Abnormally High Degree Connectivity of the Orbitofrontal Cortex in Obsessive-Compulsive Disorder
Abnormally High Degree Connectivity of the Orbitofrontal Cortex in Obsessive-Compulsive Disorder
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DOI：
10.1001/jamapsychiatry.2013.173
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发表时间：
2013-06-01
期刊：
影响因子：
25.8
通讯作者：
Kathmann, Norbert
中科院分区：
文献类型：
--
作者：
Beucke, Jan C.;Sepulcre, Jorge;Kathmann, Norbert
重要性：强迫症（OCD）的神经生物学模型预测了涉及眶额皮质和基底神经节的脑回路的过度活跃，但目前尚不清楚这些区域是否也以改变的脑网络properties.Objectives.确定OCD患者异常程度连接的区域，并调查连接测量是否受OCD中抗抑郁药物的影响。设计：使用静息态功能磁共振成像和数据驱动的无模型方法进行病例对照横断面研究，以测试未用药的强迫症患者与健康对照组相比全脑、远端和局部连接程度的变化。23名强迫症患者（12名女性，11名男性）未接受药物治疗，23名强迫症患者（14名女性，9名男性）接受抗抑郁药物治疗，以及2名年龄、性别、利手、教育水平和智商匹配的同等大小的对照样本。测试每个体素的远距离和局部功能连接程度的统计参数图（体素水平的枢纽分析）和强迫症症状严重程度。结果：未经药物治疗的强迫症患者在眶额皮质和丘脑底核中表现出更大的远端连接，在眶额皮质中表现出更大的局部连接和壳核此外，眶额皮质和壳核的远距离连接与全球强迫症症状的严重程度呈正相关。药物治疗的强迫症患者表现出减少局部连接的腹侧纹状体相比，unmedicated patients.Conclusions和相关性：一致的神经生物学模型的强迫症，眶额皮质和基底神经节是hyperconnected在未用药的患者。眶额皮质和基底神经节的远端连接改变的发现代表了与皮质纹状体回路外的远端皮质区的更大连接的初步证据。此外，这些数据表明，抗抑郁药物可能会减少连接皮质基底神经节丘脑皮质电路在强迫症。
Importance: Neurobiological models of obsessive-compulsive disorder (OCD) predict hyperactivity in brain circuits involving the orbitofrontal cortex and the basal ganglia, but it is unclear whether these areas are also characterized by altered brain network properties.Objectives: To determine regions of abnormal degree connectivity in patients with OCD and to investigate whether connectivity measures are affected by antidepressant medication in OCD.Design: Case-control cross-sectional study using resting-state functional magnetic resonance imaging and a data-driven, model-free method to test for alterations in the degree of whole-brain, distant, and local connectivity in unmedicated patients with OCD compared with healthy controls.Setting: Outpatient clinic for OCD.Participants: Twenty-three patients with OCD (12 women, 11 men) receiving no medication, 23 patients-with OCD(14 women, 9 men) treated with antidepressant medication, and 2 equally sized control samples matched for age, sex, handedness, educational level, and IQ.Main Outcome Measures: Statistical parametric maps testing the degree of distant and local functional connectivity of each voxel (hub analysis at voxel level) and OCD symptom severity.Results: Unmedicated patients with OCD showed greater distant connectivity in the orbitofrontal cortex and subthalamic nucleus and greater local connectivity in the orbitofrontal cortex and the putamen. Furthermore, distant connectivity of the orbitofrontal cortex and the putamen positively correlated with global OCD symptom severity. Medicated patients with OCD showed reduced local connectivity of the ventral striatum compared with the unmedicated patients.Conclusions and Relevance: Consistent with neurobiological models of OCD, the orbitofrontal cortex and the basal ganglia are hyperconnected in unmedicated patients. The finding of distant connectivity alterations of the orbitofrontal cortex and the basal ganglia represents initial evidence of greater connections with distant cortical areas outside of corticostriatal circuitry. Furthermore, these data suggest that antidepressant medication may reduce connectivity within corticobasal ganglia-thalamo-cortical circuits in OCD.