Aberrant default mode network in patients with obsessive-compulsive disorder: an fMRI study

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Jang, J. H.; Kim, J. H.; Jung, W. H.; Kang, D. H.; Choi, C. H.; Kwon, J. S.; Lee, J. M.

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Objective: Resting state functional connectivity is a relatively
novel functional magnetic resonance imaging (fMRI) approach
that analyzes the temporal correlation of blood oxygen leveldependent
(BOLD) signal fluctuations in different brain areas
that is not attributable to specific inputs and outputs. It represents
neuronal activity that is intrinsically generated by the
brain. Many researchers have been emphasized the functional
connectivity across distributed brain areas during resting state. In
the neuropsychiatric field, abnormal functional connectivity was reported in disorders such as Alzheimer's dementia, schizophrenia,
or depression. However, there have been no studies regarding
functional connectivity during resting state in the patients with
obsessive-compulsive disorder (OCD).
The aim of the current study was to determine whether functional
connectivity in default mode network was altered in patients
with OCD during resting state. It was hypothesized that OCD
patients would show abnormal spatial and/or temporal patterns
in default mode network. We also hypothesized altered activation
of regions would include anterior cingulate cortex and prefrontal
cortex, which have been shown to have altered activation in
previous studies of OCD.
Method: Twenty-two patients with OCD (16 drug-naive, and 6
drug-free at least 4 weeks), and 22 age-, and sex-matched healthy
comparison subjects were included in this study. All subjects
underwent 4.68-min resting state functional scanning runs (120
volumes) in eyes closed conditions. The posterior cingulate cortex
(pCC) region was chosen as the seed region for the connectivity
analysis. Correlations between temporal connectivity with the
PCC seed region in each regions of interest and clinical measures
were also assessed.
Results: At the time of the study, the patients had a mean
duration of illness of 7.61 (SD=5.33) years. The mean scores
for obsessive and compulsive symptoms measured by the YaleBrown
Obsessive Compulsive Scale were 11.50 (SD = 4.42) and
9.86 (SD = 4.99), respectively. The mean scores for the Beck
Depression Inventory (BDI) and the Beck Anxiety Inventory
(BAI) were 16.09 (SD= 10.93) and 17.77 (SD= 15.12) for OCD
patients, and 3.65 (SD =4.93) and 4.05 (SD = 5.20) for comparison
subjects, respectively.
The patients with OCD demonstrated lesser default mode
activity compared to the comparison subjects in the anterior
cingulate cortex, putamen, insula and superior frontal gyrus. OCD
patients had greater default mode activity in the posterior cingulate
cortex. The BAI score was negatively correlated with connectivity
between the PCC seed region and the putamen.
Conclusions: The current study is the first resting state fMRI
study demonstrating disruption of functional connectivity in the
default mode network in drug-free OCD patients. We detected
decreases in default mode activity in the anterior cingulate cortex,
putamen, insula and prefrontal cortex, which are components
of the fronto-subcortical circuitry in OCD patients. These data
provide evidence for fronto-subcortical dysfunction in patients
with OCD. Further research to clarify the functional connectivity
change after treatment should increase our understanding of the
pathophysiology of OCD.
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College of Medicine/School of Medicine (의과대학/대학원)Psychiatry (정신과학전공)Journal Papers (저널논문_정신과학전공)
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