Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, PR China.
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, PR China; Shanghai Key Laboratory of Psychotic Disorders, PR China.
J Affect Disord. 2021 Feb 15;281:899-907. doi: 10.1016/j.jad.2020.11.037. Epub 2020 Nov 13.
Convergent evidence has demonstrated that trait impulsivity, a key feature in obsessive-compulsive disorder (OCD), involves dysregulated frontal-striatal circuits. The present study aims to explore relationships between frontal-striatal circuits, trait impulsivity, and obsessive-compulsive symptoms.
Thirty-six unmedicated patients with OCD and 50 healthy controls (HCs) matched for age, sex, and years of education underwent a magnetic resonance imaging (MRI) procedure. Voxel-wise statistical parametric analysis was used to investigate the differences in resting-state functional connectivity between brain regions functionally connected to six pairs of a-priori defined striatal seed regions, between patients with OCD and HCs. Associations between frontal-striatal connectivity and both trait impulsivity and symptom severity of OCD were analyzed.
The results showed altered striatal functional connectivity in OCD group compared to HCs, including increased connectivity of dorsal caudate (DC)-orbitofrontal cortex (OFC), ventral striatum (VS)-OFC, VS-medial prefrontal cortex, and putamen-sensorimotor area, and decreased functional connectivity of DC-anterior cingulate cortex (ACC), putamen-ACC, and putamen-dorsolateral prefrontal cortex (DLPFC). Furthermore, the putamen-DLPFC connectivity was negatively correlated with attentional impulsivity in the OCD group, but showed a positive correlation in HCs.
The present findings suggested that dorsal cognitive circuits could reflect the level of inhibitory control, which is balanced with the impulsive drive in healthy controls, but breakdown in OCD. Our findings supported that DLPFC-putamen connectivity underlying trait impulsivity, which were involved in the pathophysiology of OCD. The findings have provided new insights into the neurobiological mechanisms of OCD.
已有大量证据表明,特质冲动性是强迫症(OCD)的一个关键特征,涉及前额纹状体回路的失调。本研究旨在探索前额纹状体回路、特质冲动性与强迫症状之间的关系。
36 名未接受药物治疗的强迫症患者和 50 名年龄、性别和受教育年限相匹配的健康对照者(HCs)接受了磁共振成像(MRI)检查。使用基于体素的统计参数分析,研究了强迫症患者和 HCs 之间与预先定义的 6 对纹状体种子区域功能连接的脑区之间的静息态功能连接的差异。分析了前额纹状体连接与特质冲动性和 OCD 症状严重程度之间的关系。
结果显示,与 HCs 相比,OCD 组的纹状体功能连接发生了改变,包括背侧尾状核(DC)-眶额皮质(OFC)、腹侧纹状体(VS)-OFC、VS-内侧前额叶皮质和壳核-感觉运动区的连接增加,而 DC-前扣带皮质(ACC)、壳核-ACC 和壳核-背外侧前额叶皮质(DLPFC)的功能连接减少。此外,壳核-DLPFC 的连接与 OCD 组的注意冲动性呈负相关,而在 HCs 中则呈正相关。
本研究结果表明,背侧认知回路可能反映了抑制控制的水平,在健康对照者中,这种抑制控制与冲动驱力平衡,但在强迫症中则出现失调。我们的发现支持了特质冲动性下的 DLPFC-壳核连接,这与 OCD 的病理生理学有关。这些发现为 OCD 的神经生物学机制提供了新的见解。