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Chen H, Xie M, Ouyang M, Yuan F, Yu J, Song S, Liu N, Zhang N. The impact of illness duration on brain activity in goal-directed and habit-learning systems in obsessive-compulsive disorder progression: A resting-state functional imaging study. Neuroscience 2024; 553:74-88. [PMID: 38964449 DOI: 10.1016/j.neuroscience.2024.06.018] [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: 12/07/2023] [Revised: 06/13/2024] [Accepted: 06/18/2024] [Indexed: 07/06/2024]
Abstract
It is increasingly evident that structural and functional changes in brain regions associated with obsessive-compulsive disorder (OCD) are often related to the development of the disease. However, limited research has been conducted on how the progression of OCD may lead to an imbalance between goal-directed and habit-learning systems. This study employs resting-state functional imaging to examine the relationship between illness duration and abnormal brain function in goal-directed/habitual-learning systems. Demographic, clinical, and multimodal fMRI data were collected from participants. Our findings suggest that, compared to healthy controls, individuals with OCD exhibit abnormal brain functional indicators in both goal-directed and habit-learning brain regions, with a more pronounced reduction observed in the goal-directed regions. Additionally, abnormal brain activity is associated with illness duration, and the abnormalities observed in goal-directed regions are more effective in distinguishing different courses of OCD patients. Patients with different durations of OCD have functional abnormalities in the goal-directed and habitual-learning brain regions. There are differences in the degree of abnormality in different brain regions, and these abnormalities may disrupt the balance between goal-directed and habitual-learning systems, leading to increasing reliance on repetitive behaviors.
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Affiliation(s)
- Haocheng Chen
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Minyao Xie
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Mengyuan Ouyang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Fangzheng Yuan
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Jianping Yu
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Shasha Song
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Na Liu
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
| | - Ning Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China.
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Aglamiş S, Murat Aydın A, Eroglu Y, Burakgazi G, Atmaca M. Diffusion-Weighted MRI Findings of Caudate Nucleus and Putamen in Patients With Obsessive-Compulsive Disorder. Cureus 2021; 13:e17023. [PMID: 34522504 PMCID: PMC8425491 DOI: 10.7759/cureus.17023] [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] [Accepted: 08/09/2021] [Indexed: 11/05/2022] Open
Abstract
Objective The purpose of this study was to establish the diffusion-weighted magnetic resonance imaging (DW-MRI) findings of the caudate nucleus and putamen in patients with obsessive-compulsive disorder (OCD) and to obtain new information on the etiopathogenesis of OCD, which is still unclear. Methods The study comprised 20 patients with OCDs and 20 healthy volunteers. In these cases, DW-MRI and diffusion-weighted echo-planar images (DW-EPI) at b600 and b1000 gradient values were taken and the measurements were made using the apparent diffusion coefficient (ADC) maps of each group at b600 and b1000 values from the caudate nucleus and putamen. Results When the DW-MRI examination in patients with OCD was compared with the control group, the mean ADC values in the caudate nucleus and putamen were not found to have statistically significantly changed. In addition, there were no significant differences regarding the right and left caudate nuclei and putamen ADC values at the b600 and b1000 in the patients with OCD or the control group. Conclusion There are still many unknowns about the neurobiology of OCD. When the DW-MRI examination of the patients with OCD was compared with the control group in our study, no significant difference was found between the ADC values of the caudate nucleus and putamen. Further studies are required for this present study on DW-MRI in patients with OCD to be meaningful.
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Affiliation(s)
- Serpil Aglamiş
- Department of Radiology, Firat University School of Medicine, Elazig, TUR
| | - Ayşe Murat Aydın
- Department of Radiology, Firat University School of Medicine, Elazig, TUR
| | - Yesim Eroglu
- Department of Radiology, Firat University School of Medicine, Elazig, TUR
| | - Gülen Burakgazi
- Department of Radiology, Recep Tayyip Erdogan University School of Medicine, Rize, TUR
| | - Murad Atmaca
- Department of Psychiatry, Firat University School of Medicine, Elazig, TUR
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Busatto G, Rosa PG, Serpa MH, Squarzoni P, Duran FL. Psychiatric neuroimaging research in Brazil: historical overview, current challenges, and future opportunities. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2021; 43:83-101. [PMID: 32520165 PMCID: PMC7861184 DOI: 10.1590/1516-4446-2019-0757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/03/2020] [Indexed: 11/23/2022]
Abstract
The last four decades have witnessed tremendous growth in research studies applying neuroimaging methods to evaluate pathophysiological and treatment aspects of psychiatric disorders around the world. This article provides a brief history of psychiatric neuroimaging research in Brazil, including quantitative information about the growth of this field in the country over the past 20 years. Also described are the various methodologies used, the wealth of scientific questions investigated, and the strength of international collaborations established. Finally, examples of the many methodological advances that have emerged in the field of in vivo neuroimaging are provided, with discussion of the challenges faced by psychiatric research groups in Brazil, a country of limited resources, to continue incorporating such innovations to generate novel scientific data of local and global relevance.
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Affiliation(s)
- Geraldo Busatto
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Pedro G. Rosa
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Mauricio H. Serpa
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paula Squarzoni
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Fabio L. Duran
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Dominke C, Graham-Schmidt K, Gentsch A, Schütz-Bosbach S. Action inhibition in individuals with high obsessive-compulsive trait of incompleteness: An ERP study. Biol Psychol 2021; 159:108019. [PMID: 33460785 DOI: 10.1016/j.biopsycho.2021.108019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 12/01/2020] [Accepted: 01/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Missing action completion signals are assumed to trigger repetitive behavior and feelings of the action "not being right". This proposal is based mostly on individual's self-reports. Here, we investigated the influence of experimentally manipulated action completion experience and the obsessive-compulsive (OC) trait of incompleteness on behavioral and neurophysiological measures of action inhibition. METHODS Action completion was manipulated in an adapted Go/NoGo task, and OC trait incompleteness was assessed in healthy participants. More commission errors and faster responses were expected after missing action completion, especially for individuals with high OC trait incompleteness. The inhibition-related event-related potentials (ERPs) N200 and P300 were also measured. RESULTS High OC trait incompleteness led to more errors following omitted- and faster responses during commission errors following incongruent outcomes. Furthermore, lower N200 was associated with worse response inhibition, and high OC trait incompleteness was associated with reduced N200, but not reduced P300 amplitude. These findings provide evidence that trait-like feelings of incompleteness may underlie maladaptive action repetition and impaired inhibitory control as observed in OCD.
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Affiliation(s)
- Clara Dominke
- General and Experimental Psychology, Ludwig-Maximilians-University, Munich, Leopoldstr. 13, München, 80802, Germany.
| | - Kyran Graham-Schmidt
- General and Experimental Psychology, Ludwig-Maximilians-University, Munich, Leopoldstr. 13, München, 80802, Germany
| | - Antje Gentsch
- General and Experimental Psychology, Ludwig-Maximilians-University, Munich, Leopoldstr. 13, München, 80802, Germany
| | - Simone Schütz-Bosbach
- General and Experimental Psychology, Ludwig-Maximilians-University, Munich, Leopoldstr. 13, München, 80802, Germany
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Ota M, Kanie A, Kobayashi Y, Nakajima A, Sato N, Horikoshi M. Pseudo-continuous arterial spin labeling MRI study of patients with obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2020; 303:111124. [PMID: 32563075 DOI: 10.1016/j.pscychresns.2020.111124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/18/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
Abstract
Arterial spin labeling (ASL) magnetic resonance imaging is a novel technique that can measure regional cerebral blood flow (rCBF). Here we used pseudo-continuous ASL (pCASL) to examine the structural and functional imaging data in patients with obsessive-compulsive disorder (OCD). We estimated the gray matter volume imaging and pCASL imaging data by means of a voxel-by-voxel statistical analysis. We evaluated the differences of rCBF and gray matter volume between the OCD patients and healthy subjects. We detected a significant rCBF reduction in OCD patients in the right posterior cingulate extending to the lingual gyrus, thalamus, and hippocampus, and a significant increase in the left temporal gyrus and left frontal white matter region, compared with healthy subjects. We also observed a significant reduction in gray matter volume of OCD patients in the right hippocampus. We also estimated the correlation between the clinical severity of OCD and the rCBF and gray matter volumes, and found significant negative correlations between the severity of illness and the regional gray matter volume in the bilateral anterior cingulate corti. Our study demonstrated significant changes of rCBF in the cortico-striato-thalamo-cortical pathway around the hippocampus in OCD patients. These findings may help to elucidate the pathogenesis of OCD.
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Affiliation(s)
- Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502, Japan; Department of Neuropsychiatry, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8576, Japan.
| | - Ayako Kanie
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502, Japan
| | - Yuki Kobayashi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502, Japan
| | - Aiichiro Nakajima
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502, Japan
| | - Noriko Sato
- Department of Radiology, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo 187-8502, Japan
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A voxel-based analysis of cerebral blood flow abnormalities in obsessive-compulsive disorder using pseudo-continuous arterial spin labeling MRI. PLoS One 2020; 15:e0236512. [PMID: 32706796 PMCID: PMC7380600 DOI: 10.1371/journal.pone.0236512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 07/07/2020] [Indexed: 11/19/2022] Open
Abstract
Objective To identify abnormalities of regional cerebral blood flow (rCBF) in individuals with obsessive-compulsive disorder (OCD) by conducting a voxel-based analysis of pseudo-continuous arterial spin labeling (pCASL) perfusion images. Materials and methods This prospective study included 23 OCD patients (nine males, 14 females; age 21–62 years; mean ± SD 37.2 ± 10.7 years) diagnosed based on DSM-IV-TR criteria and 64 healthy controls (27 males, 37 females; age 20–64 years; mean ± SD 38.3 ± 12.8 years). Subjects were recruited from October 2011 to August 2017. Imaging was performed on a 3T scanner. Quantitative rCBF maps generated from pCASL images were co-registered and resliced with the three-dimensional T1-weighted images, and then spatially normalized to a brain template and smoothed. We used statistical nonparametric mapping to assess the differences in rCBF and gray matter volume between the OCD and control groups. The significance level was set at the p-value <0.05 with family-wise error rate correction for multiple comparisons. Results Compared to the control group, there were significant rCBF reductions in the right putamen, right frontal operculum, left midcingulate cortex, and right temporal pole in the OCD group. There were no significant between-group differences in the gray matter volume. Conclusion The pCASL imaging noninvasively detected physiologically disrupted areas without structural abnormalities in OCD patients. The rCBF reductions observed in these regions in OCD patients could be associated with the pathophysiology of OCD.
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Yildiz S, Uğur K, Taşkent İ, Atmaca M. Insula Volume in Patients Diagnosed with Obsessive Compulsive Disorder and its Relation with Clinical Variables. ACTA ACUST UNITED AC 2020; 57:89-92. [PMID: 32550772 DOI: 10.29399/npa.24830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 11/25/2019] [Indexed: 11/07/2022]
Abstract
Introduction Neuroimaging studies performed in recent years on patients with obsessive compulsive disorder have determined anomalies that are possibly associated with the determinant signs and symptoms of the disease. The purpose of this study is to investigate the morphometric changes in insula volume and related parameters in order to understand the etiopathogenesis of obsessive compulsive disorder better. Method Throughout the study, 20 patients eligible for the study criteria, who were diagnosed with OCD according to DSM-5 diagnostic criteria and receiving inpatient or outpatient treatment after applying to Fırat University Hospital Psychiatry Department, and 13 healthy subjects in the control group have been included in the study. Sociodemographic and Clinical Data Form, Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Yale-Brown Obsession Compulsive Scale (Y-BOCS) and SCID-I have been applied to the patients. Volumetric measurements were performed on the insula by using magnetic resonance imaging (MRI) in patient and control groups. Results No significant difference was observed between patients with Obsessive Compulsive Disorder and healthy controls with regard to insula volume. Discussion It may be stated that insula may be associated with both the pathophysiology and clinical course of the disease. It is suggested that studies considering the imaging methods examining the functional characteristics of this area and tests on cognitive functions together may lead to significant and efficient results.
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Affiliation(s)
- Sevler Yildiz
- Tunceli State Hospital, Department of Psychiatry, Tunceli, Turkey
| | - Kerim Uğur
- Malatya Training and Research Hospital, Department of Psychiatry, Malatya, Turkey
| | - İsmail Taşkent
- Muş State Hospital, Department of Radiology, Muş, Turkey
| | - Murad Atmaca
- Fırat University, Medical Faculty, Department of Psychiatry, Elazığ, Turkey
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Hazari N, Narayanaswamy JC, Venkatasubramanian G. Neuroimaging findings in obsessive-compulsive disorder: A narrative review to elucidate neurobiological underpinnings. Indian J Psychiatry 2019; 61:S9-S29. [PMID: 30745673 PMCID: PMC6343409 DOI: 10.4103/psychiatry.indianjpsychiatry_525_18] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Obsessive compulsive disorder (OCD) is a common psychiatric illness and significant research has been ongoing to understand its neurobiological basis. Neuroimaging studies right from the 1980s have revealed significant differences between OCD patients and healthy controls. Initial imaging findings showing hyperactivity in the prefrontal cortex (mainly orbitofrontal cortex), anterior cingulate cortex and caudate nucleus led to the postulation of the cortico-striato-thalamo-cortical (CSTC) model for the neurobiology of OCD. However, in the last two decades emerging evidence suggests the involvement of widespread associative networks, including regions of the parietal cortex, limbic areas (including amygdala) and cerebellum. This narrative review discusses findings from structural [Magnetic Resonance Imaging (MRI), Diffusion Tensor Imaging(DTI)], functional [(functional MRI (fMRI), Single photon emission computed tomography (SPECT), Positron emission tomography (PET), functional near-infrared spectroscopy (fNIRS)], combined structural and functional imaging studies and meta-analyses. Subsequently, we collate these findings to describe the neurobiology of OCD including CSTC circuit, limbic system, parietal cortex, cerebellum, default mode network and salience network. In future, neuroimaging may emerge as a valuable tool for personalised medicine in OCD treatment.
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Affiliation(s)
- Nandita Hazari
- Department of Psychiatry, Vidyasagar Institute of Mental Health and Neurosciences, Delhi, India
| | - Janardhanan C Narayanaswamy
- Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, OCD Clinic, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Wierenga CE, Lavender JM, Hays CC. The potential of calibrated fMRI in the understanding of stress in eating disorders. Neurobiol Stress 2018; 9:64-73. [PMID: 30450374 PMCID: PMC6234260 DOI: 10.1016/j.ynstr.2018.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/18/2018] [Accepted: 08/17/2018] [Indexed: 12/18/2022] Open
Abstract
Eating disorders (ED), including Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Binge Eating Disorder (BED), are medically dangerous psychiatric disorders of unknown etiology. Accumulating evidence supports a biopsychosocial model that includes genetic heritability, neurobiological vulnerability, and psychosocial factors, such as stress, in the development and maintenance of ED. Notably, stress hormones influence appetite and eating, and dysfunction of the physiological stress response has been implicated in ED pathophysiology. Stress signals also appear associated with food reward neurocircuitry response in ED, providing a possible mechanism for the role of stress in appetite dysregulation. This paper provides a review of some of the interacting psychological, behavioral, physiological, and neurobiological mechanisms involved in the stress response among individuals with ED, and discusses novel neuroimaging techniques to address potential physiological confounds of studying neural correlates of stress in ED, such as calibrated fMRI.
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Affiliation(s)
- Christina E Wierenga
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
| | - Jason M Lavender
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
| | - Chelsea C Hays
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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Zhou DD, Wang W, Wang GM, Li DQ, Kuang L. An updated meta-analysis: Short-term therapeutic effects of repeated transcranial magnetic stimulation in treating obsessive-compulsive disorder. J Affect Disord 2017; 215:187-196. [PMID: 28340445 DOI: 10.1016/j.jad.2017.03.033] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 02/07/2017] [Accepted: 03/06/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study was conducted to evaluate the short-term therapeutic effects of using repeated transcranial magnetic stimulation (rTMS) to treat obsessive-compulsive disorder (OCD) and to examine potential influencing factors. METHOD We searched the PubMed, EMBASE, CENTRAL, Wanfang, CNKI, and Sinomed databases on September 18, 2016 and reviewed the references of previous meta-analyses. Sham-controlled, randomized clinical trials using rTMS to treat OCD were included. Hedge's g was calculated for the effect size. Subgroup analyses and univariate meta-regressions were conducted. RESULTS Twenty studies with 791 patients were included. A large effect size (g=0.71; 95%CI, 0.55-0.87; P<0.001) was found for the therapeutic effect. Targeting the supplementary motor area (SMA) (g=0.56; 95%CI, 0.12-1.01; P<0.001), left dorsolateral prefrontal cortex (DLPFC) (g=0.47; 95%CI, 0.02-0.93; P=0.02), bilateral DLPFC (g=0.65; 95%CI, 0.38-0.92; P<0.001) and right DLPFC (g=0.93; 95%CI, 0.70-1.15; P<0.001), excluding the orbitofrontal cortex (OFC) (g=0.56; 95%CI, -0.05-1.18; P=0.07), showed significant improvements over sham treatments. Both low-frequency (g=0.73; 95%CI, 0.50-0.96; P<0.001) and high-frequency (g=0.70; 95%CI, 0.51-0.89; P<0.001) treatments were significantly better than sham treatments, with no significant differences between the effects of the two frequencies. The subgroup analyses indicated that patients who were non-treatment resistant, lacked concurrent major depressive disorder (MDD) and received threshold-intensity rTMS showed larger therapeutic effects than the corresponding subgroups. The subgroup analysis according to sham strategy showed that tilted coils yielded larger effects than sham coils. Meta-regression analyses revealed that none of the continuous variables were significantly associated with the therapeutic effects. LIMITATIONS Only short-term therapeutic effects were assessed in this study. CONCLUSIONS Based on this study, the short-term therapeutic effects of rTMS are superior to those of sham treatments. The site of stimulation, stimulation frequency and intensity and sham condition were identified as potential factors modulating short-term therapeutic effects. The findings of this study may inspire future research.
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Affiliation(s)
- Dong-Dong Zhou
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Gao-Mao Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Da-Qi Li
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China; Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Shen CY, Wang YJ, Liu XM, Zhang XQ, Ren XJ, Ma XY, Sun JJ, Feng K, Sun GX, Xu B, Liu PZ. Improvement of Orbitofrontal Cortex Function Associated with Blephrospasm Symptom Remission. Eur Neurol 2017; 77:288-294. [PMID: 28391280 DOI: 10.1159/000471850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 03/21/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine whether orbitofrontal cortex (OFC) function improves with blepharospasm (BSP) symptom remission using a verbal fluency task and near-infrared spectroscopy (NIRS). METHODS Nineteen BSP patients and 9 healthy controls (HCs) matched by gender and education were examined using NIRS. The BSP patients were divided into 2 groups based on the onset or remission of BSP symptoms. A covariance analysis was conducted to analyze the differences among the 3 groups to avoid the influence of different ages. The least significant difference was used to process the post hoc test. RESULTS The hemoglobin concentration and cerebral blood flow of the bilateral orbitofrontal area (channels 27, 31, 34, 37, and 39) were not significantly different between the BSP remission and HC groups (p > 0.05); however, both groups were significantly increased compared with the BSP onset group (BSP remission group vs. BSP onset group: p = 0.003, p = 0.018, p = 0.013, p = 0.001, and p = 0.011, respectively; BSP remission group vs. BSP onset group: p = 0.037, p = 0.044, p = 0.023, p = 0.016, and p = 0.025, respectively). CONCLUSION This is the first investigation to control for symptom stages in BSP patients examined via NIRS. Cognitive ability and OFC function improve with BSP symptom remission. Thus, the OFC may be inter-connected with motor and cognitive symptoms in BSP.
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Affiliation(s)
- Chen-Yu Shen
- Yuquan Hospital, Clinical Neuroscience Institute, Medical Center, Tsinghua University, Beijing, China
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Mitra S, Mucha M, Khatri SN, Glenon R, Schulte MK, Bult-Ito A. Attenuation of Compulsive-Like Behavior Through Positive Allosteric Modulation of α4β2 Nicotinic Acetylcholine Receptors in Non-Induced Compulsive-Like Mice. Front Behav Neurosci 2017; 10:244. [PMID: 28105008 PMCID: PMC5214813 DOI: 10.3389/fnbeh.2016.00244] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 12/14/2016] [Indexed: 11/23/2022] Open
Abstract
Nicotinic α4β2 receptors are the most abundant subtypes of nicotinic acetylcholine receptors (nAChRs) expressed in brain regions implicated in obsessive compulsive disorder (OCD). These receptors are known to modify normal and addictive behaviors by modulating neuronal excitability. Desformylflustrabromine (dFBr) is a novel, positive allosteric modulator (PAM) of high acetylcholine sensitivity (HS) and low acetylcholine sensitivity (LS) α4β2 nAChRs. The present study tested the hypothesis that positive allosteric modulation of α4β2 receptors by dFBr will attenuate compulsive-like behavior in a non-induced compulsive-like mouse model. Male mice (Mus musculus) selected for compulsive-like nesting behavior (NB; 48 animals; 12 per group) received acute (once) and chronic (every day for 32 days) subcutaneous injection of dFBr at 2, 4 and 6 mg/kg doses. Saline was used as a control (0 mg/kg). Compulsive-like NB was assessed after 1, 2, 3, 4, 5 and 24 h, while compulsive-like marble burying (MB) and anxiety-like open field (OF) behaviors were performed 2 h after dFBr administration. In the acute administration protocol, dFBr dose dependently attenuated NB and MB. Rapid effects (1–2 h after drug administration) of dFBr on MB and NB were observed for the chronic administration which was in congruence with the acute study. Chronic administration also revealed sustained suppression of NB by dFBr following 5 weeks of treatment. In both the acute and chronic regimen dFBr did not modulate OF behaviors. This research demonstrates the novel role of positive allosteric modulation of α4β2 nicotinic receptors by dFBr as a translational potential for OCD.
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Affiliation(s)
- Swarup Mitra
- Department of Chemistry and Biochemistry, University of Alaska FairbanksFairbanks, AK, USA; IDeA Network of Biomedical Research Excellence (INBRE), University of Alaska FairbanksFairbanks, AK, USA
| | - Mckenzie Mucha
- Department of Chemistry and Biochemistry, University of Alaska Fairbanks Fairbanks, AK, USA
| | - Shailesh N Khatri
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, University of the Sciences Philadelphia, PA, USA
| | - Richard Glenon
- Department of Medicinal Chemistry, School of Pharmacy, Virginia Commonwealth University Richmond, VA, USA
| | - Marvin K Schulte
- Department of Pharmaceutical Sciences, Philadelphia College of Pharmacy, University of the Sciences Philadelphia, PA, USA
| | - Abel Bult-Ito
- Department of Biology and Wildlife, University of Alaska Fairbanks Fairbanks, AK, USA
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13
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Yamamuro K, Ota T, Iida J, Kishimoto N, Nakanishi Y, Kishimoto T. Persistence of impulsivity in pediatric and adolescent patients with obsessive-compulsive disorder. Psychiatry Clin Neurosci 2017; 71:36-43. [PMID: 27701796 DOI: 10.1111/pcn.12465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 08/23/2016] [Accepted: 09/23/2016] [Indexed: 11/30/2022]
Abstract
AIM Increasing clinical evidence points to impulsivity as a symptom of obsessive-compulsive disorder (OCD). However, little is known about its persistence over time. METHODS In this study, we evaluated the performance of 12 pediatric patients with OCD on the Stroop color-word task, which assesses impulsivity, and compared this with age- and sex-matched controls. In parallel, we measured changes in hemodynamic responses during the task, using near-infrared spectroscopy. As patients in the OCD group were naïve to treatment, we compared results before and after 3-year medication with serotonin reuptake inhibitors. RESULTS We report that, compared with controls, the OCD group had significantly poorer performance and less activation in the prefrontal cortex during the Stroop color-word task. Surprisingly, while serotonin-reuptake-inhibitors treatment reduced OCD symptomology, it did not improve the diminished hemodynamic responses or task performance of these patients. CONCLUSION Our findings suggest that a persistent deficit exists in the inhibitory control of pediatric patients with OCD; they also provide insight into the pathophysiology of OCD.
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Affiliation(s)
- Kazuhiko Yamamuro
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toyosaku Ota
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Junzo Iida
- Faculty of Nursing, Nara Medical University School of Medicine, Kashihara, Japan
| | - Naoko Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Yoko Nakanishi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toshifumi Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
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14
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Rǎdulescu A, Marra R. A mathematical model of reward and executive circuitry in obsessive compulsive disorder. J Theor Biol 2016; 414:165-175. [PMID: 27915073 DOI: 10.1016/j.jtbi.2016.11.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 10/07/2016] [Accepted: 11/29/2016] [Indexed: 01/01/2023]
Abstract
The neuronal circuit that controls obsessive and compulsive behaviors involves a complex network of brain regions (some with known involvement in reward processing). Among these are cortical regions, the striatum and the thalamus (which compose the CSTC pathway), limbic areas such as the amygdala and the hippocampus, as well as dopamine pathways. Abnormal dynamic behavior in this brain network is a hallmark feature of patients with increased anxiety and motor activity, like the ones affected by OCD. There is currently no clear understanding of precisely what mechanisms generate these behaviors. We attempt to investigate a collection of connectivity hypotheses of OCD by means of a computational model of the brain circuitry that governs reward and motion execution. Mathematically, we use methods from ordinary differential equations and continuous time dynamical systems. We use classical analytical methods as well as computational approaches to study phenomena in the phase plane (e.g., behavior of the system's solutions when given certain initial conditions) and in the parameter space (e.g., sensitive dependence of initial conditions). We find that different obsessive-compulsive subtypes may correspond to different abnormalities in the network connectivity profiles. We suggest that it is a combination of parameters (connectivity strengths between regions), rather than the value of any one parameter taken independently, that provide the best basis for predicting behavior, and for understanding the heterogeneity of the illness.
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Affiliation(s)
- Anca Rǎdulescu
- Department of Mathematics, State University of New York at New Paltz, New Paltz, NY, USA.
| | - Rachel Marra
- Department of Astronomy, State University of New York at New Paltz, New Paltz, NY 12561, USA
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15
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Yamamuro K, Ota T, Iida J, Kishimoto N, Nakanishi Y, Matsuura H, Uratani M, Okazaki K, Kishimoto T. A longitudinal event-related potential study of selective serotonin reuptake inhibitor therapy in treatment-naïve pediatric obsessive compulsive disorder patients. Psychiatry Res 2016; 245:217-223. [PMID: 27552672 DOI: 10.1016/j.psychres.2016.07.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/04/2016] [Accepted: 07/18/2016] [Indexed: 11/18/2022]
Abstract
Obsessive-compulsive disorder (OCD) is characterized by obsessive thoughts and/or compulsive behaviors, involving specific cognition and/or information processing disorders. Event-related potentials (ERPs) are commonly used as physiological measures of cognitive function. In conscious patients, ERPs are easily and non-invasively measured. Previous ERP studies have revealed differences between OCD patients and control subjects. Whether ERPs reflect the pharmacological effects of OCD treatment, particularly in treatment-naïve pediatric patients, remains unknown. We used the Child's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) to evaluate the symptomatic severity of 12 treatment-naïve pediatric OCD patients. Comparisons were made with 12 age-, sex-, and intelligence-matched controls. The P300 and mismatch negativity (MMN) components were measured during an auditory odd-ball task at baseline in both groups and after the 3-year serotonin reuptake inhibitor (SSRI) treatment in OCD patients. Compared with controls, P300 amplitudes were smaller n the OCD group at Fz, Cz, Pz, C3, and C4. After SSRI treatment, P300 amplitudes increased partly at Fz and C4 in association with symptomatic improvements. We found a significant positive correlation between P300 amplitude in C4 and CY-BOCS scores. Our findings confirm the utility of SSRIs in pediatric OCD, and suggest the utility of ERPs for evaluating pharmacological effects in treatment-naïve pediatric OCD patients.
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Affiliation(s)
- Kazuhiko Yamamuro
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan.
| | - Toyosaku Ota
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Junzo Iida
- Faculty of Nursing, Nara Medical University School of Medicine, Kashihara, Japan
| | - Naoko Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Yoko Nakanishi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | | | - Mitsuhiro Uratani
- Department of Psychiatry, Nara Prefectural General Rehabilitation Center, Shiki, Japan
| | - Kosuke Okazaki
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toshifumi Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
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16
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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: 64] [Impact Index Per Article: 8.0] [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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17
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Yamamuro K, Okada K, Kishimoto N, Ota T, Iida J, Kishimoto T. A longitudinal, event-related potential pilot study of adult obsessive-compulsive disorder with 1-year follow-up. Neuropsychiatr Dis Treat 2016; 12:2463-2471. [PMID: 27713631 PMCID: PMC5045237 DOI: 10.2147/ndt.s117100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AIM Earlier brain imaging research studies have suggested that brain abnormalities in obsessive-compulsive disorder (OCD) normalize as clinical symptoms improve. However, although many studies have investigated event-related potentials (ERPs) in patients with OCD compared with healthy control subjects, it is currently unknown whether ERP changes reflect pharmacological and psychotherapeutic effects. As such, the current study examined the neurocognitive components of OCD to elucidate the pathophysiological abnormalities involved in the disorder, including the frontal-subcortical circuits. METHODS The Yale-Brown Obsessive-Compulsive Scale was used to evaluate 14 adult patients with OCD. The present study also included ten age-, sex-, and IQ-matched controls. The P300 and mismatch negativity (MMN) components during an auditory oddball task at baseline for both groups and after 1 year of treatment for patients with OCD were measured. RESULTS Compared with controls, P300 amplitude was attenuated in the OCD group at Cz and C4 at baseline. Pharmacotherapy and psychotherapy treatment for 1 year reduced OCD symptomology. P300 amplitude after 1 year of treatment was significantly increased, indicating normalization compared with baseline at Fz, Cz, C3, and C4. We found no differences in P300 latency, MMN amplitude, or MMN latency between baseline and after one year of treatment. CONCLUSION ERPs may be a useful tool for evaluating pharmacological and cognitive behavioral therapy in adult patients with OCD.
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Affiliation(s)
- Kazuhiko Yamamuro
- Department of Psychiatry, Nara Medical University School of Medicine
| | - Koji Okada
- Department of Psychiatry, Jingumaecocorono-Clinic
| | - Naoko Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine
| | - Toyosaku Ota
- Department of Psychiatry, Nara Medical University School of Medicine
| | - Junzo Iida
- Faculty of Nursing, Nara Medical University School of Medicine, Kashihara, Japan
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18
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Olson CA, Hale LR, Hamilton N, Powell JN, Martin LE, Savage CR. Altered source memory retrieval is associated with pathological doubt in obsessive-compulsive disorder. Behav Brain Res 2016; 296:53-60. [PMID: 26315458 PMCID: PMC4720123 DOI: 10.1016/j.bbr.2015.08.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/17/2015] [Accepted: 08/21/2015] [Indexed: 12/18/2022]
Abstract
Individuals with obsessive-compulsive disorder (OCD) often complain of doubt related to memory. As neuropsychological research has demonstrated that individuals with OCD tend to focus on details and miss the larger context, the construct of source (contextual) memory may be particularly relevant to memory complaints in OCD. Memory for object versus contextual information relies on partially distinct regions within the prefrontal cortex, parietal and medial temporal lobe, and may be differentially impacted by OCD. In the present study, we sought to test the hypothesis that individuals with OCD exhibit impaired source memory retrieval using a novel memory paradigm - The Memory for Rooms Test (MFRT) - a four-room memory task in which participants walk through four rooms and attempt to encode and remember objects. Demographically matched individuals with OCD and healthy controls studied objects in the context of four rooms, and then completed a memory retrieval test while undergoing functional magnetic resonance imaging (fMRI). While no differences were observed in source memory accuracy, individuals with OCD exhibited greater task related activation in the posterior cingulate cortex (PCC) relative to healthy controls during correct source memory retrieval. During correct object recognition, individuals with OCD failed to recruit the dorsolateral prefrontal(DLPFC)/premotor, left mPFC, and right parietal regions to the same extent as healthy controls. Our results suggest abnormal recruitment of frontal-parietal and PCC regions during source verses object memory retrieval in OCD. Within the OCD group, activation in the PCC and the premotor/DLPFC was associated with greater pathological doubt. This finding is consistent with the observation that OCD patients often experience extreme doubt, even when memory performance is intact.
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Affiliation(s)
- Christy A Olson
- Center for Health Behavior Neuroscience, University of Kansas Medical Center, Kansas City, KS, United States; Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, United States.
| | - Lisa R Hale
- Kansas City Center for Anxiety Treatment, Overland Park, KS, United States
| | - Nancy Hamilton
- Department of Psychology, University of Kansas, Lawrence, KS, United States
| | - Joshua N Powell
- Center for Health Behavior Neuroscience, University of Kansas Medical Center, Kansas City, KS, United States
| | - Laura E Martin
- Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, KS, United States
| | - Cary R Savage
- Center for Health Behavior Neuroscience, University of Kansas Medical Center, Kansas City, KS, United States
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19
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Yamamuro K, Ota T, Nakanishi Y, Matsuura H, Okazaki K, Kishimoto N, Takahashi H, Iwasaka H, Iida J, Kishimoto T. Event-related potentials in drug-naïve pediatric patients with obsessive-compulsive disorder. Psychiatry Res 2015; 230:394-9. [PMID: 26410771 DOI: 10.1016/j.psychres.2015.09.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 08/06/2015] [Accepted: 09/15/2015] [Indexed: 11/17/2022]
Abstract
Obsessive-compulsive disorder (OCD) is one of the most common mental health disorders, characterized by obsessive thoughts and/or compulsive behaviors, which may involve specific disorders in cognition and/or information processing. Event-related potentials (ERPs) are commonly used as physiological measures of cognitive function as they are easily measured and noninvasive. In the present study, 20 drug-naïve pediatric patients with OCD were compared with 20 healthy control participants who were age- and sex-matched to perform the ERP. Based on the guidelines for evoked potential measurement, the P300 and mismatch negativity (MMN) were obtained by auditory odd-ball tasks. We found that the amplitudes of the P300 components in the Fz, Cz, Pz, C3, and C4 regions were significantly smaller in the OCD group compared with the control group. There were no between-group differences in P300 latency, MMN amplitude, or MMN latency. Moreover, we found significant correlations between scores on the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) and P300 amplitudes at Cz, Pz, and C3. The present study is the first to report smaller P300s and the associations between P300 abnormalities and CY-BOCS scores.
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Affiliation(s)
- Kazuhiko Yamamuro
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toyosaku Ota
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan.
| | - Yoko Nakanishi
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | | | - Kosuke Okazaki
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Naoko Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | | | - Hidemi Iwasaka
- Department of Education, Nara University of Education, Nara, Japan
| | - Junzo Iida
- Faculty of Nursing, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toshifumi Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
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20
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Chaves C, Marque CR, Maia-de-Oliveira JP, Wichert-Ana L, Ferrari TB, Santos AC, Araújo D, Machado-de-Sousa JP, Bressan RA, Elkis H, Crippa JA, Guimarães FS, Zuardi AW, Baker GB, Dursun SM, Hallak JEC. Effects of minocycline add-on treatment on brain morphometry and cerebral perfusion in recent-onset schizophrenia. Schizophr Res 2015; 161:439-45. [PMID: 25497439 DOI: 10.1016/j.schres.2014.11.031] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 11/14/2014] [Accepted: 11/20/2014] [Indexed: 10/24/2022]
Abstract
Increasing evidence suggests that the tetracycline antibiotic minocycline has neuroprotective effects and is a potential treatment for schizophrenia. However, the mechanisms of action of minocycline in the CNS remain elusive. The aim of this study was to investigate the effects of minocycline on brain morphology and cerebral perfusion in patients with recent-onset schizophrenia after 12months of a randomized double-blind, placebo-controlled clinical trial of minocycline add-on treatment. This study included 24 outpatients with recent-onset schizophrenia randomized for 12months of adjuvant treatment with minocycline (200mg/d) or placebo. MRI (1.5T) and [(99m)Tc]-ECD SPECT brain scans were performed at the end of the 12-month of trial. Between-condition comparisons of SPECT and MRI brain images were performed using statistical parametric mapping and analyzed by voxel-based morphometry (VBM). Minocycline adjuvant treatment significantly reduced positive and negative symptoms when compared with placebo. The VBM analysis of MRI scans showed that the patients in the placebo group had significant lower gray matter volumes in the midposterior cingulate cortex and in the precentral gyrus in comparison with the patients in the minocycline group. In addition, a decreased ECD uptake in the minocycline condition was observed in fronto-temporal areas. These results suggest that minocycline may protect against gray matter loss and modulate fronto-temporal areas involved in the pathophysiology of schizophrenia. Furthermore, minocycline add-on treatment may be a potential treatment in the early stages of schizophrenia and may ameliorate clinical deterioration and brain alterations observed in this period.
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Affiliation(s)
- Cristiano Chaves
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil.
| | - Cristiane R Marque
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - João P Maia-de-Oliveira
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil; Department of Clinical Medicine, Federal University of Rio Grande do Norte, Brazil
| | - Lauro Wichert-Ana
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; Department of Internal Medicine, Division of Nuclear Medicine, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Thiago B Ferrari
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Antonio C Santos
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; Department of Internal Medicine, Division of Radiology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - David Araújo
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Canada
| | - João P Machado-de-Sousa
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Rodrigo A Bressan
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo, Brazil
| | - Helio Elkis
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil
| | - José A Crippa
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Francisco S Guimarães
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; Department of Pharmacology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
| | - Glen B Baker
- National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil; Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Canada
| | - Serdar M Dursun
- National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil; Neurochemical Research Unit, Department of Psychiatry, University of Alberta, Canada
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Division of Psychiatry, Ribeirão Preto Medical School, University of São Paulo, Brazil; National Science and Technology Institute for Translational Medicine (INCT-TM), Brazil
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21
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Koganemaru S, Sawamoto N, Aso T, Sagara A, Ikkaku T, Shimada K, Kanematsu M, Takahashi R, Domen K, Fukuyama H, Mima T. Task-specific brain reorganization in motor recovery induced by a hybrid-rehabilitation combining training with brain stimulation after stroke. Neurosci Res 2014; 92:29-38. [PMID: 25450315 DOI: 10.1016/j.neures.2014.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 10/03/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
Recently, we have developed a new hybrid-rehabilitation combining 5Hz repetitive transcranial magnetic stimulation and extensor motor training of the paretic upper-limb for stroke patients with flexor hypertonia. We previously showed that the extensor-specific plastic change in M1 was associated with beneficial effects of our protocol (Koganemaru et al., 2010). Here, we investigated whether extensor-specific multiregional brain reorganization occurred after the hybrid-rehabilitation using functional magnetic resonance imaging. Eleven chronic stroke patients were scanned while performing upper-limb extensor movements. Untrained flexor movements were used as a control condition. The scanning and clinical assessments were done before, immediately and 2 weeks after the hybrid-rehabilitation. As a result, during the trained extensor movements, the imaging analysis showed a significant reduction of brain activity in the ipsilesional sensorimotor cortex, the contralesional cingulate motor cortex and the contralesional premotor cortex in association with functional improvements of the paretic hands. The activation change was not found for the control condition. Our results suggested that use-dependent plasticity induced by repetitive motor training with brain stimulation might be related to task-specific multi-regional brain reorganization. It provides a key to understand why repetitive training of the target action is one of the most powerful rehabilitation strategies to help patients.
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Affiliation(s)
- Satoko Koganemaru
- Brain Integrative Science, Kyoto University School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan; Human Brain Research Center, Kyoto University School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Nobukatsu Sawamoto
- Department of Neurology, Kyoto University School of Medicine, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Toshihiko Aso
- Human Brain Research Center, Kyoto University School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akiko Sagara
- Department of Physical and Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Tomoko Ikkaku
- Department of Physical and Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Kenji Shimada
- Department of Physical and Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Madoka Kanematsu
- Department of Physical and Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University School of Medicine, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kazuhisa Domen
- Department of Physical and Rehabilitation Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Hidenao Fukuyama
- Human Brain Research Center, Kyoto University School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
| | - Tatsuya Mima
- Human Brain Research Center, Kyoto University School of Medicine, Sakyo-ku, Kyoto 606-8507, Japan
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22
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Nakao T, Okada K, Kanba S. Neurobiological model of obsessive-compulsive disorder: evidence from recent neuropsychological and neuroimaging findings. Psychiatry Clin Neurosci 2014; 68:587-605. [PMID: 24762196 DOI: 10.1111/pcn.12195] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2014] [Indexed: 12/16/2022]
Abstract
Obsessive-compulsive disorder (OCD) was previously considered refractory to most types of therapeutic intervention. There is now, however, ample evidence that selective serotonin reuptake inhibitors and behavior therapy are highly effective methods for treatment of OCD. Furthermore, recent neurobiological studies of OCD have found a close correlation between clinical symptoms, cognitive function, and brain function. A large number of previous neuroimaging studies using positron emission tomography, single-photon emission computed tomography or functional magnetic resonance imaging (fMRI) have identified abnormally high activities throughout the frontal cortex and subcortical structures in patients with OCD. Most studies reported excessive activation of these areas during symptom provocation. Furthermore, these hyperactivities were decreased after successful treatment using either selective serotonin reuptake inhibitors or behavioral therapy. Based on these findings, an orbitofronto-striatal model has been postulated as an abnormal neural circuit that mediates symptomatic expression of OCD. On the other hand, previous neuropsychological studies of OCD have reported cognitive dysfunction in executive function, attention, nonverbal memory, and visuospatial skills. Moreover, recent fMRI studies have revealed a correlation between neuropsychological dysfunction and clinical symptoms in OCD by using neuropsychological tasks during fMRI. The evidence from fMRI studies suggests that broader regions, including dorsolateral prefrontal and posterior regions, might be involved in the pathophysiology of OCD. Further, we should consider that OCD is heterogeneous and might have several different neural systems related to clinical factors, such as symptom dimensions. This review outlines recent neuropsychological and neuroimaging studies of OCD. We will also describe several neurobiological models that have been developed recently. Advanced findings in these fields will update the conventional biological model of OCD.
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Affiliation(s)
- Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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23
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Wen SL, Cheng MF, Cheng MH, Yue JH, Li JF, Xie LJ. Neurocognitive dysfunction and regional cerebral blood flow in medically naïve patients with obsessive-compulsive disorder. Dev Neuropsychol 2014; 39:37-50. [PMID: 24405183 DOI: 10.1080/87565641.2013.839682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Previous research characterizes obsessive compulsive disorder (OCD) as a complex neurobehavioral disorder that may have multiple etiologies ( den Braber et al., 2008 ). This study analyzed neurocognitive function and change in regional cerebral blood flow (rCBF) to characterize OCD. Neurocognitive function and rCBF were examined in medically naïve patients with OCD and contrasted with controls. Results of this study indicated that the neurocognitive functions impaired in OCD are memory, attention, and executive function, which are primarily associated with the frontal and occipital lobes. Dysfunction in the basal ganglia and occipital lobes were associated with OCD and may be an etiological factor in the disorder.
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Affiliation(s)
- Sheng-lin Wen
- a Department of Psychology, Third Affiliated Hospital , Sun Yat-sen University , Guangzhou , China
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Abstract
PURPOSE OF REVIEW Evidence-based pharmacological interventions for obsessive compulsive disorder (OCD) are targeted mainly at the serotonergic and dopaminergic pathways, and are not always effective. It is timely to review the growing evidence from animal models and clinical research (e.g., brain imaging, genetics) on the role of the glutamatergic system in OCD. RECENT FINDINGS Emerging evidence from both animal models and clinical research (including brain imaging, neurogenetics) supports the glutamatergic system as a potential target for pharmacotherapy in OCD. Although there have been relatively few randomized controlled trials of glutamatergic agents in pediatric or adult OCD to date, there is some work on riluzole, memantine, ketamine, topiramate, lamotrigine, N-acetylcysteine, and D-cycloserine. SUMMARY Given the need for more efficacious treatments in OCD, and given emergent findings on the role of the glutamatergic system in this disorder, there is a need for additional pharmacotherapy trials on glutamatergic agents in OCD. Possible research designs for such trials might include stand-alone approaches, pharmacotherapy augmentation, or psychotherapy augmentation.
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Pallanti S, Grassi G, Cantisani A. Emerging drugs to treat obsessive-compulsive disorder. Expert Opin Emerg Drugs 2013; 19:67-77. [PMID: 24377420 DOI: 10.1517/14728214.2014.875157] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Obsessive-compulsive disorder (OCD) is a chronic and disabling neuropsychiatric disorder with a lifetime prevalence of approximately 1 - 2% and a rate of treatment resistance of 40%. Other disorders have been related to OCD and have been grouped together in a separate DSM-5 chapter, hypothesizing the existence of an 'OC spectrum', showing a paradigm shift in the conceptualization of the disorder. AREAS COVERED A review of the most important and recent neurobiological findings that sustain the hypothesis of a more sophisticated model of the disorder is provided, together with a brief overview of the most relevant pharmacological animal models of OCD and its first-line treatments. Current research goals, new compounds tested and the rationale behind the development of these new pharmacologic agents are then explained and reviewed. EXPERT OPINION In the past years, no effective novel compounds have emerged for the treatment of OCD, even if many efforts has been made in the study of its neurobiological underpinnings. Relevant changes in the conceptualization of the disorder, suggested by interesting new neurobiological evidences, may result helpful in the development of new treatments.
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Affiliation(s)
- Stefano Pallanti
- University of Florence, Department of Psychiatry , via delle Gore 2H, 50141 Florence , Italy
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Aronson JP, Katnani HA, Eskandar EN. Neuromodulation for obsessive-compulsive disorder. Neurosurg Clin N Am 2013; 25:85-101. [PMID: 24262902 DOI: 10.1016/j.nec.2013.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article describes the basis for neuromodulation procedures for obsessive-compulsive disorder (OCD) and summarizes the literature on the efficacy of these interventions. Discussion includes neural circuitry underlying OCD pathology, the history and types of ablative procedures, the targets and modalities used for neuromodulation, and future therapeutic directions.
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Affiliation(s)
- Joshua P Aronson
- Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
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Morphometric brain characterization of refractory obsessive-compulsive disorder: diffeomorphic anatomic registration using exponentiated Lie algebra. Prog Neuropsychopharmacol Biol Psychiatry 2013; 46:126-31. [PMID: 23876787 DOI: 10.1016/j.pnpbp.2013.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/10/2013] [Accepted: 07/11/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Few studies have used neuroimaging to characterize treatment-refractory obsessive-compulsive disorder (OCD). This study sought to explore gray matter structure in patients with treatment-refractory OCD and compare it with that of healthy controls. METHODS A total of 18 subjects with treatment-refractory OCD and 26 healthy volunteers were analyzed by MRI using a 3.0-T scanner and voxel-based morphometry (VBM). Diffeomorphic anatomical registration using exponentiated Lie algebra (DARTEL) was used to identify structural changes in gray matter associated with treatment-refractory OCD. A partial correlation model was used to analyze whether morphometric changes were associated with Yale-Brown Obsessive-Compulsive Scale scores and illness duration. RESULTS Gray matter volume did not differ significantly between the two groups. Treatment-refractory OCD patients showed significantly lower gray matter density than healthy subjects in the left posterior cingulate cortex (PCC) and mediodorsal thalamus (MD) and significantly higher gray matter density in the left dorsal striatum (putamen). These changes did not correlate with symptom severity or illness duration. CONCLUSIONS Our findings provide new evidence of deficits in gray matter density in treatment-refractory OCD patients. These patients may show characteristic density abnormalities in the left PCC, MD and dorsal striatum (putamen), which should be verified in longitudinal studies.
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Karadağ F, Kalkan Oğuzhanoğlu N, Yüksel D, Kıraç S, Cura C, Ozdel O, Ateşci F. The comparison of pre- and post-treatment (99m)Tc HMPAO brain SPECT images in patients with obsessive-compulsive disorder. Psychiatry Res 2013; 213:169-77. [PMID: 23149026 DOI: 10.1016/j.pscychresns.2012.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 06/20/2012] [Accepted: 07/11/2012] [Indexed: 01/09/2023]
Abstract
The objective of the present study was to compare brain activation in patients with obsessive-compulsive disorder (OCD) who received pharmacotherapy (selective serotonin reuptake inhibitor (SSRI) or a SSRI-risperidone combination) with that in healthy controls using (99m)Tc-hexamethyl propyleneamine oxime (HMPAO) brain single photon emission tomography (SPECT). Twelve OCD patients achieving clinical response (seven SSRI responders, five patients responded to SSRI plus risperidone) underwent post-treatment SPECT scan. The baseline regional cerebral blood flow (rCBF) was significantly reduced in a large part of the cerebral cortex and the left cingulate gyrus in OCD patients compared with controls. After a 50% reduction of the OCD symptoms, bilaterally increased rCBF in the thalamus showed a significant effect of time in both of the patient groups. In the remitted state, although rCBF in the cingulate gyrus did not differ in SSRI responders compared with controls, patients who responded to the combination of SSRI+ risperidone showed significant hypoperfusion in the left anterior cingulate gyrus. SSRI responders had normalized rCBF in the frontal region relative to the control group. Consequently, based on our results, we attribute the observed thalamic rCBF alteration to SSRI treatment. Our results also suggested that brain perfusion changes associated with clinical remission may differ across patient subgroups.
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Affiliation(s)
- Filiz Karadağ
- Pamukkale University, Medical Faculty, Department of Psychiatry, Denizli 20100, Turkey
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Volpato C, Piccione F, Cavinato M, Duzzi D, Schiff S, Foscolo L, Venneri A. Modulation of affective symptoms and resting state activity by brain stimulation in a treatment-resistant case of obsessive-compulsive disorder. Neurocase 2013; 19:360-70. [PMID: 22554168 DOI: 10.1080/13554794.2012.667131] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The effect of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) on psychopathological symptoms and resting state brain activity was assessed in a patient with obsessive-compulsive disorder (OCD). tDCS and rTMS had no effect on OC symptoms. tDCS, however, improved depression and anxiety. Functional magnetic resonance imaging at baseline showed an interhemispheric asymmetry with hyperactivation of the left and hypoactivation of the right anterior neural circuits. A reduction of interhemispheric imbalance was detected after tDCS but not after rTMS. tDCS seems to be more effective than rTMS in restoring interhemispheric imbalance and improving anxiety and depression in OCD.
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Wen SL, Cheng MH, Cheng MF, Yue JH, Wang H. Pharmacotherapy response and regional cerebral blood flow characteristics in patients with obsessive-compulsive disorder. Behav Brain Funct 2013; 9:31. [PMID: 23898909 PMCID: PMC3733897 DOI: 10.1186/1744-9081-9-31] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 07/20/2013] [Indexed: 12/03/2022] Open
Abstract
Objective To analyze the correlation between the pharmacotherapy response and the characteristics of the pre-treatment regional cerebral blood flow (rCBF) in patients with obsessive-compulsive disorder (OCD). Methods Single-photon emission-computed tomography (SPECT) was used to determine the pre-treatment rCBF in 30 OCD patients and 30 normal controls. Based on their clinical remission response, the subjects were divided into two groups: selective serotonin reuptake inhibitors (SSRIs) and SSRIs plus quetiapine. The subjects with clinical remission response were identified after treatment for a period of 24 weeks, and the rCBF imaging data were processed using statistical parametric mapping (SPM) software with two-sample Z-tests. Results Nineteen OCD patients who achieved clinical remission were included in the study. Increased rCBF in forebrain regions, including the frontal lobe, cingulate gyrus, hypothalamus, and basal ganglia, was found in 11 responders to SSRIs compared to normal control patients. The eight SSRI plus quetiapine responders exhibited a decrease in rCBF within posterior brain regions, including the parietal lobe, cerebellar vermis, and occipital lobe, and an increase in rCBF in the frontal lobe, thalamus, basal ganglia, and cerebellum tonsil compared to normal control patients. Conclusions The characteristics of increased rCBF in forebrain regions and decreased rCBF in posterior brain regions before treatment of OCD patients was a potentially predictor of treatment response to guide treatment options.
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Okada K, Ota T, Iida J, Kishimoto N, Kishimoto T. Lower prefrontal activity in adults with obsessive-compulsive disorder as measured by near-infrared spectroscopy. Prog Neuropsychopharmacol Biol Psychiatry 2013; 43:7-13. [PMID: 23220093 DOI: 10.1016/j.pnpbp.2012.11.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 11/05/2012] [Accepted: 11/28/2012] [Indexed: 11/25/2022]
Abstract
Recent developments in near-infrared spectroscopy (NIRS) have enabled the non-invasive elucidation of the neurobiological underpinnings of psychiatric disorders. Functional neuroimaging studies in human patients have suggested that the frontal cortex and subcortical structures may play a role in the pathophysiology of obsessive-compulsive disorder (OCD). Here we used NIRS to investigate neurobiological function in 12 patients with OCD and 12 age- and sex-matched, healthy control subjects. The relative concentrations of oxyhemoglobin (oxy-Hb) were measured with prefrontal probes every 0.1 s, during performance of a Stroop color-word task, using 24-channel NIRS. Oxy-Hb changes in the prefrontal cortex of the OCD group were significantly smaller than those in the control group, especially in the left lateral prefrontal cortex. These results suggest that patients with OCD have reduced prefrontal hemodynamic responses as measured by NIRS.
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Affiliation(s)
- Koji Okada
- Department of Psychiatry, Nara Medical University, Nara 634-8522, Japan.
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Ota T, Iida J, Sawada M, Suehiro Y, Yamamuro K, Matsuura H, Tanaka S, Kishimoto N, Negoro H, Kishimoto T. Reduced prefrontal hemodynamic response in pediatric obsessive-compulsive disorder as measured by near-infrared spectroscopy. Child Psychiatry Hum Dev 2013; 44:265-77. [PMID: 22833309 DOI: 10.1007/s10578-012-0323-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Recent developments in near-infrared spectroscopy (NIRS) have enabled non-invasive clarification of brain functions in psychiatric disorders. Functional neuroimaging studies of patients with obsessive-compulsive disorder (OCD) have suggested that the frontal cortex and subcortical structures may play a role in the pathophysiology of the disorder. Twelve treatment-naïve children with OCD and 12 age- and sex-matched healthy control subjects participated in the present study after giving consent. The relative concentrations of oxyhemoglobin (oxy-Hb) were measured with prefrontal probes every 0.1 s during the Stroop color-word task, using 24-channel NIRS machines. During the Stroop color-word task, the oxy-Hb changes in the OCD group were significantly smaller than those in the control group in the prefrontal cortex, especially in the frontopolar cortex. The present study suggests that children with OCD have reduced prefrontal hemodynamic response as measured by NIRS.
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Affiliation(s)
- Toyosaku Ota
- Department of Psychiatry, Nara Medical University, 840 Shijyou-cho, Kashihara-shi, 634-8522, Nara, Japan.
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Kreiss DS, Coffman CF, Fiacco NR, Granger JC, Helton BM, Jackson JC, Kim LV, Mistry RS, Mizer TM, Palmer LV, Vacca JA, Winkler SS, Zimmer BA. Ritualistic Chewing Behavior induced by mCPP in the rat is an animal model of Obsessive Compulsive Disorder. Pharmacol Biochem Behav 2013; 104:119-24. [DOI: 10.1016/j.pbb.2013.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 11/26/2012] [Accepted: 01/10/2013] [Indexed: 10/27/2022]
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Hirosawa R, Narumoto J, Sakai Y, Nishida S, Ishida T, Nakamae T, Takei Y, Fukui K. Reduced dorsolateral prefrontal cortical hemodynamic response in adult obsessive-compulsive disorder as measured by near-infrared spectroscopy during the verbal fluency task. Neuropsychiatr Dis Treat 2013; 9:955-62. [PMID: 23874098 PMCID: PMC3713899 DOI: 10.2147/ndt.s45402] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Near-infrared spectroscopy has helped our understanding of the neurobiological mechanisms of psychiatric disorders and has advantages including noninvasiveness, lower cost, and ease of use compared with other imaging techniques, like functional magnetic resonance imaging. The verbal fluency task is the most common and well established task used to assess cognitive activation during near-infrared spectroscopy. Recent functional neuroimaging studies have shown that the orbitofrontal cortex and other brain regions, including the dorsolateral prefrontal cortex, may play important roles in the pathophysiology of obsessive-compulsive disorder (OCD). This study aimed to evaluate hemodynamic responses in the dorsolateral prefrontal cortex in patients with OCD using near-infrared spectroscopy during the verbal fluency task and to compare these with dorsolateral prefrontal cortex responses in healthy controls. METHODS Twenty patients with OCD and 20 controls matched for age, gender, handedness, and estimated intelligence quotient participated in this study. The verbal fluency task was used to elicit near-infrared spectroscopic activation and consisted of a 30-second pre-task, followed by three repetitions of a 20-second verbal fluency task (total 60 seconds), followed by a 70-second post-task period. The near-infrared spectroscopy experiment was conducted on the same day as surveys of obsessive-compulsive symptoms, depression, and anxiety. Z-scores for changes in the concentration of oxygenated hemoglobin were compared between the OCD patients and controls in 14 channels set over the left and right dorsolateral prefrontal cortex and frontopolar areas. RESULTS During the verbal fluency task, significant task-related activation was detected in both the OCD group and the controls. Changes in oxygenated hemoglobin concentration in the right dorsolateral prefrontal cortex were significantly smaller in the OCD group than in the controls, but were not statistically significant after correction for multiple comparisons. CONCLUSION Patients with OCD have reduced prefrontal, especially right dorsolateral prefrontal, cortical hemodynamic responses as measured by near-infrared spectroscopy during the verbal fluency task. These results support the hypothesis that the dorsolateral prefrontal cortex plays a role in the pathophysiology of OCD.
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Affiliation(s)
- Rikuei Hirosawa
- Department of Psychiatry, Graduate School of Medicine, Kyoto Prefectural University of Medicine, Kyoto
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Zurowski B, Kordon A, Weber-Fahr W, Voderholzer U, Kuelz AK, Freyer T, Wahl K, Büchel C, Hohagen F. Relevance of orbitofrontal neurochemistry for the outcome of cognitive-behavioural therapy in patients with obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci 2012; 262:617-24. [PMID: 22427151 DOI: 10.1007/s00406-012-0304-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Accepted: 02/24/2012] [Indexed: 10/28/2022]
Abstract
Since the advent of non-invasive methods such as proton magnetic resonance spectroscopy ((1)H-MRS), obsessive-compulsive disorder (OCD) has been increasingly associated with an altered composition of neurometabolites and neurotransmitters in several brain areas. Particularly, Inositol has not only been implicated in OCD pathophysiology, but also shown effective in pilot studies in therapy-refractory OCD patients. However, the relevance of regional brain neurochemistry for therapy outcome has not yet been investigated. Whereas numerous neuroimaging findings support a dysfunction of the orbitofrontal cortex (OFC) in OCD, MR-spectroscopic investigations of this region are missing. (1)H-MRS and psychometric measurements were obtained from twenty unmedicated patients with OCD, subsequently enrolled in a 3-month structured inpatient cognitive-behavioural therapy programme, and from eleven matched control subjects. Multiple regression of symptom score changes (Y-BOCS) on (myo-)inositol concentrations in three areas (right orbitofrontal cortex (OFC), right striatum and anterior cingulate cortex) was performed. The concentration of (myo-)inositol in the OFC only predicted the outcome of subsequent CBT regarding Y-BOCS score reduction (Spearman's r(s) = .81, P < 0.003, corrected). The (myo-)inositol concentration did not differ between OCD patients and healthy controls and did not change during therapy. We provide preliminary evidence for a neurochemical marker that may prove informative about a patient's future benefit from behaviour therapy. Inositol, a metabolite involved in cellular signal transduction and a spectroscopic marker of glial activity, predicted the response to CBT selectively in the OFC, adding to the evidence for OFC involvement in OCD and highlighting neurobiological underpinnings of psychotherapy.
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Affiliation(s)
- Bartosz Zurowski
- Center for Integrative Psychiatry, University of Luebeck, Germany.
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Aoki Y, Aoki A, Suwa H. Reduction of N-acetylaspartate in the medial prefrontal cortex correlated with symptom severity in obsessive-compulsive disorder: meta-analyses of (1)H-MRS studies. Transl Psychiatry 2012; 2:e153. [PMID: 22892718 PMCID: PMC3432192 DOI: 10.1038/tp.2012.78] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 07/09/2012] [Accepted: 07/14/2012] [Indexed: 11/09/2022] Open
Abstract
Structural and functional neuroimaging findings suggest that disturbance of the cortico-striato-thalamo-cortical (CSTC) circuits may underlie obsessive-compulsive disorder (OCD). However, some studies with (1)H-magnetic resonance spectroscopy ((1)H-MRS) reported altered level of N-acetylaspartate (NAA), they yielded inconsistency in direction and location of abnormality within CSTC circuits. We conducted a comprehensive literature search and a meta-analysis of (1)H-MRS studies in OCD. Seventeen met the inclusion criteria for a meta-analysis. Data were separated by frontal cortex region: medial prefrontal cortex (mPFC), dorsolateral prefrontal cortex, orbitofrontal cortex, basal ganglia and thalamus. The mean and s.d. of the NAA measure were calculated for each region. A random effects model integrating 16 separate datasets with 225 OCD patients and 233 healthy comparison subjects demonstrated that OCD patients exhibit decreased NAA levels in the frontal cortex (P=0.025), but no significant changes in the basal ganglia (P=0.770) or thalamus (P=0.466). Sensitivity analysis in an anatomically specified subgroup consisting of datasets examining the mPFC demonstrated marginally significant reduction of NAA (P=0.061). Meta-regression revealed that NAA reduction in the mPFC was positively correlated with symptom severity measured by Yale-Brown Obsessive Compulsive Scale (P=0.011). The specific reduction of NAA in the mPFC and significant relationship between neurochemical alteration in the mPFC and symptom severity indicate that the mPFC is one of the brain regions that directly related to abnormal behavior in the pathophysiology of OCD. The current meta-analysis indicates that cortices and sub-cortices contribute in different ways to the etiology of OCD.
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Affiliation(s)
- Yuta Aoki
- Department of Psychiatry, Tokyo Metropolitan Health and Medical Treatment Corporation, Ebara Hospital, Ota, Tokyo, Japan.
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Lagemann T, Rentzsch J, Montag C, Gallinat J, Jockers-Scherübl M, Winter C, Reischies FM. Early orbitofrontal hyperactivation in obsessive-compulsive disorder. Psychiatry Res 2012; 202:257-63. [PMID: 22809741 DOI: 10.1016/j.pscychresns.2011.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Revised: 10/05/2011] [Accepted: 10/06/2011] [Indexed: 11/19/2022]
Abstract
Dysfunctional activity in the orbitofrontal cortex (OFC) is one of the core features in the pathophysiology of obsessive-compulsive disorder (OCD). Neuroimaging studies indicate orbitofrontal hyperactivation during the resting state as well as during symptom provocation, whereas orbitofrontal hypoactivation has been reported during tasks designed to dissociate specific cognitive processes. Combined magnetoencephalic and functional magnetic resonance imaging studies show early involvement of the OFC in stimulus processing in healthy subjects. However, it is unclear whether OFC activation is dysfunctional at an early stage in patients with OCD. We investigated early electrical OFC activation evoked by reward and punishment feedback in a visual probabilistic object reversal task (pORT). Patients with OCD (n=23) and healthy controls (n=27), matched for gender, age and educational level, performed the pORT during a 29-channel electroencephalographic recording. Low resolution brain electromagnetic tomography was applied to localize orbitofrontal sources of neuronal activity at 80 to 200 ms post-stimulus. Group comparison showed significantly higher orbitofrontal activation in OCD patients at 100-120 ms after the reward stimulus. No group differences were found with respect to OFC activation in response to punishment stimuli and in task performance. Results substantiate dysfunctional OFC activity at a very early stage in the processing of reward stimuli in patients with OCD. Our results provide support for the assumption that the OFC plays a more active role in the processing of visual stimuli as previously supposed. As orbitofrontal hyperactivation following rewarding feedback occurred as early as 100 ms after receipt of the visual stimulus in patients with OCD, and as we did not find any OFC dysfunction following negative feedback, our findings may point towards a specific early disturbance of reward processing in OCD. This finding might have implications for cognitive behavioural therapy of this disorder.
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Affiliation(s)
- Tobias Lagemann
- Department of Psychiatry and Psychotherapy, Charité, Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
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Bourne SK, Eckhardt CA, Sheth SA, Eskandar EN. Mechanisms of deep brain stimulation for obsessive compulsive disorder: effects upon cells and circuits. Front Integr Neurosci 2012; 6:29. [PMID: 22712007 PMCID: PMC3375018 DOI: 10.3389/fnint.2012.00029] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 05/24/2012] [Indexed: 12/28/2022] Open
Abstract
Deep brain stimulation (DBS) has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive compulsive disorder (OCD), which is characterized by recurrent unwanted thoughts or ideas (obsessions) and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions). Abnormal activity in cortico-striato-thalamo-cortical (CSTC) circuits including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), ventral striatum, and mediodorsal (MD) thalamus has been implicated in OCD. To this end a number of DBS targets including the anterior limb of the internal capsule (ALIC), ventral capsule/ventral striatum (VC/VS), ventral caudate nucleus, subthalamic nucleus (STN), and nucleus accumbens (NAc) have been investigated for the treatment of OCD. Despite its efficacy and widespread use in movement disorders, the mechanism of DBS is not fully understood, especially as it relates to psychiatric disorders. While initially thought to create a functional lesion akin to ablative procedures, it is increasingly clear that DBS may induce clinical benefit through activation of axonal fibers spanning the CSTC circuits, alteration of oscillatory activity within this network, and/or release of critical neurotransmitters. In this article we review how the use of DBS for OCD informs our understanding of both the mechanisms of DBS and the circuitry of OCD. We review the literature on DBS for OCD and discuss potential mechanisms of action at the neuronal level as well as the broader circuit level.
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Affiliation(s)
- Sarah K Bourne
- Department of Neurosurgery, Massachusetts General Hospital, Boston MA, USA
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Hoexter MQ, de Souza Duran FL, D'Alcante CC, Dougherty DD, Shavitt RG, Lopes AC, Diniz JB, Deckersbach T, Batistuzzo MC, Bressan RA, Miguel EC, Busatto GF. Gray matter volumes in obsessive-compulsive disorder before and after fluoxetine or cognitive-behavior therapy: a randomized clinical trial. Neuropsychopharmacology 2012; 37:734-45. [PMID: 22030709 PMCID: PMC3260985 DOI: 10.1038/npp.2011.250] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Serotonin reuptake inhibitors and cognitive-behavior therapy (CBT) are considered first-line treatments for obsessive-compulsive disorder (OCD). However, little is known about their modulatory effects on regional brain morphology in OCD patients. We sought to document structural brain abnormalities in treatment-naive OCD patients and to determine the effects of pharmacological and cognitive-behavioral treatments on regional brain volumes. Treatment-naive patients with OCD (n=38) underwent structural magnetic resonance imaging scan before and after a 12-week randomized clinical trial with either fluoxetine or group CBT. Matched-healthy controls (n=36) were also scanned at baseline. Voxel-based morphometry was used to compare regional gray matter (GM) volumes of regions of interest (ROIs) placed in the orbitofrontal, anterior cingulate and temporolimbic cortices, striatum, and thalamus. Treatment-naive OCD patients presented smaller GM volume in the left putamen, bilateral medial orbitofrontal, and left anterior cingulate cortices than did controls (p<0.05, corrected for multiple comparisons). After treatment with either fluoxetine or CBT (n=26), GM volume abnormalities in the left putamen were no longer detectable relative to controls. ROI-based within-group comparisons revealed that GM volume in the left putamen significantly increased (p<0.012) in fluoxetine-treated patients (n=13), whereas no significant GM volume changes were observed in CBT-treated patients (n=13). This study supports the involvement of orbitofronto/cingulo-striatal loops in the pathophysiology of OCD and suggests that fluoxetine and CBT may have distinct neurobiological mechanisms of action.
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Affiliation(s)
- Marcelo Queiroz Hoexter
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil,Interdisciplinary Laboratory for Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Centro de Medicina Nuclear do HC-FMUSP, Laboratório de Neuroimagem em Psiquiatria—LIM21, Rua Ovidio Pires Campos, s/n, 3 andar, CEP: 05403-911, São Paulo, SP, Brazil. Tel: +55 11 3069 7896, Fax: +55 11 3082 1015, E-mail:
| | | | - Carina Chaubet D'Alcante
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Darin Dean Dougherty
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Roseli Gedanke Shavitt
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Antonio Carlos Lopes
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Juliana Belo Diniz
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Rodrigo Affonseca Bressan
- Interdisciplinary Laboratory for Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Geraldo Filho Busatto
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
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Serotonin 2A receptor, serotonin transporter and dopamine transporter alterations in dogs with compulsive behaviour as a promising model for human obsessive-compulsive disorder. Psychiatry Res 2012; 201:78-87. [PMID: 22285716 DOI: 10.1016/j.pscychresns.2011.06.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Revised: 06/05/2011] [Accepted: 06/11/2011] [Indexed: 02/08/2023]
Abstract
Neuro-imaging studies have shown altered, yet often inconsistent, serotonergic and dopaminergic neurotransmission in patients with obsessive-compulsive disorder (OCD). We investigated both serotonergic and dopaminergic neurotransmission in 9 drug-naïve dogs with compulsive behaviour, as a potential model for human OCD. Single photon emission computed tomography was used with (123)I-R91150 and (123)I-FP-CIT, in combination with (99m)Tc-ECD brain perfusion co-registration, to measure the serotonin (5-HT) 2A receptor, dopamine transporter (DAT) and serotonin transporter (SERT) availability. Fifteen normally behaving dogs were used as reference group. Significantly lower 5-HT2A receptor radioligand availability in frontal and temporal cortices (bilateral) was observed. Further, in 78% of the compulsive dogs abnormal DAT ratios in left and right striatum were demonstrated. Interestingly, both increased and decreased DAT ratios were observed. Finally, significantly lower subcortical perfusion and (hypo)thalamic SERT availability were observed in the compulsive dogs. This study provides evidence for imbalanced serotonergic and dopaminergic pathways in the pathophysiology of compulsions in dogs. The similarities with the altered neurotransmission in human OCD provide construct validity for this non-induced, natural canine model, suggesting its usefulness for future investigations of the pathophysiology of human OCD as well as the effectiveness of psychopharmacological interventions.
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41
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Del Casale A, Kotzalidis GD, Rapinesi C, Serata D, Ambrosi E, Simonetti A, Pompili M, Ferracuti S, Tatarelli R, Girardi P. Functional neuroimaging in obsessive-compulsive disorder. Neuropsychobiology 2011; 64:61-85. [PMID: 21701225 DOI: 10.1159/000325223] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 01/23/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM Obsessive-compulsive disorder (OCD) is a severe, highly prevalent and chronically disabling psychiatric disorder that usually emerges during childhood or adolescence. This paper aims to review the literature on functional neuroimaging in OCD, analysing the reported dysfunctional connectivity in the corticostriatothalamocortical circuitry. METHOD This study included papers published in peer-reviewed journals dealing with functional imaging in OCD. RESULTS Striatal dysfunction, mainly of the caudate nucleus, leads to inefficient thalamic gating, resulting in hyperactivity within the orbitofrontal cortex (intrusive thoughts) and the anterior cingulate cortex (non-specific anxiety). Compulsions consist of ritualistic behaviours performed to recruit the inefficient striatum and neutralise unwanted thoughts and anxiety. Functional neuroimaging findings are discussed against the background of specific cognitive impairments, mainly regarding visuospatial processing, executive functioning and motor speed. Cognitive deficits are partial and specific, matching imaging data. CONCLUSIONS Several studies have targeted brain regions hypothesised to be involved in the pathogenesis of OCD, showing the existence of dysfunctional connectivity in the corticostriatothalamocortical circuitry. Improvements in spatial resolution of neuroimaging techniques may contribute to a better understanding of the neurocircuitry of OCD and other anxiety disorders.
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Affiliation(s)
- A Del Casale
- NESMOS (Neurosciences, Mental Health, and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University and Sant'Andrea Hospital, Rome, Italy.
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Attention deficit/hyperactivity disorder: is there a correlation between dopamine transporter density and cerebral blood flow? Clin Nucl Med 2011; 36:656-60. [PMID: 21716015 DOI: 10.1097/rlu.0b013e318219b49d] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Attention deficit/hyperactivity disorder (ADHD) is one of the most frequent behavioral problems in school-age children. Although the etiology remains unclear, the involvement of the dopaminergic system has been suggested by genetic studies that report an overexpression of the dopamine transporter (DAT) gene. In spite of these abnormalities being directly related to the decrease of dopamine (DA) in the striatum (STR), abnormalities in brain perfusion have also been observed in cortical-subcortical structures. Functional neuroimaging studies have suggested that the DA concentration may cause changes in the cerebral blood flow (CBF). The objective of our study was to evaluate the relationship between DAT density in STR and cortical-subcortical impairment in CBF. Based on the hypothesis that there is a correlation between DA availability and brain perfusion, we postulated that individuals with ADHD, with a higher DAT density in the basal ganglia, will have lower perfusion in the fronto-striatal-cerebellar networks. We used Tc-99m TRODAT-1 SPECT to measure DAT density and Tc-99m ECD SPECT to assess brain perfusion. Ten adolescents diagnosed with ADHD by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were investigated. Analysis with Statistical Parametric Mapping 5 corrected for multiple comparisons, using small volume correction, showed a significant negative correlation between the DAT density in the STR and CBF in the cingulate gyrus, frontal lobe, temporal lobe, and cerebellum (pFDR <0.01). Our findings suggest that higher DAT density in the STR was associated with a decrease in the regional CBF in the cortical and subcortical attention network.
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43
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Lamm C, Granic I, Zelazo PD, Lewis MD. Magnitude and chronometry of neural mechanisms of emotion regulation in subtypes of aggressive children. Brain Cogn 2011; 77:159-69. [PMID: 21940093 DOI: 10.1016/j.bandc.2011.06.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 06/28/2011] [Indexed: 11/30/2022]
Abstract
Emotion regulation is a key social skill and children who fail to master it are at risk for clinical disorders. Specific styles of emotion regulation have been associated with particular patterns of prefrontal activation. We investigated whether anxious aggressive children would reveal a different pattern of cortical activation than non-anxious aggressive children and normally-developing children. We examined the magnitude and timing of source activation underlying the N2-an ERP associated with inhibitory control-during a go/nogo task with a negative emotion induction component (loss of earned points). We estimated cortical activation for two regions of interest-a ventral prefrontal and a dorsomedial prefrontal region-for three 100-ms windows over the range of the N2 (200-500 ms). Anxious aggressive children showed high ventral prefrontal activation in the early window; non-anxious aggressive children showed high ventral prefrontal activation in the late window, but only for the duration of the emotion induction; and normally-developing children showed low ventral prefrontal activation throughout. There were no group differences in dorsomedial prefrontal activation. These results suggest that anxious aggressive children recruit ventral prefrontal activation quickly and indiscriminately, possibly giving rise to their rigid, threat-oriented approach to conflict. The late ventral prefrontal activation seen for non-anxious aggressive children may underlie a more delayed, situation-specific, but ineffective response to frustration.
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Affiliation(s)
- Connie Lamm
- Child Development Laboratory, Department of Human Development, University of Maryland, MD 20742-1131, USA.
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44
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Benetti S, McCrory E, Arulanantham S, De Sanctis T, McGuire P, Mechelli A. Attachment style, affective loss and gray matter volume: a voxel-based morphometry study. Hum Brain Mapp 2011; 31:1482-9. [PMID: 20127871 DOI: 10.1002/hbm.20954] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Early patterns of infant attachment have been shown to be an important influence on adult social behavior. Animal studies suggest that patterns of early attachment influence brain development, contributing to permanent alterations in neural structure; however, there are no previous studies investigating whether differences in attachment style are associated with differences in brain structure in humans. In this study, we used Magnetic Resonance Imaging (MRI) and voxel-based morphometry (VBM) to examine for the first time the association between attachment style, affective loss (for example, death of a loved one) and gray matter volume in a healthy sample of adults (n = 32). Attachment style was assessed on two dimensions (anxious and avoidant) using the ECR-Revised questionnaire. High attachment-related anxiety was associated with decreased gray matter in the anterior temporal pole and increased gray matter in the left lateral orbital gyrus. A greater number of affective losses was associated with increased gray matter volume in the cerebellum; in this region, however, the impact of affective losses was significantly moderated by the level of attachment-related avoidance. These findings indicate that differences in attachment style are associated with differences in the neural structure of regions implicated in emotion regulation. It is hypothesized that early attachment experience may contribute to structural brain differences associated with attachment style in adulthood; furthermore, these findings point to a neuronal mechanism through which attachment style may mediate individual differences in responses to affective loss.
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Affiliation(s)
- Stefania Benetti
- Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, London SE5 8AF, United Kingdom
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45
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Cerebellar nuclei are activated by high-frequency stimulation of the subthalamic nucleus. Neurosci Lett 2011; 496:111-5. [DOI: 10.1016/j.neulet.2011.03.094] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 03/18/2011] [Accepted: 03/30/2011] [Indexed: 11/17/2022]
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Moers-Hornikx VMP, Vles JSH, Lim LW, Ayyildiz M, Kaplan S, Gavilanes AWD, Hoogland G, Steinbusch HWM, Temel Y. Periaqueductal grey stimulation induced panic-like behaviour is accompanied by deactivation of the deep cerebellar nuclei. THE CEREBELLUM 2011; 10:61-9. [PMID: 21076996 PMCID: PMC3038216 DOI: 10.1007/s12311-010-0228-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Until recently, the cerebellum was primarily considered to be a structure involved in motor behaviour. New anatomical and clinical evidence has shown that the cerebellum is also involved in higher cognitive functions and non-motor behavioural changes. Functional imaging in patients with anxiety disorders and in cholecystokinin tetrapeptide-induced panic-attacks shows activation changes in the cerebellum. Deep brain stimulation of the dorsolateral periaqueductal grey (dlPAG) and the ventromedial hypothalamus (VMH) in rats has been shown to induce escape behaviour, which mimics a panic attack in humans. We used this animal model to study the neuronal activation in the deep cerebellar nuclei (DCbN) using c-Fos immunohistochemistry. c-Fos expression in the DCbN decreased significantly after inducing escape behaviour by stimulation of the dlPAG and the VMH, indicating that the DCbN were deactivated. This study demonstrates that the DCbN are directly or indirectly involved in panic attacks. We suggest that the cerebellum plays a role in the selection of relevant information, and that deactivation of the cerebellar nuclei is required to allow inappropriate behaviour to occur, such as panic attacks.
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Rao NP, Arasappa R, Reddy NN, Venkatasubramanian G, Reddy YCJ. Emotional interference in obsessive-compulsive disorder: a neuropsychological study using optimized emotional Stroop test. Psychiatry Res 2010; 180:99-104. [PMID: 20546928 DOI: 10.1016/j.psychres.2009.10.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 10/04/2009] [Accepted: 10/27/2009] [Indexed: 11/16/2022]
Abstract
Contents related to threat and associated cognitive processes are proposed to be the central characteristic of obsessive-compulsive disorder (OCD) according to 'threat-relatedness hypothesis'. However, evidence for attention bias toward emotionally salient stimuli using the emotional Stroop test is equivocal. This discrepancy could be due to methodological issues, mainly differences in the lexical characters of words. Fifty Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) OCD patients (23 washers and 27 checkers) and 50 age-, handedness- and sex-matched healthy controls were examined with an optimized version of the emotional Stroop test (i.e., with lexically matched words) and color-Stroop test. Twenty-four patients were clinically symptomatic and 26 were remitted. OCD patients had significantly higher attention bias only for negative OCD stimuli as calculated by negatively valenced OCD interference score but not for neutral or non-OCD emotional stimuli. Symptomatic patients had significantly higher bias, but not the remitted patients. There were no significant correlations between other illness-related variables (age at onset, illness duration, and medication dose) and Stroop test performance. Study findings suggest the presence of selective emotional bias for OCD relevant stimuli in these patients and this bias is potentially related to symptomatic status. These observations are in tune with the threat-relatedness hypothesis.
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Affiliation(s)
- Naren Prahlada Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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Apostolova I, Block S, Buchert R, Osen B, Conradi M, Tabrizian S, Gensichen S, Schröder-Hartwig K, Fricke S, Rufer M, Weiss A, Hand I, Clausen M, Obrocki J. Effects of behavioral therapy or pharmacotherapy on brain glucose metabolism in subjects with obsessive-compulsive disorder as assessed by brain FDG PET. Psychiatry Res 2010; 184:105-16. [PMID: 20947317 DOI: 10.1016/j.pscychresns.2010.08.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 08/22/2010] [Accepted: 08/24/2010] [Indexed: 10/18/2022]
Abstract
This prospective study investigated the effect of pharmacotherapy (PT) and cognitive behavioral therapy (CBT) on cerebral glucose metabolism in adults with obsessive-compulsive disorder (OCD). Dynamic positron emission tomography (PET) of the brain with F-18-fluorodeoxyglucose (FDG) was performed before and after treatment in 16 subjects diagnosed for OCD for at least 2 years (PT: n=7). Pre-to-post-treatment change of scaled local metabolic rate of glucose (SLMRGlc) was assessed separately in therapy responders and non-responders. Correlation was tested between SLMRGlc change and change of OCD, depression, or anxiety symptoms. SLMRGlc increased in the right caudate after successful therapy. The increase tended to correlate with the improvement of OCD symptom severity. The finding of increased local caudate activity after successful therapy is in contrast to most previous studies. Possible explanations include effects of therapy on concomitant depression symptoms and/or the large proportion of early-onset OCD in the present sample.
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Affiliation(s)
- Ivayla Apostolova
- Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Haynes WIA, Mallet L. High-frequency stimulation of deep brain structures in obsessive-compulsive disorder: the search for a valid circuit. Eur J Neurosci 2010; 32:1118-27. [DOI: 10.1111/j.1460-9568.2010.07418.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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50
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Sanematsu H, Nakao T, Yoshiura T, Nabeyama M, Togao O, Tomita M, Masuda Y, Nakatani E, Nakagawa A, Kanba S. Predictors of treatment response to fluvoxamine in obsessive-compulsive disorder: an fMRI study. J Psychiatr Res 2010; 44:193-200. [PMID: 19758599 DOI: 10.1016/j.jpsychires.2009.08.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Revised: 06/22/2009] [Accepted: 08/17/2009] [Indexed: 10/20/2022]
Abstract
Recent neuroimaging studies suggest that the pathophysiology of obsessive-compulsive disorder (OCD) may involve more widely distributed large-scale brain systems, including the parietal, occipital, and cerebellar areas, rather than the conventional orbitofronto-striatal model. We hypothesized that not only orbitofrontal cortex and caudate nucleus activities but also posterior brain regions might be associated with subsequent treatment response to serotonin reuptake inhibitors in OCD. The participants were 17 patients with OCD. Each patient was required to undergo fluvoxamine pharmacotherapy for 12 weeks. Before treatment, fMRI images of the subjects were obtained in the context of a symptom-provocation paradigm. The percentage changes in total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores, from pre- to post-treatment, served as the index of treatment response. Statistical Parametric Mapping was used to identify brain loci where pre-treatment brain activation significantly correlated with the subsequent treatment response. Fifteen of 17 patients completed the 12-week treatment. During the symptom provocation task, patients showed brain activation in the left superior temporal gyrus (STG), left precuneus, left frontal cortices, right cerebellum, and right frontal cortices. We found that pre-treatment activation in the right cerebellum (Z-score=5.10, x,y,z=22,-84,-18) and the left STG (Z-score=4.95, x,y,z=-62,-22,0) was positively correlated with the improvement in the Y-BOCS score. Our results suggest that pre-treatment activation in the right cerebellum and in the left STG predict subsequent reduction in OCD symptom severity. There is every possibility that fMRI can be used as a tool to predict treatment response.
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Affiliation(s)
- Hirokuni Sanematsu
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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