Symptom-specific functional and structural connectivity of the fronto-striatal circuitry in obsessive-compulsive disorder

强迫症中额叶纹状体回路的症状特异性功能和结构连接

• 批准号: 221535930
• 负责人: Professorin Dr. Kathrin Koch
• 金额: --
• 依托单位: Klinik für Psychiatrie und Psychotherapie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2012
• 资助国家: 德国
• 起止时间: 2011-12-31 至 2015-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/221535930?language=en
• 关键词: Symptom; specific; functional; structural; connectivity

Obsessive-compulsive disorder (OCD) is a severe psychiatric illness that is characterized by high symptom heterogeneity. Whereas some patients suffer mainly from contamination fears or washing compulsions, others are affected predominantly by obsessive behaviors such as checking compulsions. Recent studies indicated that established therapies are not equally effective in the different psychopathological subgroups. Moreover, there is increasing evidence showing that the different symptom dimensions may be mediated by partially distinct neural systems and may be associated with symptom-specific alterations in functional and structural connectivity within relevant, mainly fronto-striatal, networks.Thus, a more specific characterization of psychopathological subgroups or symptom dimensions in OCD is sensible and important, both from a diagnostic and etiologic perspective, as well as for therapeutic reasons. Multimodal studies investigating specific functional systems (functional connectivity) and subserving white matter fiber tracts (structural connectivity) with regard to symptom-specific alterations have not been performed in OCD so far. Against this background, the proposed project aims at investigating symptom-specific alterations in functional and structural connectivity in patients with OCD. The study will be focusing on patients with predominantly checking compulsions as well as patients with predominantly contamination fears and washing compulsions. These symptom dimensions have been shown to be relatively independent from each other and to be characterized by high construct validity thus allowing for a reliable discrimination of groups. To this aim, the project will employ neurocognitive paradigms examining decision making under uncertainty, reward processing and cognitive control, i.e. processes involving mainly fronto-striatal networks which are known to be altered in the context of the disorder. Structural connectivity will be determined by means of diffusion tensor imaging (DTI). Specific fiber tracts will be examined using tract-based spatial statistics and probabilistic fiber tracking. Postulated alterations in functional connectivity will be studied with ¿Dynamic Causal Modeling¿ (DCM) and will be related to respective white matter alterations using correlational and voxel-based methods. This multimodal procedure should provide specific information about the pathophysiological substrates underlying alterations in functional and structural connectivity in patients with OCD that allow for a neurobiological differentiation between different symptom dimensions or patient subgroups. Perspectively, the identification of symptom-specific neurofunctional alterations may provide the basis for personalized pharmacological and psychotherapeutic treatment strategies.

强迫症（OCD）是一种严重的精神病，其特征是高症状异质性。尽管有些患者主要受到污染或洗涤强迫的痛苦，但其他患者则主要受到诸如检查强迫等强迫行为的影响。最近的研究表明，在不同的心理病理亚组中，已建立的疗法并不同等有效。此外，越来越多的证据表明，不同的症状维度可能是通过部分不同的神经系统介导的，并且可能与症状和结构连通性在相关（主要是额叶，网络）内的功能和结构连接性的特定变化有关。这是OCD中的精神病理学亚组或症状更为具体的特征，而OCD的特征是敏感的，并且既有诊断又是一个重要的诊断。迄今为止，尚未在OCD中对研究特定功能系统（功能连通性）和对特定于症状的变化的白质纤维区（结构连通性）进行的多模式研究。在此背景下，拟议的项目旨在研究强迫症患者功能和结构连通性的特定症状变化。该研究将重点关注具有检查强迫的患者以及主要污染恐惧和洗涤强迫的患者。这些症状维度已被证明相对彼此相对独立，并且具有高构造有效性的特征，因此可以对组的可靠歧视。为此，该项目将采用神经认知范式检查在不确定性，奖励处理和认知控制下的决策，即涉及的过程主要是额叶纹状体网络，这些网络已知在疾病的背景下发生了改变。结构连通性将通过扩散张量成像（DTI）来确定。将使用基于道的空间统计和概率纤维跟踪来检查特定的纤维道。将使用“动态因果建模”（DCM）研究功能连接性的假设改变，并将与基于相关和基于体素的方法的相对白质变化有关。该多模式程序应提供有关OCD患者功能和结构连通性改变的病理生理基材的特定信息，这些信息允许不同症状维度或患者亚组之间的神经生物学分化。从角度看，症状特异性神经功能改变的识别可能为个性化的药物和心理治疗策略提供了基础。

项目成果

Hypogyrification in obsessive-compulsive disorder

• DOI: 10.1017/s0033291716003202
• 发表时间: 2017-04-01
• 期刊: PSYCHOLOGICAL MEDICINE
• 影响因子: 6.9
• 作者: Rus, O. G.;Reess, T. J.;Koch, K.
• 通讯作者: Koch, K.

Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta- and Mega-Analysis.

• DOI: 10.1176/appi.ajp.2016.16020201
• 发表时间: 2017-01-01
• 期刊: The American journal of psychiatry
• 作者: Boedhoe PS;Schmaal L;Abe Y;Ameis SH;Arnold PD;Batistuzzo MC;Benedetti F;Beucke JC;Bollettini I;Bose A;Brem S;Calvo A;Cheng Y;Cho KI;Dallaspezia S;Denys D;Fitzgerald KD;Fouche JP;Giménez M;Gruner P;Hanna GL;Hibar DP;Hoexter MQ;Hu H;Huyser C;Ikari K;Jahanshad N;Kathmann N;Kaufmann C;Koch K;Kwon JS;Lazaro L;Liu Y;Lochner C;Marsh R;Martínez-Zalacaín I;Mataix-Cols D;Menchón JM;Minuzzi L;Nakamae T;Nakao T;Narayanaswamy JC;Piras F;Piras F;Pittenger C;Reddy YC;Sato JR;Simpson HB;Soreni N;Soriano-Mas C;Spalletta G;Stevens MC;Szeszko PR;Tolin DF;Venkatasubramanian G;Walitza S;Wang Z;van Wingen GA;Xu J;Xu X;Yun JY;Zhao Q;ENIGMA OCD Working Group;Thompson PM;Stein DJ;van den Heuvel OA
• 通讯作者: van den Heuvel OA