Connectome-wide Functional Connectivity Abnormalities in Youth With Obsessive-Compulsive Symptoms

Obsessive-compulsive symptomatology (OCS) is common in adolescence but usually does not meet the diagnostic threshold for obsessive-compulsive disorder. Nevertheless, both obsessive-compulsive disorder and subthreshold OCS are associated with increased likelihood of experiencing other serious psychiatric conditions, including depression and suicidal ideation. Unfortunately, there is limited information on the neurobiology of OCS.

Here, we undertook one of the first brain imaging studies of OCS in a large adolescent sample (analyzed n = 832) from the Philadelphia Neurodevelopmental Cohort. We investigated resting-state functional magnetic resonance imaging functional connectivity using complementary analytic approaches that focus on different neuroanatomical scales, from known functional systems to connectome-wide tests.

We found a robust pattern of connectome-wide, OCS-related differences, as well as evidence of specific abnormalities involving known functional systems, including dorsal and ventral attention, frontoparietal, and default mode systems. Analysis of cerebral perfusion imaging and high-resolution structural imaging did not show OCS-related differences, consistent with domain specificity to functional connectivity.

The brain connectomic associations with OCS reported here, together with early studies of its clinical relevance, support the potential for OCS as an early marker of psychiatric risk that may enhance our understanding of mechanisms underlying the onset of adolescent psychopathology.