Džinalija Nadža, Veer Ilya M, Simpson H Blair, Ivanov Iliyan, Balachander Srinivas, Benedetti Francesco, Calesella Federico, Fitzsimmons Sophie M D D, Grützmann Rosa, Hagen Kristen, Hansen Bjarne, Heinzel Stephan, Huijser Chaim, Ipser Jonathan, Jaspers-Fayer Fern, de Joode Niels T, Kathmann Norbert, Kim Minah, Kwon Jun Soo, Liu Wenjuan, Lochner Christine, Martinez-Zalacain Ignacio, Menchon Jose M, Narayanaswamy Janardhanan C, Olivier Ian S, Postma Tjardo S, Reddy Y C Janardhan, Soriano-Mas Carles, Stewart S Evelyn, Thomopoulos Sophia I, Thorsen Anders L, Vai Benedetta, Veltman Dick J, Venkatasubramanian Ganesan, Voon Valerie, Waller Lea, van der Werf Ysbrand D, Zhao Yi-Jie, Stein Dan J, Thompson Paul M, van den Heuvel Odile A, Vriend Chris
Amsterdam UMC, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands.
Amsterdam UMC, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.
bioRxiv. 2025 Aug 21:2025.08.20.671231. doi: 10.1101/2025.08.20.671231.
Obsessive-compulsive disorder (OCD) is associated with impaired executive function and altered activity in associated neural circuits, contributing to reduced goal-directed behavior. To investigate neural activation during executive control, we conducted a mega-analysis in the ENIGMA-OCD consortium pooling individual participant data from 475 individuals with OCD and 345 healthy controls across 15 fMRI tasks collected worldwide.
Individual participant data was uniformly processed using HALFpipe to construct voxelwise statistical images of executive control and task load contrasts. Parameter estimates extracted from regions of interest were entered into multilevel Bayesian models to examine regional and whole-brain effects of diagnosis, and, within OCD, the influence of medication status, symptom severity, and age of onset on task activation.
We observed a robust task activation pattern across individuals with OCD and control participants in executive control regions across tasks. Relative to controls, individuals with OCD showed moderate to very strong evidence of weaker activation of the dorsolateral prefrontal cortex, precuneus, frontal eye fields, and inferior parietal lobule during executive control (all positive posterior probabilities [P+]<0.1). Individuals with OCD also showed stronger activation in regions of the default mode network during executive function relative to controls. We found little evidence for differential activation during executive control in task-positive regions related to disease onset, severity and medication status.
In the first mega-analysis of fMRI studies of executive function in OCD, we found strong evidence of weaker frontoparietal activation during executive control tasks. Our findings also suggest a failure of default mode network regions to appropriately disengage during task performance in OCD.
强迫症（OCD）与执行功能受损及相关神经回路活动改变有关，导致目标导向行为减少。为了研究执行控制过程中的神经激活情况，我们在ENIGMA - OCD联盟中进行了一项元分析，汇总了来自全球475名强迫症患者和345名健康对照者在15项功能磁共振成像（fMRI）任务中的个体参与者数据。
使用HALFpipe对个体参与者数据进行统一处理，以构建执行控制和任务负荷对比的体素级统计图像。从感兴趣区域提取的参数估计值被输入到多级贝叶斯模型中，以检查诊断的区域和全脑效应，以及在强迫症患者中，药物状态、症状严重程度和发病年龄对任务激活的影响。
我们在强迫症患者和对照参与者中观察到了跨任务执行控制区域的强大任务激活模式。相对于对照组，强迫症患者在执行控制期间，背外侧前额叶皮层、楔前叶、额叶眼区和顶下小叶激活减弱，有中度到非常强的证据（所有后验概率[P+]<0.1）。相对于对照组，强迫症患者在执行功能期间默认模式网络区域的激活也更强。我们几乎没有发现与疾病发作、严重程度和药物状态相关的任务阳性区域在执行控制期间有差异激活的证据。
在对强迫症执行功能的fMRI研究的首次元分析中，我们发现了强有力的证据表明在执行控制任务期间额顶叶激活减弱。我们的研究结果还表明，在强迫症患者执行任务期间，默认模式网络区域未能适当脱离。
