Neural primacy of the dorsolateral prefrontal cortex in patients with obsessive-compulsive disorder

Li, Hailong; Hu, Xinyu; Gao, Yingxue; Cao, Lingxiao; Zhang, Lianqing; Bu, Xuan; Lu, Lu; Wang, Yanlin; Tang, Shi; Li, Bin; Yang, Yanchun; Biswal, Bharat B.; Gong, Qiyong; Huang, Xiaoqi

doi:10.1016/j.nicl.2020.102432

Cited by 20 publications

(16 citation statements)

References 66 publications

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“… 22 The previous investigation in OCD patients showed reduced functional connectivity in the right DLPFC and the right OFC, and activity in the right OFC had an inhibitory on the right DLPFC. 38 There have been previous studies on the left, right, and bilateral OFC, and the results are not consistent because of the different protocols used in treatment. 27 , 39–42 A double-blind cross-over study evaluated the efficacy of low-frequency rTMS over the right OFC with a double-cone coil in patients suffering from OCD.…”

Section: Discussionmentioning

confidence: 90%

Continuous Theta-Burst Stimulation Over the Right Orbitofrontal Cortex in Treatment-Resistant Obsessive-Compulsive Disorder Treatment: A Randomized Sham-Controlled Trial

Liu¹,

Shao²,

Liao³

et al. 2021

IJGM

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Purpose Examining whether modulation of right orbitofrontal cortex (OFC) activity by continuous theta-burst stimulation (cTBS) affects obsessive-compulsive disorder (OCD) symptoms. Patients and Methods A total of 28 treatment-resistant OCD participants were treated with either active or sham cTBS of the OFC twice per day, for five days a week, for 2 weeks, in a double-blinded manner. Clinical response to treatment was determined using the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS). Results There were no statistically significant differences between the 2 groups after two weeks of treatment in the Yale–Brown Obsessive-Compulsive Scale score (group*time interaction, F2,20=0.996, p=0.387) and other secondary outcome measures, including anxiety symptoms and responder rates. Depressive symptoms improved significantly in the active group (p=0.027), but the significant difference disappeared at 6 weeks (p=0.089). Conclusion This is the first randomized controlled study using cTBS in the right OFC to observe the improvement of treatment-resistant OCD symptoms. It is safe to use cTBS, but 2 weeks of treatment is not enough to achieve a curative effect. Future studies are needed to explore more advanced stimulation parameters suitable for the treatment of OCD. Clinical Trial Registration www.chictr.org.cn , identifier ChiCTR2000034814.

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Section: Discussionmentioning

confidence: 90%

Continuous Theta-Burst Stimulation Over the Right Orbitofrontal Cortex in Treatment-Resistant Obsessive-Compulsive Disorder Treatment: A Randomized Sham-Controlled Trial

Liu¹,

Shao²,

Liao³

et al. 2021

IJGM

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“…A recent study utilized rs-fMRI to investigate the neural prioritization of the DLPFC in sufferers of OCD. They discovered abnormalities in the DLPFC-right orbitofrontal cortex circuit, DLPFC-inferior temporal gyri circuit, and DLPFC cerebellar circuit, verifying neural circuit abnormalities in an OCD patient alternative model (58). Therefore, DLPFC damage related to TA may cause symptoms of OCD in patients.…”

Section: Discussionmentioning

confidence: 87%

Altered Intrinsic Brain Activity in Patients With Toothache Using the Percent Amplitude of a Fluctuation Method: A Resting-State fMRI Study

Yang

Shao²,

Shen³

et al. 2022

Front. Neurol.

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ObjectiveThe percent amplitude of fluctuation (PerAF) technique was utilized to evaluate the neural functions of specific cerebrum areas in patients with toothache (TA).Patients and MethodsAn aggregation of 18 patients with TA (eight males and 10 females) were included in the study. We also recruited 18 healthy controls (HCs; eight men and 10 women) aligned for sex and age. Resting functional magnetic resonance imaging (rs-fMRI) scans were obtained. Then, we utilized the PerAF method and a support vector machine (SVM) to analyze the image data and measure neural abnormalities in related cerebrum areas. Receiver operating characteristic (ROC) curve analysis was utilized to appraise the two data sets.ResultsThe PerAF signals in the right dorsolateral superior frontal gyrus (RDSFG) and the right posterior central gyrus (RPCG) of TA sufferers were lower than HC signals. These results may reveal neural dysfunctions in relevant cerebrum regions. The AUC values of PerAF in the two areas were 0.979 in the RDSFG and 0.979 in the RPCG. The SVM results suggested that PerAF could be utilized to distinguish the TA group from HCs with a sensitivity of 75.00%, a specificity of 66.67%, and an accuracy of 70.83%.ConclusionPatients with TA had marked differences in PerAF values in some regions of the cerebrum. Changes in PerAF values represented distinctions in blood oxygen level dependent semaphore intensity, which reflected the overactivity or inactivation of some cerebrum areas in those suffering from TA. At the same time, we analyzed the PerAF values of TAs with ROC curve, which can be helpful for the diagnosis of TA severity and subsequent treatment. Our results may help to elucidate the pathological mechanism of TA.

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“…In prior resting-state fMRI studies, altered connectivity regarding the DLPFC has been found in OCD patients relative to HCs, suggesting that the DLPFC might be central to OCD pathophysiology (11,49). A more recent rs-fMRI study using bivariate Granger causality analysis demonstrated the abnormal causal interactions of DLPFC-related circuits in patients with OCD (50). Our finding that greater activation in the DLPFC during the MR task was associated with severe obsessivecompulsive symptoms may be related to patients' efforts to resist their symptoms during cognitive tasks.…”

Section: Discussionmentioning

confidence: 98%

Brain Activation of Patients With Obsessive-Compulsive Disorder During a Mental Rotation Task: A Functional MRI Study

Jung

Kim

et al. 2021

Front. Psychiatry

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Functional neuroimaging studies have implicated alterations in frontostriatal and frontoparietal circuits in obsessive-compulsive disorder (OCD) during various tasks. To date, however, brain activation for visuospatial function in conjunction with symptoms in OCD has not been comprehensively evaluated. To elucidate the relationship between neural activity, cognitive function, and obsessive-compulsive symptoms, we investigated regional brain activation during the performance of a visuospatial task in patients with OCD using functional magnetic resonance imaging (fMRI). Seventeen medication-free patients with OCD and 21 age-, sex-, and IQ-matched healthy controls participated in this study. Functional magnetic resonance imaging data were obtained while the subjects performed a mental rotation (MR) task. Brain activation during the task was compared between the two groups using a two-sample t-test. Voxel-wise whole-brain multiple regression analyses were also performed to examine the relationship between obsessive-compulsive symptom severity and neural activity during the task. The two groups did not differ in MR task performance. Both groups also showed similar task-related activation patterns in frontoparietal regions with no significant differences. Activation in the right dorsolateral prefrontal cortex in patients with OCD during the MR task was positively associated with their total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores. This study identified the specific brain areas associated with the interaction between symptom severity and visuospatial cognitive function during an MR task in medication-free patients with OCD. These findings may serve as potential neuromodulation targets for OCD treatment.

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Neural primacy of the dorsolateral prefrontal cortex in patients with obsessive-compulsive disorder

Abstract: Highlights Medication-free OCD patients were recruited to explore the neural primacy of DLPFC. Three abnormal causal interactions related to DLPFC were identified in OCD patients. Directionality of interaction within and between neural networks is disrupted in OCD.

Cited by 20 publications

References 66 publications

Continuous Theta-Burst Stimulation Over the Right Orbitofrontal Cortex in Treatment-Resistant Obsessive-Compulsive Disorder Treatment: A Randomized Sham-Controlled Trial

Continuous Theta-Burst Stimulation Over the Right Orbitofrontal Cortex in Treatment-Resistant Obsessive-Compulsive Disorder Treatment: A Randomized Sham-Controlled Trial

Altered Intrinsic Brain Activity in Patients With Toothache Using the Percent Amplitude of a Fluctuation Method: A Resting-State fMRI Study

Brain Activation of Patients With Obsessive-Compulsive Disorder During a Mental Rotation Task: A Functional MRI Study

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