Common neurofunctional dysregulations characterize obsessive–compulsive, substance use, and gaming disorders—An activation likelihood meta‐analysis of functional imaging studies

Abstract

Compulsivity and loss of behavioral control represent core symptoms in obsessive–compulsive disorder (OCD), substance use disorder (SUD), and internet gaming disorder (IGD). Despite elaborated animal models suggesting that compulsivity is mediated by cortico‐striatal circuits and a growing number of neuroimaging case–control studies, common neurofunctional alterations in these disorders have not been systematically examined. The present activation likelihood estimation (ALE) meta‐analysis capitalized on previous functional magnetic resonance imaging (fMRI) studies to determine shared neurofunctional alterations among the three disorders. Task‐based fMRI studies of individuals with SUD, OCD, or IGD were obtained. ALE was performed within each disorder. Next, contrast and conjunction meta‐analyses were performed to determine differential and common alterations. Task‐paradigm classes were group according to Research Domain Criteria (RDoC) domains to determine contributions of underlying behavioral domains. One hundred forty‐four articles were included representing data from n = 6897 individuals (SUD = 2418, controls = 2332; IGD = 361, controls = 360; OCD = 715, controls = 711) from case–control studies. Conjunction meta‐analyses revealed shared alterations in the anterior insular cortex between OCD and SUDs. SUD exhibited additionally pronounced dorsal‐striatal alterations compared with both, OCD and IGD. IGD shared frontal, particularly cingulate alterations with all SUDs, while IGD demonstrated pronounced temporal alterations compared with both, SUD and OCD. No robust overlap between IGD and OCD was observed. Across the disorders, neurofunctional alterations were mainly contributed by cognitive systems and positive valence RDoC domains. The present findings indicate that neurofunctional dysregulations in prefrontal regions engaged in regulatory‐control represent shared neurofunctional alterations across substance and behavioral addictions, while shared neurofunctional dysregulations in the anterior insula may mediate compulsivity in substance addiction and OCD.

Dysregulated anterior insula reactivity as robust functional biomarker for chronic pain—Meta‐analytic evidence from neuroimaging studies

“…This network clearly resembles the rs‐fMRI “salience” network, anchored in the anterior insula and the midcingulate cortex (Seeley et al, 2007), which plays an important role in the regulation of interoceptive versus external guided attention (Xin et al, 2021; Yao et al, 2018) and the guidance of flexible behavior (Menon & Uddin, 2010; Seeley et al, 2007). Abnormalities in this network have been repeatedly observed in chronic pain (Cauda et al, 2009; Hemington, Wu, Kucyi, Inman, & Davis, 2016; Wu, Inman, & Davis, 2013) and neuropsychiatric conditions, including depression (Manoliu et al, 2014; Shao et al, 2018), anxiety (Geng, Li, Chen, Li, & Gu, 2016), or addiction (Klugah‐Brown et al, 2020, 2021) which are commonly found to be co‐morbid in chronic pain (Bair, Robinson, Katon, & Kroenke, 2003; Finan & Smith, 2013). These results, therefore, support the hypothesis that chronic pain patients might present an impairment of the salience network and, possibly, of its main functions.…”

Shared network‐level functional alterations across substance use disorders: A multi‐level kernel density meta‐analysis of resting‐state functional connectivity studies

“…Recent meta-analyses confirm these engagements by identifying altered neural activation patterns within isolated brain regions involved in executive control and habit formation in SUD. 3,19 Additionally, a recent meta-analysis on rsFC in SUD 4 showed a convergent hyperconnectivity effect for clusters located in the striatum (putamen and caudate) and middle frontal gyrus in individuals with SUD compared with HC. While this investigation offers important insights with regard to general network alterations in SUD, the between and within network-level alterations across studies remain elusive.…”

Common abnormality of gray matter integrity in substance use disorder and obsessive‐compulsive disorder: A comparative voxel‐based meta‐analysis

“…Across the SUDs examined, the insula showed marked decreases in the GMV. The insula alteration was functionally shown in our previous study suggesting common neurofunctional alterations in this region across SUDs (Klugah‐Brown et al, 2020 ) as well as between SUDs and OCD (Klugah‐Brown et al, 2021 ). The insula has increasingly been noted as addiction relevant region, probably via its important role in interoceptive processing, decision making, and/or risky behavior which may promote substance abuse despite being aware of the negative consequences (Naqvi & Bechara, 2009 ).…”