Dysfunctional Brain Circuits Overlap in Lesional and Idiopathic Obsessive-Compulsive Disorder

Area of Science:

• Neuroscience
• Neurology
• Psychiatry

Background:

• Obsessive-compulsive disorder (OCD) can arise after brain damage, but the precise locations and connections of these lesions remain unclear.
• Understanding lesion patterns is crucial for deciphering the neurobiological underpinnings of OCD.

Purpose of the Study:

• To identify the distribution and connectivity patterns of brain lesions associated with OCD.
• To determine if these patterns relate to known brain networks implicated in primary OCD.

Main Methods:

• A systematic literature search identified cases of OCD with focal brain lesions.
• Connectivity analysis used normative functional connectivity data (N=1000) to map lesion networks.
• OCD-associated lesion networks were compared to control lesions (N=608).

Main Results:

• OCD-associated lesions frequently involved the orbitofrontal cortex and right temporal pole compared to controls.
• A distinct brain network was identified, connected to OCD-associated lesions.
• This network overlapped with areas showing abnormal brain imaging and effective brain stimulation targets in primary OCD.

Conclusions:

• Lesion locations in OCD consistently map to a specific brain network.
• This network is consistent with neuroimaging findings and treatment targets in primary OCD.
• Findings provide a neuroanatomical framework for understanding OCD pathogenesis.