Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
Psychol Med. 2023 Mar;53(4):1468-1478. doi: 10.1017/S0033291721003044. Epub 2021 Aug 16.
Prior investigation of adult patients with obsessive compulsive disorder (OCD) has found greater functional connectivity within orbitofrontal-striatal-thalamic (OST) circuitry, as well as altered connectivity within and between large-scale brain networks such as the cingulo-opercular network (CON) and default mode network (DMN), relative to controls. However, as adult OCD patients often have high rates of co-morbid anxiety and long durations of illness, little is known about the functional connectivity of these networks in relation to OCD specifically, or in young patients near illness onset.
In this study, unmedicated female patients with OCD (ages 8-21 years, = 23) were compared to age-matched female patients with anxiety disorders ( = 26), and healthy female youth ( = 44). Resting-state functional connectivity was used to determine the strength of functional connectivity within and between OST, CON, and DMN.
Functional connectivity within the CON was significantly greater in the OCD group as compared to the anxiety and healthy control groups. Additionally, the OCD group displayed greater functional connectivity between OST and CON compared to the other two groups, which did not differ significantly from each other.
Our findings indicate that previously noted network connectivity differences in pediatric patients with OCD were likely not attributable to co-morbid anxiety disorders. Moreover, these results suggest that specific patterns of hyperconnectivity within CON and between CON and OST circuitry may characterize OCD relative to non-OCD anxiety disorders in youth. This study improves understanding of network dysfunction underlying pediatric OCD as compared to pediatric anxiety.
先前对成年强迫症（OCD）患者的研究发现，与对照组相比，眶额皮层-纹状体-丘脑（OST）回路中的功能连接更强，以及扣带-脑岛网络（CON）和默认模式网络（DMN）等大型脑网络内和网络间的连接发生改变。然而，由于成年 OCD 患者往往有较高的共病焦虑率和较长的病程，因此对于这些网络的功能连接与 OCD 之间的关系，或者与疾病发病前期的年轻患者之间的关系知之甚少。
在这项研究中，我们将未接受药物治疗的 OCD 女性患者（年龄 8-21 岁，n=23）与年龄匹配的焦虑障碍女性患者（n=26）和健康女性青少年（n=44）进行比较。使用静息态功能连接来确定 OST、CON 和 DMN 内和网络间的功能连接强度。
与焦虑症和健康对照组相比，OCD 组 CON 内的功能连接明显更强。此外，与其他两组相比，OCD 组 OST 和 CON 之间的功能连接更强，但两组之间没有显著差异。
我们的研究结果表明，在儿科 OCD 患者中观察到的先前的网络连接差异可能不是由共病焦虑障碍引起的。此外，这些结果表明，在青年时期，与非 OCD 焦虑障碍相比，CON 内和 CON 与 OST 回路之间特定的过度连接模式可能是 OCD 的特征。与儿科焦虑症相比，这项研究增进了对儿科 OCD 下的网络功能障碍的理解。
