Altered Cingulostriatal Coupling in Obsessive-Compulsive Disorder
Altered Cingulostriatal Coupling in Obsessive-Compulsive Disorder
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DOI：
10.1089/brain.2012.0078
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发表时间：
2012-08-01
影响因子：
3.4
通讯作者：
Kathmann, Norbert
中科院分区：
文献类型：
--
作者：
Beucke, Jan Carl;Kaufmann, Christian;Kathmann, Norbert
强迫症(OCD)的神经生物学模型假定涉及扣带回和眶前叶皮质的皮质纹状体网络异常，但在该患者组的实验成像研究中，这些系统内的连接很少涉及。使用已知的涉及扣带回皮质和腹侧纹状体的货币强化范例，本研究试图测试预期可能的惩罚的强迫症患者的皮质纹状体偶联改变。前中扣带回(AMCC)是一个整合了负面情绪、疼痛和认知控制的区域，由于其在强迫症中的特殊相关性，被选为种子区域，代表了扣带回切开术的神经外科靶点，并显示出对强迫症患者错误的反应增加。心理生理交互作用分析的结果显示，当强迫症患者预见到潜在的惩罚时，aMCC和腹侧纹状体之间发生了显著的变化，反向耦合。这一异常连接了当代两个主要的神经外科强迫症靶点，并提供了强迫症患者皮质纹状体连接改变的直接实验证据。值得注意的是，除了扣带纹状体通路的改变外，还发现了与传统皮质纹状体回路之外的皮质区域的异常aMCC偶联。总之，这些发现支持了应用连接性方法研究强迫症患者皮质纹状体网络的重要性，并有利于应用有效的连接性方法来研究执行涉及症状激发和强化学习的任务的强迫症患者的皮质纹状体异常。
Neurobiological models of obsessive-compulsive disorder (OCD) assume abnormalities in corticostriatal networks involving cingulate and orbitofrontal cortices, but the connectivity within these systems is rarely addressed in experimental imaging studies in this patient group. Using an established monetary reinforcement paradigm known to involve the cingulate cortex and the ventral striatum, the present study sought to test for altered corticostriatal coupling in OCD patients anticipating potential punishment. The anterior midcingulate cortex (aMCC), a region integrating negative emotion, pain, and cognitive control, was chosen as a seed region due to its particular relevance in OCD, representing the neurosurgical target for cingulotomy, and showing increased responses to errors in OCD patients. Results from psychophysiological interaction analyses revealed that significantly altered, inverse coupling occurs between the aMCC and the ventral striatum when OCD patients anticipate potential punishment. This abnormality links the two major contemporary neurosurgical OCD target sites, and provides direct experimental evidence of altered corticostriatal connectivity in OCD. Noteworthy, an abnormal aMCC coupling with cortical areas outside of traditional corticostriatal circuitry was identified besides the alteration in the cingulostriatal pathway. In conclusion, these findings support the importance of applying connectivity methods to study corticostriatal networks in OCD, and favor the application of effective connectivity methods to study corticostriatal abnormalities in OCD patients performing tasks that involve symptom provocation and reinforcement learning.