Neurocircuit dynamics of arbitration between decision-making strategies across obsessive-compulsive and related disorders.
Neurocircuit dynamics of arbitration between decision-making strategies across obsessive-compulsive and related disorders.
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DOI：
10.1016/j.nicl.2022.103073
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发表时间：
2022
影响因子：
4.2
通讯作者：
Feusner, Jamie D.
中科院分区：
文献类型：
--
作者：
Seok, Darsol;Tadayonnejad, Reza;Wong, Wan-wa;O'Neill, Joseph;Cockburn, Jeff;Bari, Ausaf A.;O'Doherty, John P.;Feusner, Jamie D.
关键词：
强迫症及相关障碍（Obsessive-compulsive and related disorders，OCRD）包括强迫症和BDD。决策仲裁的神经差异可能是强迫症症状的基础。静息状态有效连接被用来评估仲裁电路。通过左侧腹外侧前额叶皮层对强迫症患者的左侧壳核抑制作用更大。较强的左壳核抑制与较轻的症状相关。强迫症和强迫行为是强迫症（OCD）和强迫症相关疾病（如躯体畸形恐惧症（BDD））的核心组成部分。强迫性行为可能是由于习惯性和目标导向性决策策略的不平衡。这些症状与习惯性和目标导向决策的神经回路之间的关系，以及这些策略之间的仲裁，仍然是未知的。本研究在两个具有强迫和强迫的队列中检查了这些系统节点之间的静息状态有效连接，每个队列都与其相应的健康对照组进行了比较：OCD（nOCD = 43; nhealthy = 24）和BDD（nBDD = 21; nhealthy = 16）。在强迫症患者中，左腹外侧前额叶皮层（仲裁系统的一个节点）比习惯系统的一个节点（左后外侧壳核）表现出更多的抑制性因果影响。在这方面的抑制因果关系的影响表现出一种趋势，与对照组相比，在个人与BDD相似的模式。在强迫症和BDD患者中，负连接性越强的人，强迫和强迫的严重程度越低。这些关系在习惯性或目标导向回路中并不明显，也与抑郁或焦虑的神经病学无关。这些结果表明，仲裁系统的异常可能代表了这两种相关疾病的共同神经表型，这是特定于强迫症症状。除了疾病分类学的影响，这些结果确定了新的，电路特定的治疗的潜在目标。
Obsessive-compulsive and related disorders (OCRD) include OCD and BDD. Neural differences in decision-making arbitration may underlie OCRD symptoms. Resting-state effective connectivity was used to assess arbitration circuitry. Greater left putamen inhibition via left ventrolateral prefrontal cortex in OCRD. Stronger left putamen inhibition was correlated with less severe symptoms. Obsessions and compulsions are central components of obsessive–compulsive disorder (OCD) and obsessive–compulsive related disorders such as body dysmorphic disorder (BDD). Compulsive behaviours may result from an imbalance of habitual and goal-directed decision-making strategies. The relationship between these symptoms and the neural circuitry underlying habitual and goal-directed decision-making, and the arbitration between these strategies, remains unknown. This study examined resting state effective connectivity between nodes of these systems in two cohorts with obsessions and compulsions, each compared with their own corresponding healthy controls: OCD (nOCD = 43; nhealthy = 24) and BDD (nBDD = 21; nhealthy = 16). In individuals with OCD, the left ventrolateral prefrontal cortex, a node of the arbitration system, exhibited more inhibitory causal influence over the left posterolateral putamen, a node of the habitual system, compared with controls. Inhibitory causal influence in this connection showed a trend for a similar pattern in individuals with BDD compared with controls. Those with stronger negative connectivity had lower obsession and compulsion severity in both those with OCD and those with BDD. These relationships were not evident within the habitual or goal-directed circuits, nor were they associated with depressive or anxious symptomatology. These results suggest that abnormalities in the arbitration system may represent a shared neural phenotype across these two related disorders that is specific to obsessive–compulsive symptoms. In addition to nosological implications, these results identify potential targets for novel, circuit-specific treatments.
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