Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Medical Psychological Institute of Central South University, Changsha, Hunan, China.
Hum Brain Mapp. 2023 Nov;44(16):5460-5470. doi: 10.1002/hbm.26457. Epub 2023 Sep 8.
Although it was acknowledged that patients with obsessive-compulsive disorder (OCD) would exhibit cognitive inflexibility, the underlying neural mechanism has not been fully clarified. Therefore, this study aimed to investigate the neural substrates involved in cognitive inflexibility among individuals with OCD. A total of 42 patients with OCD and 48 healthy controls (HCs) completed clinical assessment and functional magnetic resonance imaging (fMRI) data collection during cued task switching. Behavioral performances and fMRI activation were compared between the OCD group and the HC group. Psychophysiological interactions (PPIs) analyses were applied to explore functional connectivity related to task switching. Pearson correlation was used to investigate the relationships among behavioral performance, fMRI activity, and obsessive-compulsive symptoms in OCD. The OCD group had a greater switch cost than HCs (χ = 5.89, p < .05). A significant difference in reaction time was found during switch (χ = 17.72, p < .001) and repeat (χ = 16.60, p = .018) between the two groups, while there was no significant difference in group accuracy. Comparison of group differences showed that the OCD group had increased activation in the right superior parietal cortex (rSPL) during task switching, and exhibited increased connectivity of frontoparietal network/default mode network (FPN-DMN; i.e., middle frontal gyrus [MFG]/inferior parietal cortex-precuneus, MFG-middle/posterior cingulate gyrus) and within the FPN (inferior parietal cortex-postcentral gyrus). In the OCD group, the compulsion score was positively correlated with accuracy during switch (r = .405, p = .008, FDRq <.05), and negatively correlated with activation of rSPL (r = -.328, p = .034, FDRq >.05). Patients with OCD had impaired cognitive flexibility and cautious response strategy. The neural mechanism of cognitive inflexibility in OCD may involve increased activation in the rSPL, as well as hyperconnectivity within the FPN and between the FPN and DMN.
虽然已经承认强迫症 (OCD) 患者会表现出认知灵活性不足，但潜在的神经机制尚未完全阐明。因此，本研究旨在探讨 OCD 患者认知灵活性的神经基础。共有 42 名 OCD 患者和 48 名健康对照者（HCs）完成了临床评估和功能磁共振成像（fMRI）数据采集，在此过程中他们需要完成提示任务切换。比较 OCD 组和 HCs 组的行为表现和 fMRI 激活情况。应用心理生理交互（PPIs）分析来探索与任务切换相关的功能连接。Pearson 相关性用于研究 OCD 中行为表现、fMRI 活动和强迫症状之间的关系。与 HCs 相比，OCD 组的转换代价更大（χ = 5.89，p < .05）。两组之间的反应时间在转换（χ = 17.72，p < .001）和重复（χ = 16.60，p = .018）时存在显著差异，而在组间准确率上无显著差异。组间差异比较显示，OCD 组在任务切换期间右侧顶上回（rSPL）的激活增加，并且额顶网络/默认模式网络（FPN-DMN；即，额中回/顶下小叶-楔前叶，额中回/后扣带回）和 FPN 内的连接增强（顶下小叶-中央后回）。在 OCD 组中，强迫得分与转换时的准确率呈正相关（r = .405，p = .008，FDRq<.05），与 rSPL 的激活呈负相关（r = -.328，p = .034，FDRq>.05）。OCD 患者的认知灵活性受损，反应策略谨慎。OCD 患者认知灵活性的神经机制可能涉及 rSPL 的激活增加，以及 FPN 内和 FPN 与 DMN 之间的过度连接。
