Cognitive control networks in OCD: A resting-state connectivity study in unmedicated patients with obsessive-compulsive disorder and their unaffected relatives

Vries, Froukje E. de; Wit, Stella J. de; Heuvel, Odile A. van den; Veltman, Dick J.; Cath, Daniëlle C.; Balkom, A.J.L.M. van; Werf, Ysbrand D. van der

doi:10.1080/15622975.2017.1353132

Cited by 38 publications

(34 citation statements)

References 54 publications

(76 reference statements)

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“…consistent with other literature of alterations in circuits (e.g., frontostriatal, cingulo-opercular) supporting cognitive control processes in OCD (e.g., refs. [22][23][24][25]. Thus, we hypothesized that 1) relative to matched healthy participants, unmedicated patients with OCD would show increased conflict-related responses in frontostriatal and cingulo-opercular (e.g., insula, anterior cingulate cortex [ACC]) regions and 2) such activity would predict EX/RP outcomes.…”

Section: Significancementioning

confidence: 99%

Task-based fMRI predicts response and remission to exposure therapy in obsessive-compulsive disorder

Pagliaccio

Middleton²,

Hezel³

et al. 2019

Proc. Natl. Acad. Sci. U.S.A.

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Exposure and ritual prevention (EX/RP) is an effective first-line treatment for obsessive-compulsive disorder (OCD), but only some patients achieve minimal symptoms following EX/RP. Herein, we investigate whether task-based neural activity can predict who responds best to EX/RP. Unmedicated adult patients with OCD (n = 36) and healthy participants (n = 33) completed the Simon Spatial Incompatibility Task during high-resolution, multiband functional MRI (fMRI); patients were then offered twice-weekly EX/RP (17 sessions). Linear mixed-effects models were used to identify brain regions where conflict-related activity moderated the slope of change in Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) scores across treatment. Conflict-related activity in the left pallidum and 35 cortical parcels/regions significantly predicted symptom improvement with EX/RP for patients with OCD (false discovery rate-corrected P < 0.05). Significant parcels/regions included cingulo-opercular and default mode network regions, specifically the anterior insula and anterior and posterior cingulate. Summarizing across these parcels/regions, greater conflict-related activity predicted greater EX/RP response and which patients achieved remission (Y-BOCS score ≤ 12; Cohen’s d = 1.68) with >80% sensitivity and specificity. The association between brain activity and treatment response was partially mediated by patient EX/RP adherence (b = −2.99; 43.61% of total effect; P = 0.02). Brain activity and adherence together were highly predictive of remission. Together, these findings suggest that cingulo-opercular and default mode regions typically implicated in task control and introspective processes, respectively, may be targets for novel treatments that augment the ability of persons with OCD to resolve cognitive conflict and thereby facilitate adherence to EX/RP, increasing the likelihood of remission.

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Section: Significancementioning

confidence: 99%

Task-based fMRI predicts response and remission to exposure therapy in obsessive-compulsive disorder

Pagliaccio

Middleton²,

Hezel³

et al. 2019

Proc. Natl. Acad. Sci. U.S.A.

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“…This network integrates visceral, autonomic, and sensory data to assess the homeostatic relevance or "salience" of internal and external stimuli, and the maintenance of tonic alertness or sustained attention (Sadaghiani & D'Esposito, 2015). Abnormalities in this network have been reported for obsessive compulsive disorder (OCD) (de Vries et al, 2017), psychosis (Sheffield et al, 2017), and mood and anxiety disorders (de Witte & Mueller, 2016). Abnormalities in this network have been reported for obsessive compulsive disorder (OCD) (de Vries et al, 2017), psychosis (Sheffield et al, 2017), and mood and anxiety disorders (de Witte & Mueller, 2016).…”

Section: Specific Nodal Effectmentioning

confidence: 99%

Focal application of accelerated iTBS results in global changes in graph measures

Klooster

Franklin

Besseling

et al. 2018

Human Brain Mapping

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Graph analysis was used to study the effects of accelerated intermittent theta burst stimulation (aiTBS) on the brain's network topology in medication‐resistant depressed patients. Anatomical and resting‐state functional MRI (rs‐fMRI) was recorded at baseline and after sham and verum stimulation. Depression severity was assessed using the Hamilton Depression Rating Scale (HDRS). Using various graph measures, the different effects of sham and verum aiTBS were calculated. It was also investigated whether changes in graph measures were correlated to clinical responses. Furthermore, by correlating baseline graph measures with the changes in HDRS in terms of percentage, the potential of graph measures as biomarker was studied. Although no differences were observed between the effects of verum and sham stimulation on whole‐brain graph measures and changes in graph measures did not correlate with clinical response, the baseline values of clustering coefficient and global efficiency showed to be predictive of the clinical response to verum aiTBS. Nodal effects were found throughout the whole brain. The distribution of these effects could not be linked to the strength of the functional connectivity between the stimulation site and the node. This study showed that the effects of aiTBS on graph measures distribute beyond the actual stimulation site. However, additional research into the complex interactions between different areas in the brain is necessary to understand the effects of aiTBS in more detail.

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“…Functional changes within the striatum are suspected to have a role in cognitive dysfunction and symptoms of OCD (31,32,57). We directly investigated these notions with a methodology that distinguishes DS versus VS functions coupled with fMRI in OCD.…”

Section: Striatum In Ocdmentioning

confidence: 99%

“…The volumetric abnormalities in OCD are also reflected in resting state basal activity and activity related to cognitive tasks. Positron Emission Tomography (PET) and resting fMRI have found increased glucose metabolism and increased activity in regions of VS compared to controls (30)(31)(32)(33)(34)(35)(36). Interestingly, it appears that reversal learning (37) and reward learning (38), cognitive functions mediated by VS, are diminished in OCD patients, coupled with decreased VS activity compared to healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Striatum-Mediated Deficits in Stimulus-Response Learning and Decision-Making in OCD

et al. 2020

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Obsessive compulsive disorder (OCD) is a prevalent psychiatric disorder characterized by obsessions and compulsions. Studies investigating symptomatology and cognitive deficits in OCD frequently implicate the striatum. The aim of this study was to explore striatum-mediated cognitive deficits in patients with OCD as they complete a stimulusresponse learning task previously shown to differentially rely on the dorsal (DS) and ventral striatum (VS). We hypothesized that patients with OCD will show both impaired decisionmaking and learning, coupled with reduced task-relevant activity in DS and VS, respectively, compared to healthy controls. We found that patients with OCD (n = 14) exhibited decision-making deficits and learned associations slower compared to healthy age-matched controls (n = 16). Along with these behavioral deficits, OCD patients had reduced task-relevant activity in DS and VS, compared to controls. This study reveals that responses in DS and VS are altered in OCD, and sheds light on the cognitive deficits and symptoms experienced by patients with OCD.

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Cognitive control networks in OCD: A resting-state connectivity study in unmedicated patients with obsessive-compulsive disorder and their unaffected relatives

Cited by 38 publications

References 54 publications

Task-based fMRI predicts response and remission to exposure therapy in obsessive-compulsive disorder

Task-based fMRI predicts response and remission to exposure therapy in obsessive-compulsive disorder

Focal application of accelerated iTBS results in global changes in graph measures

Striatum-Mediated Deficits in Stimulus-Response Learning and Decision-Making in OCD

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