Department of Adolescent Psychiatry, National Center for Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, South Korea.
Department of Biomedical Engineering, Keimyung University, Daegu, South Korea.
Prog Neuropsychopharmacol Biol Psychiatry. 2014 Aug 4;53:149-55. doi: 10.1016/j.pnpbp.2014.04.007. Epub 2014 Apr 24.
Neurobiological models of obsessive-compulsive disorder (OCD) emphasize disturbances of the corticostriatal circuit, but it remains unclear as to how these complex network dysfunctions correspond to heterogeneous OCD phenotypes. We aimed to investigate corticostriatal functional connectivity alterations distinct to OCD characterized predominantly by contamination/washing symptoms. Functional connectivity strengths of the striatal seed regions with remaining brain regions during the resting condition and the contamination symptom provocation condition were compared among 13 OCD patients with predominant contamination/washing symptoms (CON), 13 OCD patients without these symptoms (NCON), and 18 healthy controls. The CON group showed distinctively altered functional connectivity between the ventral striatum and the insula during both the resting and symptom-provoking conditions. Also, the connectivity strength between the ventral striatum and the insula significantly correlated with contamination/washing symptom severity. As common connectivity alterations of the whole OCD subjects, corticostriatal circuits involving the orbitofrontal and temporal cortices were again confirmed. To our knowledge, this is the first study that examined specific abnormalities in functional connectivity of contamination/washing symptom dimension OCD. The findings suggest limbic network dysfunctions to play a pivotal role in contamination/washing symptoms, possibly associated with emotionally salient error awareness. Our study sample allowed us to evaluate the corticostriatal network dysfunction underlying the contamination/washing symptom dimension, which leaves other major symptom dimensions to be explored in the future.
强迫症（OCD）的神经生物学模型强调皮质纹状体回路的紊乱，但这些复杂网络功能障碍如何与异质的 OCD 表型相对应仍不清楚。我们旨在研究以污染/洗涤症状为主的 OCD 所特有的皮质纹状体功能连接改变。比较了 13 例以污染/洗涤症状为主的 OCD 患者（CON）、13 例无这些症状的 OCD 患者（NCON）和 18 例健康对照组在静息状态和污染症状诱发状态下纹状体种子区域与其余脑区的功能连接强度。CON 组在静息和症状诱发条件下腹侧纹状体与岛叶之间的功能连接明显改变。此外，腹侧纹状体与岛叶之间的连接强度与污染/洗涤症状的严重程度显著相关。作为整个 OCD 患者的常见连接改变，涉及眶额皮质和颞叶皮质的皮质纹状体回路再次得到证实。据我们所知，这是第一项研究特定于污染/洗涤症状维度 OCD 的功能连接异常的研究。研究结果表明边缘网络功能障碍在污染/洗涤症状中起关键作用，可能与情绪相关的错误意识有关。我们的研究样本允许我们评估污染/洗涤症状维度的皮质纹状体网络功能障碍，而其他主要症状维度将在未来进行探索。
