Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Psychology, Daegu University, Gyeongsan, Republic of Korea.
Psychol Med. 2021 Jun;51(8):1320-1328. doi: 10.1017/S0033291720000057. Epub 2020 Jan 30.
Obsession and delusion are theoretically distinct from each other in terms of reality testing. Despite such phenomenological distinction, no extant studies have examined the identification of common and distinct neural correlates of obsession and delusion by employing biologically grounded methods. Here, we investigated dimensional effects of obsession and delusion spanning across the traditional diagnostic boundaries reflected upon the resting-state functional connectivity (RSFC) using connectome-wide association studies (CWAS).
Our study sample comprised of 96 patients with obsessive-compulsive disorder, 75 patients with schizophrenia, and 65 healthy controls. A connectome-wide analysis was conducted to examine the relationship between obsession and delusion severity and RFSC using multivariate distance-based matrix regression.
Obsession was associated with the supplementary motor area, precentral gyrus, and superior parietal lobule, while delusion was associated with the precuneus. Follow-up seed-based RSFC and modularity analyses revealed that obsession was related to aberrant inter-network connectivity strength. Additional inter-network analyses demonstrated the association between obsession severity and inter-network connectivity between the frontoparietal control network and the dorsal attention network.
Our CWAS study based on the Research Domain Criteria (RDoC) provides novel evidence for the circuit-level functional dysconnectivity associated with obsession and delusion severity across diagnostic boundaries. Further refinement and accumulation of biomarkers from studies embedded within the RDoC framework would provide useful information in treating individuals who have some obsession or delusion symptoms but cannot be identified by the category of clinical symptoms alone.
从现实检验的角度来看，强迫观念和妄想在理论上是不同的。尽管存在这种现象学上的区别，但目前还没有研究通过采用基于生物学的方法来检查强迫观念和妄想的共同和独特的神经相关性。在这里，我们使用连接组全关联研究（CWAS），考察了横跨传统诊断边界的强迫观念和妄想的维度效应，反映在静息态功能连接（RSFC）上。
我们的研究样本包括 96 名强迫症患者、75 名精神分裂症患者和 65 名健康对照者。进行了连接组全分析，以使用多元距离矩阵回归来检查强迫观念和妄想严重程度与 RSFC 之间的关系。
强迫观念与补充运动区、中央前回和上顶叶有关，而妄想与楔前叶有关。后续的基于种子的 RSFC 和模块性分析显示，强迫观念与异常的网络间连接强度有关。额外的网络间分析表明，强迫观念严重程度与额顶控制网络和背侧注意网络之间的网络间连接有关。
我们基于研究领域标准（RDoC）的 CWAS 研究为跨越诊断边界的强迫观念和妄想严重程度相关的回路水平功能连接障碍提供了新的证据。从 RDoC 框架内嵌入的研究中进一步细化和积累生物标志物，将为治疗那些有一些强迫观念或妄想症状但不能仅通过临床症状类别来识别的个体提供有用的信息。
