neuroimaging and electrophysiology. The majority of resting-state functional neuroimaging studies demonstrated dACC hyperactivity in patients with OCD relative to that in controls, while task-based studies were more variable. Electrophysiological studies showed altered dACC-related biomarkers of cognitive control, such as error-related negativity in OCD patients. These studies were combined with the cognitive control neurophysiology literature, including the recently elaborated expected value of control theory of dACC function. The authors suggest that a central feature of OCD pathophysiology involves the generation of mis-specified cognitive control signals by the dACC, and they elaborate on this theory and provide suggestions for further study. CONCLUSIONS Although abnormalities in brain structure and function in OCD are distributed across a wide network, the dACC plays a central role. The authors propose a theory of cognitive control dysfunction in OCD that attempts to explain the therapeutic efficacy of dACC neuromodulation. This theoretical framework should help to guide further research into targeted treatments of OCD and other disorders of cognitive control.
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Affiliation(s)
- Robert A McGovern
- Department of Neurological Surgery, The Neurological Institute, Columbia University Medical Center, New York, New York
| | - Sameer A Sheth
- Department of Neurological Surgery, The Neurological Institute, Columbia University Medical Center, New York, New York
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Bernstein GA, Mueller BA, Schreiner MW, Campbell SM, Regan EK, Nelson PM, Houri AK, Lee SS, Zagoloff AD, Lim KO, Yacoub ES, Cullen KR. Abnormal striatal resting-state functional connectivity in adolescents with obsessive-compulsive disorder. Psychiatry Res 2016; 247:49-56. [PMID: 26674413 PMCID: PMC4716880 DOI: 10.1016/j.pscychresns.2015.11.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 10/09/2015] [Accepted: 11/16/2015] [Indexed: 12/15/2022]
Abstract
Neuroimaging research has implicated abnormalities in cortico-striatal-thalamic-cortical (CSTC) circuitry in pediatric obsessive-compulsive disorder (OCD). In this study, resting-state functional magnetic resonance imaging (R-fMRI) was used to investigate functional connectivity in the CSTC circuitry in adolescents with OCD. Imaging was obtained with the Human Connectome Project (HCP) scanner using newly developed pulse sequences which allow for higher spatial and temporal resolution. Fifteen adolescents with OCD and 13 age- and gender-matched healthy controls (ages 12-19) underwent R-fMRI on the 3T HCP scanner. Twenty-four minutes of resting-state scans (two consecutive 12-min scans) were acquired. We investigated functional connectivity of the striatum using a seed-based, whole brain approach with anatomically-defined seeds placed in the bilateral caudate, putamen, and nucleus accumbens. Adolescents with OCD compared with controls exhibited significantly lower functional connectivity between the left putamen and a single cluster of right-sided cortical areas including parts of the orbitofrontal cortex, inferior frontal gyrus, insula, and operculum. Preliminary findings suggest that impaired striatal connectivity in adolescents with OCD in part falls within the predicted CSTC network, and also involves impaired connections between a key CSTC network region (i.e., putamen) and key regions in the salience network (i.e., insula/operculum). The relevance of impaired putamen-insula/operculum connectivity in OCD is discussed.
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Affiliation(s)
- Gail A Bernstein
- University of Minnesota, Division of Child and Adolescent Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Bryon A Mueller
- University of Minnesota, Department of Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Melinda Westlund Schreiner
- University of Minnesota, Division of Child and Adolescent Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Sarah M Campbell
- University of Minnesota, Division of Child and Adolescent Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Emily K Regan
- University of Minnesota, Division of Child and Adolescent Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Peter M Nelson
- University of Minnesota, Division of Child and Adolescent Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA; Penn State College of Education, Department of Educational Psychology, Counseling, and Special Education, 106 Cedar Building, University Park, PA 16802, USA.
| | - Alaa K Houri
- University of Minnesota, Division of Child and Adolescent Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Susanne S Lee
- University of Minnesota, Division of Child and Adolescent Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Alexandra D Zagoloff
- University of Minnesota, Division of Child and Adolescent Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Kelvin O Lim
- University of Minnesota, Department of Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
| | - Essa S Yacoub
- University of Minnesota, Center for Magnetic Resonance Research, 2021-6th Street SE, Minneapolis, MN 55455, USA.
| | - Kathryn R Cullen
- University of Minnesota, Division of Child and Adolescent Psychiatry, F282/2A West, 2450 Riverside Avenue, Minneapolis, MN 55454, USA.
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Alterations of resting state networks and structural connectivity in relation to the prefrontal and anterior cingulate cortices in late prematurity. Neuroreport 2015; 26:22-6. [PMID: 25426826 DOI: 10.1097/wnr.0000000000000296] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Late preterm birth is increasingly recognized as a risk factor for cognitive and social deficits. The prefrontal cortex is particularly vulnerable to injury in late prematurity because of its protracted development and extensive cortical connections. Our study examined children born late preterm without access to advanced postnatal care to assess structural and functional connectivity related to the prefrontal cortex. Thirty-eight preadolescents [19 born late preterm (34-36 /7 weeks gestational age) and 19 at term] were recruited from a developing community in Brazil. Participants underwent neuropsychological testing. Individuals underwent three-dimensional T1-weighted, diffusion-weighted, and resting state functional MRI. Probabilistic tractography and functional connectivity analyses were carried out using unilateral seeds combining the medial prefrontal cortex and the anterior cingulate cortex. Late preterm children showed increased functional connectivity within regions of the default mode, salience, and central-executive networks from both right and left frontal cortex seeds. Decreased functional connectivity was observed within the right parahippocampal region from left frontal seeding. Probabilistic tractography showed a pattern of decreased streamlines in frontal white matter pathways and the corpus callosum, but also increased streamlines in the left orbitofrontal white matter and the right frontal white matter when seeded from the right. Late preterm children and term control children scored similarly on neuropsychological testing. Prefrontal cortical connectivity is altered in late prematurity, with hyperconnectivity observed in key resting state networks in the absence of neuropsychological deficits. Abnormal structural connectivity indicated by probabilistic tractography suggests subtle changes in white matter development, implying disruption of normal maturation during the late gestational period.
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Degnan AJ, Wisnowski JL, Choi S, Ceschin R, Bhushan C, Leahy RM, Corby P, Schmithorst VJ, Panigrahy A. Altered Structural and Functional Connectivity in Late Preterm Preadolescence: An Anatomic Seed-Based Study of Resting State Networks Related to the Posteromedial and Lateral Parietal Cortex. PLoS One 2015; 10:e0130686. [PMID: 26098888 PMCID: PMC4476681 DOI: 10.1371/journal.pone.0130686] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 05/22/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Late preterm birth confers increased risk of developmental delay, academic difficulties and social deficits. The late third trimester may represent a critical period of development of neural networks including the default mode network (DMN), which is essential to normal cognition. Our objective is to identify functional and structural connectivity differences in the posteromedial cortex related to late preterm birth. METHODS Thirty-eight preadolescents (ages 9-13; 19 born in the late preterm period (≥32 weeks gestational age) and 19 at term) without access to advanced neonatal care were recruited from a low socioeconomic status community in Brazil. Participants underwent neurocognitive testing, 3-dimensional T1-weighted imaging, diffusion-weighted imaging and resting state functional MRI (RS-fMRI). Seed-based probabilistic diffusion tractography and RS-fMRI analyses were performed using unilateral seeds within the posterior DMN (posterior cingulate cortex, precuneus) and lateral parietal DMN (superior marginal and angular gyri). RESULTS Late preterm children demonstrated increased functional connectivity within the posterior default mode networks and increased anti-correlation with the central-executive network when seeded from the posteromedial cortex (PMC). Key differences were demonstrated between PMC components with increased anti-correlation with the salience network seen only with posterior cingulate cortex seeding but not with precuneus seeding. Probabilistic tractography showed increased streamlines within the right inferior longitudinal fasciculus and inferior fronto-occipital fasciculus within late preterm children while decreased intrahemispheric streamlines were also observed. No significant differences in neurocognitive testing were demonstrated between groups. CONCLUSION Late preterm preadolescence is associated with altered functional connectivity from the PMC and lateral parietal cortex to known distributed functional cortical networks despite no significant executive neurocognitive differences. Selective increased structural connectivity was observed in the setting of decreased posterior interhemispheric connections. Future work is needed to determine if these findings represent a compensatory adaptation employing alternate neural circuitry or could reflect subtle pathology resulting in emotional processing deficits not seen with neurocognitive testing.
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Affiliation(s)
- Andrew J. Degnan
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Radiology, University of Pittsburgh Medical Center (UPMC), 3950 Presby South Tower, 200 Lothrop Street, Pittsburgh, PA 15213, United States of America
| | - Jessica L. Wisnowski
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
| | - SoYoung Choi
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
| | - Rafael Ceschin
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Chitresh Bhushan
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Richard M. Leahy
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Patricia Corby
- Twins Institute for Genetics Research, Montes Claros, Minas Gerais 39400–115, Brazil
- New York University Bluestone Center for Clinical Research, 421 1st Ave, New York, NY 10010, United States of America
| | - Vincent J. Schmithorst
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
| | - Ashok Panigrahy
- Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Floor 2, Pittsburgh, PA, 15224, United States of America
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA 90089, United States of America
- Department of Radiology, Children’s Hospital Los Angeles, Los Angeles, CA 90027, United States of America
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States of America
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Gruner P, Anticevic A, Lee D, Pittenger C. Arbitration between Action Strategies in Obsessive-Compulsive Disorder. Neuroscientist 2015; 22:188-98. [PMID: 25605642 DOI: 10.1177/1073858414568317] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Decision making in a complex world, characterized both by predictable regularities and by frequent departures from the norm, requires dynamic switching between rapid habit-like, automatic processes and slower, more flexible evaluative processes. These strategies, formalized as "model-free" and "model-based" reinforcement learning algorithms, respectively, can lead to divergent behavioral outcomes, requiring a mechanism to arbitrate between them in a context-appropriate manner. Recent data suggest that individuals with obsessive-compulsive disorder (OCD) rely excessively on inflexible habit-like decision making during reinforcement-driven learning. We propose that inflexible reliance on habit in OCD may reflect a functional weakness in the mechanism for context-appropriate dynamic arbitration between model-free and model-based decision making. Support for this hypothesis derives from emerging functional imaging findings. A deficit in arbitration in OCD may help reconcile evidence for excessive reliance on habit in rewarded learning tasks with an older literature suggesting inappropriate recruitment of circuitry associated with model-based decision making in unreinforced procedural learning. The hypothesized deficit and corresponding circuitry may be a particularly fruitful target for interventions, including cognitive remediation.
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Affiliation(s)
- Patricia Gruner
- Department of Psychiatry, Yale University, New Haven, CT, USA Learning Based Recovery Center, VA Connecticut Health System, West Haven, CT, USA
| | - Alan Anticevic
- Department of Psychiatry, Yale University, New Haven, CT, USA Department of Psychology, Yale University, New Haven, CT, USA Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
| | - Daeyeol Lee
- Department of Psychology, Yale University, New Haven, CT, USA Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA Department of Neurobiology, Yale University, New Haven, CT, USA
| | - Christopher Pittenger
- Department of Psychiatry, Yale University, New Haven, CT, USA Department of Psychology, Yale University, New Haven, CT, USA Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA Child Study Center, Yale University, New Haven, CT, USA
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