Brain functional connectivity during induced sadness in patients with obsessive-compulsive disorder
Brain functional connectivity during induced sadness in patients with obsessive-compulsive disorder
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DOI：
10.1503/jpn.110074
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发表时间：
2012-07-01
影响因子：
4.3
通讯作者：
Yuecel, Murat
中科院分区：
文献类型：
--
作者：
Fontenelle, Leonardo F.;Harrison, Ben J.;Yuecel, Murat
背景：强迫症（OCD）与一系列与其定义症状、共病和认知缺陷相关的情绪异常有关。这项初步研究的目的是检查强迫症患者与健康对照者相比，与强迫症和情绪调节相关的额边缘回路中与实验诱发的悲伤情绪相关的大脑功能变化。方法：参与者在功能磁共振成像期间接受了经过验证的悲伤情绪诱导程序。分析的重点是绘制两组膝下前扣带皮层 (ACC) 功能连接的变化，以响应成功诱导的悲伤。结果：我们在研究中招募了 11 名强迫症患者和 10 名年龄、性别和智商匹配的对照组。与对照组不同，强迫症患者在情绪诱导过程中并没有表现出膝下 ACC 和其他额叶区域之间功能连接的预期增加。相反，患者表现出膝下 ACC 和腹侧尾状核/伏核区域与下丘脑之间的连接性增强。局限性：我们的研究包括一小部分接受部分药物治疗的患者队列，这使得我们无法调查性别或药物影响、评估各组之间的行为差异以及进行全脑分析。结论：强迫症患者在经历悲伤情绪时，腹侧纹状体和腹侧额叶皮层与膝下 ACC 的连接受到明显差异性调节。这些结果表明，在强迫症患者中，诱发的悲伤似乎激发了假设的“强迫症回路”的主要皮层下成分，这可能有助于了解为什么强迫症症状在紊乱的情绪状态下往往会发展和恶化。
Background: Obsessive-compulsive disorder (OCD) is associated with a range of emotional abnormalities linked to its defining symptoms, comorbid illnesses and cognitive deficits. The aim of this preliminary study was to examine functional changes in the brain that are associated with experimentally induced sad mood in patients with OCD compared with healthy controls in a frontolimbic circuit relevant to both OCD and mood regulation. Methods: Participants underwent a validated sad mood induction procedure during functional magnetic resonance imaging. Analyses focused on mapping changes in the functional connectivity of the subgenual anterior cingulate cortex (ACC) within and between the 2 groups in response to successfully induced sadness. Results: We enrolled 11 patients with OCD and 10 age-, sex-and IQ-matched controls in our study. Unlike controls, patients with OCD did not demonstrate predicted increases in functional connectivity between the subgenual ACC and other frontal regions during mood induction. Instead, patients demonstrated heightened connectivity between the subgenual ACC and ventral caudate/nucleus accumbens region and the hypothalamus. Limitations: Our study included a small, partially medicated patient cohort that precluded our ability to investigate sex or drug effects, evaluate behavioural differences between the groups and perform a whole-brain analysis. Conclusion: The ventral striatum and ventral frontal cortex were distinctly and differentially modulated in their connectivity with the subgenual ACC during the experience of sad mood in patients with OCD. These results suggest that, in patients with OCD, induced sadness appears to have provoked a primary subcortical component of the hypothesized "OCD circuit," which may offer insights into why OCD symptoms tend to develop and worsen during disturbed emotional states.