Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2020 Apr;5(4):438-447. doi: 10.1016/j.bpsc.2019.12.002. Epub 2019 Dec 13.
Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive, compulsive behaviors. Neuroimaging studies have implicated altered connectivity among the functional networks of the cerebral cortex in the pathophysiology of OCD. However, there has been no comprehensive investigation of the cross-talk between the cerebellum and functional networks in the cerebral cortex.
This functional neuroimaging study was completed by 44 adult participants with OCD and 43 healthy control participants. We performed large-scale data-driven brain network analysis to identify functional connectivity patterns using resting-state functional magnetic resonance imaging data.
Participants with OCD showed lower functional connectivity within the somatomotor network and greater functional connectivity among the somatomotor network, cerebellum, and subcortical network (e.g., thalamus and pallidum; all p < .005). Network-based statistics analyses demonstrated one component comprising connectivity within the somatomotor network that showed lower connectivity and a second component comprising connectivity among the somatomotor network, and motor regions in particular, and the cerebellum that showed greater connectivity in participants with OCD relative to healthy control participants. In participants with OCD, abnormal connectivity across both network-based statistics-derived components positively correlated with OCD symptom severity (p = .006).
To our knowledge, this study is the first comprehensive investigation of large-scale network alteration across the cerebral cortex, subcortical regions, and cerebellum in OCD. Our findings highlight a critical role of the cerebellum in the pathophysiology of OCD.
强迫症（OCD）的特征是存在侵入性思维和重复、强迫性行为。神经影像学研究表明，大脑皮层功能网络之间的连通性改变与 OCD 的病理生理学有关。然而，目前还没有对小脑与大脑皮层功能网络之间的串扰进行全面研究。
本功能神经影像学研究纳入了 44 名成年 OCD 患者和 43 名健康对照者。我们使用静息态功能磁共振成像数据进行了大规模数据驱动的大脑网络分析，以识别功能连接模式。
OCD 患者的躯体运动网络内功能连接降低，躯体运动网络、小脑和皮质下网络（如丘脑和苍白球）之间的功能连接增强（均 p <.005）。基于网络的统计学分析显示，一个组成部分包括躯体运动网络内的连接，其连接降低，另一个组成部分包括躯体运动网络、特别是运动区域与小脑之间的连接，OCD 患者的这些连接较健康对照组增强。在 OCD 患者中，两个基于网络的统计学分析得出的连接异常与 OCD 症状严重程度呈正相关（p =.006）。
据我们所知，本研究是首次全面研究 OCD 患者大脑皮层、皮质下区域和小脑的大规模网络改变。我们的研究结果强调了小脑在 OCD 病理生理学中的关键作用。
