Aberrant cerebellar-cerebral functional connectivity in patients with obsessive-compulsive disorder, and its trajectory after pharmacotherapy and potential for diagnosis and prediction of early treatment effects

Abstract

The trajectory of abnormal cerebellar-cerebral functional connectivity (FC) in patients with obsessive-compulsive disorder (OCD) after pharmacotherapy and the association between alterations in the cerebellar-cerebral FC and changes in the clinical features of patients with OCD, as well as the possibility of building models for diagnosis and prediction of early treatment effects of OCD were unclear. We performed a longitudinal study involving 37 patients with OCD and 37 healthy controls (HCs). Patients with OCD received a 5-week treatment with paroxetine. Resting-state functional magnetic resonance imaging, seed-based FC analyses, support vector machine (SVM), support vector regression (SVR), and correlation analyses were applied to acquire and analyze the imaging and clinical data. Compared with HCs, patients with OCD showed decreased cerebellar-cerebral FC in the executive, affective-limbic, and sensorimotor networks. After treatment, patients showed significant clinical improvement and a part of the decreased cerebellar-cerebral FCs were restored. Negative correlations between abnormal cerebellar-cerebral FC at baseline and severity of compulsions, and impairment of social function were observed. Alterations in the cerebellar-cerebral FC were correlated with changes in cognition. Abnormal cerebellar-cerebral FC at baseline could serve as potential neuroimaging biomarkers for diagnosis of OCD and prediction of early treatment effects. These findings suggested that cerebellar-cerebral FC had an important role in the neuropsychological mechanisms underlying OCD and the pharmacological mechanism underlying the treatment for OCD. It was possible to develop precision medicine to identify individuals with OCD and which patients would maximally benefit from pharmacotherapy through SVM and SVR which were based on cerebellar-cerebral FC.