Multi-level assessment of obsessive-compulsive disorder (OCD) reveals relations between neural and neurochemical levels

Abstract

Background While considerable progress has been made in exploring the psychological, the neural, and the neurochemical dimensions of OCD separately, their interplay is still an open question, especially their changes during psychotherapy. Methods Seventeen patients were assessed at these three levels by psychological questionnaires, fMRI, and venipuncture before and after inpatient psychotherapy. Seventeen controls were scanned at comparable time intervals. First, pre/post treatment changes were investigated for all three levels separately: symptom severity, whole-brain and regional activity, and the concentrations of cortisol, serotonin, dopamine, brain-derived neurotrophic factor (BDNF), and immunological parameters (IL-6, IL-10, TNFα). Second, stepwise linear modeling was used to find relations between the variables of the levels. Results The obsessive-compulsive, depressive, and overall symptom severity was significantly reduced after psychotherapy. At the neural level, the activity in the anterior cingulate cortex (ACC), in frontal regions, in the precuneus, and in the putamen had significantly decreased. No significant changes were found on the neurochemical level. When connecting the levels, a highly significant model was found that explains the decrease in neural activity of the putamen by increases of the concentrations of cortisol, IL-6, and dopamine. Conclusion Multivariate approaches offer insight on the influences that the different levels of the psychiatric disorder OCD have on each other. More research and adapted models are needed.

Smo-Shh Agonist Purmorphamine Prevents Neurobehavioral and Neurochemical Defects in 8-OH-DPAT-Induced Experimental Model of Obsessive-Compulsive Disorder

“…Neurochemical changes such as neurotransmitter imbalance, apoptosis, oxidative damage, and inflammation of neuronal cells are significant causes of the onset of compulsive-like behavior [4,87]. While there is no direct evidence for the role of the Smo-Shh agonist PUR in treating OCD, it can show a protective effect.…”

“…Abnormalities in the corticostriatal-thalamocortical (CSTC) circuit and neurochemical changes have been associated with these behavioral changes [3]. In a number of investigations, researchers found that OCD patients had higher levels of dopamine and lower levels of serotonin and growth factors such asBDNF compared to healthy people [4]. Reversing these neurochemical alterations can help treat and manage OCD.…”

Pathologically reduced neural flexibility recovers during psychotherapy of OCD patients

“…Although evidence exists that psychotherapy is able to change brain function ( Schiepek et al, 2013 , Schiepek et al, 2011 , Viol et al, 2020 ), neuroscience research has only marginally been able to give specific recommendations about how to improve the treatment of psychiatric disorders ( van den Heuvel, 2015 ), because neither psychotherapy nor medication can directly alter the activity of specific brain regions, or specific connections between regions. In contrast, our findings provide the recommendation for psychotherapy to increase flexibility.…”

Insight in obsessive-compulsive disorder: conception, clinical characteristics, neuroimaging, and treatment

“…Second-generation neuroleptics such as Risperidone and Aripiprazole can potentiate the therapeutic effect in improving the insight in some patients, although their effectiveness in treating refractory OCD patients ranges from 40 to 55% (Albert et al ., 2016 ). Moreover, structural abnormalities (Zhong et al ., 2019 ) and altered functional connectivity (Viol et al ., 2020 ; Yang et al ., 2015 ) in related brain areas partially restored in OCD patients after treatment. This suggests that OCD treatment not only ameliorates symptoms but also affects the neurophysiology of relevant brain areas.…”