Reduced functional connectivity within the limbic cortico-striato-thalamo-cortical loop in unmedicated adults with obsessive-compulsive disorder.

Reduced functional connectivity within the limbic cortico-striato-thalamo-cortical loop in unmedicated adults with obsessive-compulsive disorder.
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DOI:
10.1002/hbm.22371
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发表时间:
2014-06
影响因子:
4.8
通讯作者:
Simpson, H. Blair
Simpson, H. Blair
中科院分区:
医学2区
文献类型:
--
作者:
Posner, Jonathan;Marsh, Rachel;Maia, Tiago V.;Peterson, Bradley S.;Gruber, Allison;Simpson, H. Blair

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皮质-纹状体-丘脑-皮质(CSTC)环从皮质投射到纹状体,然后从纹状体通过苍白球投射到丘脑,最后从丘脑回到皮质。这些环与强迫症(OCD)有关,尤其集中在边缘的CSTC环,它包括眶前叶和前扣带皮质,以及腹侧纹状体。静息状态功能连通性磁共振成像(rs-fcmri)研究检测了静息状态下大脑各区域神经活动的时间相关性,检查了强迫症患者的cstc环路连通性,并建议服用药物的成人强迫症患者在这些环路内高度连通性。我们使用RS-fcMRI检查了未服药的强迫症患者(n=23)和健康对照组(n=20)CSTC环内的功能连通性。与先前在强迫症患者的药物治疗中发现边缘cstc环高连接性的rs-fcMRI研究相反,我们发现与hcs相比,未用药的强迫症患者边缘cstc环内的连接性降低。探索性分析显示,强迫症组边缘CSTC环内连通性降低与强迫症症状严重程度相关。我们在未经药物治疗的强迫症患者中发现边缘环连接不足,这突显了抗抑郁药物对连接测量的潜在混淆效应,以及未来药物和/或行为治疗对边缘CSTC环连接影响的检查价值。
Cortico-striato-thalamo-cortical (CSTC) loops project from the cortex to the striatum, then from the striatum to the thalamus via the globus pallidus, and finally from the thalamus back to the cortex again. These loops have been implicated in Obsessive-Compulsive Disorder (OCD) with particular focus on the limbic CSTC loop, which encompasses the orbitofrontal and anterior cingulate cortices, as well as the ventral striatum. Resting state functional-connectivity MRI (rs-fcMRI) studies, which examine temporal correlations in neural activity across brain regions at rest, have examined CSTC loop connectivity in patients with OCD and suggest hyperconnectivity within these loops in medicated adults with OCD. We used rs-fcMRI to examine functional connectivity within CSTC loops in unmedicated adults with OCD (n = 23) versus healthy controls (HCs) (n = 20). Contrary to prior rs-fcMRI studies in OCD patients on medications that report hyperconnectivity in the limbic CSTC loop, we found that compared with HCs, unmedicated OCD participants had reduced connectivity within the limbic CSTC loop. Exploratory analyses revealed that reduced connectivity within the limbic CSTC loop correlated with OCD symptom severity in the OCD group. Our finding of limbic loop hypoconnectivity in unmedicted OCD patients highlights the potential confounding effects of antidepressants on connectivity measures and the value of future examinations of the effects of pharmacological and/or behavioral treatments on limbic CSTC loop connectivity.
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