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Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder

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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Characterizing insula functional connectivity alterations in obsessive-compulsive disorder: from parcellation and

Lingxiao Cao^1,2, Hailong Li^1,2, Jiaxin Jiang³

¹Department of Radiology and Huaxi MR Research Center (HMRRC), Institute of Radiology and Medical Imaging, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, China.

Cerebral Cortex (New York, N.Y. : 1991)

|May 22, 2026

Summary

Obsessive-compulsive disorder (OCD) involves altered insula connectivity, particularly in the anterior region, which correlates with symptom severity. This study highlights localized brain changes rather than widespread gradient shifts in OCD patients.

Keywords:

gradient insula obsessive–compulsive disorder resting-state functional connectivity subregion

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Area of Science:

Neuroscience
Psychiatry
Brain Imaging

Background:

The insula is a key brain region integrating sensory, affective, and cognitive functions.
Its complex connectivity patterns are not well understood in obsessive-compulsive disorder (OCD).

Purpose of the Study:

To investigate functional connectivity (FC) alterations within the insula in individuals with OCD.
To differentiate between localized subregional changes and large-scale gradient shifts in insula FC.

Main Methods:

Utilized functional connectivity (FC) analysis in 92 medication-free OCD patients and 90 healthy controls.
Employed discrete parcellation and continuous gradient approaches to analyze insula connectivity.
Performed diagnosis-by-subregion factorial ANOVA to identify group differences.

Main Results:

OCD patients exhibited distinct FC alterations in anterior and posterior insula subregions.
Specifically, increased anterior insula FC and decreased posterior insula FC were observed.
Anterior insula connectivity with the dorsolateral prefrontal cortex negatively correlated with obsession severity.

Conclusions:

Insula FC alterations in OCD are localized to specific subregions, not a global gradient shift.
Anterior insula dysconnectivity is a significant feature of OCD, linked to obsessive symptoms.