College of Health and Medicine, Australian National University, Building 4, The Canberra Hospital, Hospital Rd, Garran ACT 2605, Australia.
Monarch Research Institute, Monarch Mental Health Group, Level 4, 131 York Street Sydney NSW 2000, Australia.
Cereb Cortex. 2024 Aug 1;34(8). doi: 10.1093/cercor/bhae327.
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition that is difficult to treat due to our limited understanding of its pathophysiology. Functional connectivity in brain networks, as evaluated through neuroimaging studies, plays a pivotal role in understanding OCD. While both electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) have been extensively employed in OCD research, few have fully synthesized their findings. To bridge this gap, we reviewed 166 studies (10 EEG, 156 fMRI) published up to December 2023. In EEG studies, OCD exhibited lower connectivity in delta and alpha bands, with inconsistent findings in other frequency bands. Resting-state fMRI studies reported conflicting connectivity patterns within the default mode network (DMN) and sensorimotor cortico-striato-thalamo-cortical (CSTC) circuitry. Many studies observed decreased resting-state connectivity between the DMN and salience network (SN), implicating the 'triple network model' in OCD. Task-related hyperconnectivity within the DMN-SN and hypoconnectivity between the SN and frontoparietal network suggest OCD-related cognitive inflexibility, potentially due to triple network dysfunction. In conclusion, our review highlights diverse connectivity differences in OCD, revealing complex brain network interplay that contributes to symptom manifestation. However, the presence of conflicting findings underscores the necessity for targeted research to achieve a comprehensive understanding of the pathophysiology of OCD.
强迫症（OCD）是一种使人衰弱的精神疾病，由于我们对其病理生理学的了解有限，因此难以治疗。通过神经影像学研究评估的大脑网络中的功能连接在理解 OCD 中起着关键作用。虽然脑电图（EEG）和功能磁共振成像（fMRI）都在 OCD 研究中得到了广泛应用，但很少有研究能够充分综合它们的发现。为了弥补这一差距，我们回顾了截至 2023 年 12 月发表的 166 项研究（10 项 EEG，156 项 fMRI）。在 EEG 研究中，OCD 在 delta 和 alpha 频段表现出较低的连接性，而在其他频段的发现则不一致。静息态 fMRI 研究报告了默认模式网络（DMN）和感觉运动皮质纹状体丘脑皮质（CSTC）回路内连接模式的冲突。许多研究观察到 DMN 和突显网络（SN）之间静息状态连接的减少，这表明 OCD 与“三重网络模型”有关。DMN-SN 内的任务相关超连接性和 SN 与额顶网络之间的连接不足表明 OCD 相关的认知灵活性受损，可能是由于三重网络功能障碍。总之，我们的综述强调了 OCD 中存在多种连接差异，揭示了复杂的大脑网络相互作用，这些相互作用导致了症状表现。然而，存在相互矛盾的发现这一事实突出表明需要进行有针对性的研究，以全面理解 OCD 的病理生理学。
