Altered Cortico–Striatal Functional Connectivity During Resting State in Obsessive–Compulsive Disorder

Abstract

Background: Neuroimaging studies show that obsessive–compulsive disorder (OCD) is characterized by an alteration of the cortico–striato–thalamo–cortical (CSTC) system in terms of an imbalance of activity between the direct and the indirect loop of the CSTC. As resting-state functional connectivity (FC) studies investigated only specific parts of the CSTC in patients with OCD up to now, the present study aimed at exploring FC in the CSTC as a whole. Methods: We investigated potential alterations in resting-state FC within the CSTC system in 44 OCD patients and 40 healthy controls by taking into consideration all relevant nodes of the direct and indirect CSTC loop. Results: Compared to healthy controls, OCD patients showed an increased FC between the left subthalamic nucleus (STN) and the left external globus pallidus (GPe), as well as an increased FC between the left GPe and the left internal globus pallidus (GPi). Conclusion: These findings may contribute to a better understanding of the OCD pathophysiology by providing further information on the connectivity alterations within specific regions of the CSTC system. In particular, increased FC between the STN and the left GPe may play a major role in OCD pathology. This assumption is consistent with the fact that these regions are also the main target sites of therapeutic deep brain stimulation in OCD.

Functional Connectivity Changes in Obsessive–Compulsive Disorder Correspond to Interference Control and Obsessions Severity

“…The critical role of CSTC circuits in pathophysiology of OCD has been documented using the fMRI functional connectivity (FC) approach that enables one to investigate how constituents of CSTC networks are integrated and coordinated, and to determine disorder-or symptom-specific disruptions within these networks. Most FC studies have documented that OCD patients exert increased functional coupling within CSTC loops (25)(26)(27)(28)(29) and that successful treatment is associated with reduced resting activity within the CSTC loop (30). Particular interest has been recently dedicated to the anterior cingulate cortex region.…”

White Matter Microstructure and its Relation to Clinical Features of Obsessive-Compulsive Disorder: Findings from the ENIGMA OCD Working Group

“…Abnormalities in cerebral white matter (WM) are relevant to models of anomalous brain circuitry that posit deficits in connectivity in obsessivecompulsive disorder (OCD) 1,2 . OCD has a childhood onset in over 50% of all cases, and most childhood-onset OCD cases persist into adulthood 3 .…”

“…longitudinal fasciculus and the inferior fronto-occipital fasciculus). Their altered microstructure may be related to the cognitive dysfunctions subtended by intra-hemispheric disconnection 2,53 .…”

Case Report of Dual-Site Neurostimulation and Chronic Recording of Cortico-Striatal Circuitry in a Patient With Treatment Refractory Obsessive Compulsive Disorder

“…The dominant narrative of CSTC dysfunction in OCD emphasizes CSTC hyper-connectivity (e.g., Dougherty et al, 2018;Calzà et al, 2019). There are many functional neuroimaging studies showing heightened connectivity between regions within CSTC loops (Graybiel and Rauch, 2000;Maia et al, 2008;Milad and Rauch, 2012;Brennan and Rauch, 2017;Dougherty et al, 2018).…”