Specific Patterns of Endogenous Functional Connectivity Are Associated With Harm Avoidance in Obsessive-Compulsive...

Area of Science:

• Neuroscience
• Psychiatry
• Brain Imaging

Background:

• Individuals with obsessive-compulsive disorder (OCD) exhibit persistent avoidance behaviors, even without apparent threats, impacting quality of life.
• Existing research in rodents and nonhuman primates suggests a specific brain network involved in persistent avoidance.
• Novel intervention targets are needed for OCD, prompting investigation into brain-behavior relationships.

Purpose of the Study:

• To test if specific brain network connections predict harm avoidance (HA), a trait measure of persistent avoidance relevant to OCD.
• To determine if HA, rather than an OCD diagnosis, is associated with altered functional connectivity.
• To assess the robustness of findings to comorbid symptoms and their replicability in an independent sample.

Main Methods:

• Resting-state functional connectivity magnetic resonance imaging (rs-fMRI) was employed.
• Cross-validated elastic net was used for feature selection to identify predictive brain connections.
• Poisson generalized linear models analyzed the relationship between connectivity and HA in training (n=73) and testing (n=30) subsamples.

Main Results:

• Greater harm avoidance (HA) was associated with stronger inverse connectivity between the right dorsal anterior cingulate cortex (dACC) and right basolateral amygdala (BLA).
• Stronger positive connectivity between the right ventral anterior insula and left ventral striatum also correlated with greater HA.
• The dACC-BLA connectivity finding was robust to comorbidities and medication and replicated in the independent testing subsample, suggesting trait specificity.

Conclusions:

• Stronger inverse dACC-BLA connectivity is a reliable neural correlate of persistent harm avoidance (HA) across healthy individuals and those with OCD.
• These findings support the relevance of a conserved, cross-species persistent avoidance network to OCD.
• The identified brain-behavior association has implications for developing precision-based interventions and treatments for OCD.