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Obsessive-Compulsive Disorder01:28

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Obsessive-compulsive disorder (OCD) is a mental health condition characterized by recurrent obsessions, compulsions, or both, which consume significant time and interfere with daily functioning. Obsessions involve persistent, intrusive, and unwanted thoughts, images, or urges that evoke anxiety. Common examples include irrational fears of contamination or harm. Compulsions are repetitive behaviors or mental acts performed to reduce the anxiety caused by obsessions. For instance, individuals...
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Functional connectivity in obsessive-compulsive disorder and its subtypes.

Arun Ravindran1,2, Margaret Richter2,3, Tania Jain1

  • 1Division of Mood and Anxiety Disorders, Centre for Addiction and Mental Health, Toronto, Ontario, CanadaM6J 1H4.

Psychological Medicine
|May 24, 2019
PubMed
Summary

Obsessive-compulsive disorder (OCD) is linked to altered brain connectivity, particularly in the posterior cingulate (PCg). This region shows different functional connections in OCD patients, impacting attention to emotional stimuli.

Keywords:
CheckingOCDemotionfMRIfunctional connectivityreactivitysubtypewashing

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Medical Imaging

Background:

  • Obsessive-compulsive disorder (OCD) is a debilitating anxiety disorder with unclear pathophysiology.
  • Neuroimaging reveals altered striatal and prefrontal reactivity in OCD patients during emotional tasks.
  • Investigating functional connectivity offers insights into how sensory information integrates into frontostriatal regions in OCD.

Purpose of the Study:

  • To compare neural activity and functional connectivity in OCD patients and healthy controls using fMRI.
  • To examine alterations in brain regions associated with emotion provocation in OCD.
  • To explore subtype-specific connectivity patterns in washing and checking OCD.

Main Methods:

  • Functional magnetic resonance imaging (fMRI) was used.
  • 31 OCD patients (12 washing, 19 checking subtypes) and 17 healthy volunteers participated.
  • Participants underwent an emotion provocation paradigm using visual stimuli.

Main Results:

  • OCD patients exhibited hyper-activation in the posterior cingulate (PCg) during emotion provocation.
  • Elevated PCg functional connectivity with visual cortices and frontostriatal regions was observed in OCD.
  • Checking subtypes showed increased motor cortex activity; washing subtypes showed increased anterior insula and orbitofrontal cortex activity.

Conclusions:

  • The PCg's role in modulating visual cortex and frontolimbic connectivity is diminished in OCD, affecting attention to emotional stimuli.
  • Distinct PCg connectivity profiles exist for OCD subtypes: checking linked to motor activation, washing to emotional salience networks.
  • Limitations include medication effects, overlapping symptom subtypes, and limited stimulus intensity.