Divergent Structural Responses to Pharmacological Interventions in Orbitofronto-Striato-Thalamic and Premotor
Qiming Lv1, Zhen Wang2, Chencheng Zhang3
1Institute of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institute for Biological Sciences, Chinese Academy of Sciences, Shanghai 200031, China; University of Chinese Academy of Sciences, China.
Abstract:
Prior efforts to dissect etiological and pharmacological modulations in brain morphology in obsessive-compulsive disorder (OCD) are often undermined by methodological and sampling constraints, yielding conflicting conclusions and no reliable neuromarkers. Here we evaluated alteration of regional gray matter volume including effect size (Cohen's d value) in 95 drug-naïve patients (age range: 18-55) compared to 95 healthy subjects (age: 18-63), then examined pharmacological effects in 65 medicated (age: 18-57) and 73 medication-free patients (age: 18-61). Robustness of statistical outcomes and effect sizes was rigorously tested with Monte Carlo cross-validation. Relative to controls, both drug-naïve and medication-free patients exhibited comparable volumetric increases mainly in the left thalamus (d=0.90, 0.82, respectively), left ventral striatum (d=0.88, 0.67), bilateral medial orbitofrontal cortex (d=0.86, 0.71; 0.90, 0.73), and left inferior temporal gyrus (d=0.83, 0.66), and decreased volumes in left premotor/presupplementary motor areas (d=-0.83, -0.71). Interestingly, abnormalities in the thalamus and medial orbitofrontal cortex were present in medicated patients whereas entirely absent in premotor and ventral striatum. It suggests that pharmacotherapy elicited divergent responses in orbitofronto-striato-thalamic and premotor circuits, which warrants the design of longitudinal studies investigating the potential of these neuromarkers in stratified treatments of OCD.
Insights
Obsessive-compulsive disorder (OCD) shows altered brain gray matter volumes, particularly in the thalamus and orbitofrontal cortex. Pharmacotherapy impacts these regions differently, suggesting potential for targeted OCD treatments.
Area of Science:
- Neuroscience
- Psychiatry
- Radiology
Background:
- Obsessive-compulsive disorder (OCD) research faces challenges due to methodological and sampling limitations, hindering reliable neuromarker identification.
- Previous studies on brain morphology in OCD have yielded conflicting results regarding etiological and pharmacological modulations.
Purpose of the Study:
- To evaluate regional gray matter volume alterations in drug-naïve and medicated/unmedicated OCD patients compared to healthy controls.
- To investigate the effects of pharmacotherapy on brain morphology in OCD.
- To identify potential neuromarkers for stratified OCD treatments.
Main Methods:
- Gray matter volume was assessed using volumetric analysis in 95 drug-naïve OCD patients, 65 medicated patients, 73 medication-free patients, and 95 healthy controls.
- Effect sizes (Cohen's d) were calculated to quantify volumetric changes.
- Statistical outcomes and effect sizes were validated using Monte Carlo cross-validation.
Main Results:
- Both drug-naïve and medication-free OCD patients showed increased gray matter volume in the left thalamus, left ventral striatum, bilateral medial orbitofrontal cortex, and left inferior temporal gyrus compared to controls.
- Decreased volumes were observed in the left premotor/presupplementary motor areas in both patient groups.
- Medicated patients retained abnormalities in the thalamus and medial orbitofrontal cortex, while premotor and ventral striatum abnormalities were absent, suggesting divergent pharmacotherapy responses.
Conclusions:
- Obsessive-compulsive disorder is associated with distinct gray matter volume alterations in specific brain circuits.
- Pharmacotherapy appears to differentially affect orbitofronto-striato-thalamic and premotor circuits in OCD patients.
- These findings support the need for longitudinal studies to explore the utility of these brain regions as neuromarkers for personalized OCD treatment strategies.
Related Concept Videos
01:28Obsessive-Compulsive Disorder
01:26Psychosis: Goals of Pharmacotherapy
01:24Operant Conditioning Intervention
In operant conditioning, behaviors that are...
01:27Psychosis: Pathophysiology of Schizophrenia and Other Psychotic Disorders
Researchers have identified genetic factors that increase susceptibility to schizophrenia, underscoring the intricate interplay between genetics and environment in disease development. At the core of schizophrenia's pathophysiology is excessive dopaminergic neurotransmission within...
01:15Drug Abuse and Addiction: Pharmacological Phenomena
01:30Psychosurgery
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...