Limbic cortico-striato-thalamo-cortical functional connectivity in drug-naïve patients of obsessive-compulsive disorder

Psychol Med. 2021 Jan;51(1):70-82. doi: 10.1017/S0033291719002988. Epub 2019 Oct 23.

Abstract

Background: The pathophysiology of obsessive-compulsive disorder (OCD) remains unclear despite extensive neuroimaging work on the disorder. Exposure to medication and comorbid mental disorders can confound the results of OCD studies. The goal of this study was to explore differences in brain functional connectivity (FC) within the cortico-striato-thalamo-cortical (CSTC) loop of drug-naïve and drug-free OCD patients and healthy controls (HCs).

Methods: A total of 29 drug-naïve OCD patients, 22 drug-free OCD patients, and 25 HCs matched on age, gender and education level underwent functional magnetic resonance imaging scanning at resting state. Seed-based connectivity analyses were conducted among the three groups. The Yale Brown Obsessive Compulsive Scale and clinical inventories were used to assess the clinical symptoms.

Results: Compared with HCs, the drug-naïve OCD patients had reduced FC within the limbic CSTC loop. In the drug-naïve OCD participants, we also found hyperconnectivity between the supplementary motor area and ventral and dorsal putamen (p < 0.05, corrected for multiple comparisons).

Conclusions: Exposure to antidepressants such as selective serotonin reuptake inhibitors may affect the function of some brain regions. Future longitudinal studies could help to reveal the pharmacotherapeutic mechanisms in these loops.

Keywords: Functional connectivity; functional magnetic resonance imaging; obsessive-compulsive disorder; selective serotonin reuptake inhibitor.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brain / diagnostic imaging*
  • Brain / drug effects
  • Brain / physiopathology*
  • Female
  • Humans
  • Limbic System / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / diagnostic imaging*
  • Obsessive-Compulsive Disorder / drug therapy
  • Obsessive-Compulsive Disorder / physiopathology*
  • Olfactory Cortex / physiopathology
  • Prescription Drugs / therapeutic use
  • Psychiatric Status Rating Scales
  • Thalamus / physiopathology
  • Young Adult

Substances

  • Prescription Drugs