Journal
PSYCHOLOGICAL MEDICINE
Volume 48, Issue 6, Pages 919-928Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291717002288
Keywords
Functional connectivity; obsessive-compulsive disorder; subthalamic nucleus and bed nucleus of the stria terminalis
Categories
Funding
- Carlos III Health Institute [PI13/01958, PI13/00918, PI14/00413, CIBER-CB06/03/0034]
- FEDER funds ('A way to build Europe')
- Agency of University and Research Funding Management of the Catalan Government [2014SGR1672]
- Spanish Ministry for Education, Culture and Sport [FPU13/02141]
- Rio Hortega contract from the Carlos III Health Institute [CM15/00189]
- Juan Rodes contract from the Carlos III Health Institute [JR14/00038]
- Miguel Servet contract from the Carlos III Health Institute [CPII16/00048]
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Background. The assessment of inter-regional functional connectivity (FC) has allowed for the description of the putative mechanism of action of treatments such as deep brain stimulation (DBS) of the nucleus accumbens in patients with obsessive-compulsive disorder (OCD). Nevertheless, the possible FC alterations of other clinically-effective DBS targets have not been explored. Here we evaluated the FC patterns of the subthalamic nucleus (STN) and the bed nucleus of the stria terminalis (BNST) in patients with OCD, as well as their association with symptom severity. Methods. Eighty-six patients with OCD and 104 healthy participants were recruited. A resting-state image was acquired for each participant and a seed-based analysis focused on our two regions of interest was performed using statistical parametric mapping software (SPM8). Between-group differences in FC patterns were assessed with two-sample t test models, while the association between symptom severity and FC patterns was assessed with multiple regression analyses. Results. In comparison with controls, patients with OCD showed: (1) increased FC between the left STN and the right pre-motor cortex, (2) decreased FC between the right STN and the lenticular nuclei, and (3) increased FC between the left BNST and the right frontopolar cortex. Multiple regression analyses revealed a negative association between clinical severity and FC between the right STN and lenticular nucleus. Conclusions. This study provides a neurobiological framework to understand the mechanism of action of DBS on the STN and the BNST, which seems to involve brain circuits related with motor response inhibition and anxiety control, respectively.
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