Dynamic functional abnormalities of cerebellar networks in adolescents with obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) commonly begins during adolescence, yet its neurobiological basis remains unclear. Beyond the classical cortico-striatal framework, the cerebellum has been implicated in cognitive, affective, and motor regulation, relevant to OCD. However, it is unknown whether adolescent OCD involves abnormal dynamic coordination of large-scale cerebellar networks.

Thirty-eight adolescents with OCD and 29 matched controls underwent dynamic functional network connectivity (dFNC) analysis of cerebellar networks using a sliding-window approach and k-means clustering. Connectivity states, temporal properties, and the standard deviation of dFNC across sliding windows were quantified and examined in relation to clinical symptoms through exploratory partial correlation analyses.

Compared to healthy controls, adolescents with OCD showed fewer state transitions, indicating reduced network flexibility. They also exhibited lower dFNC variability in networks, including dorsal attention network (DAN)-visual network (VN), DAN-salience network, default mode network (DMN)-VN, and DMN-somatomotor dorsal network connections. Exploratory partial correlation analysis revealed that DAN-VN dFNC variability was negatively correlated with OCI-CV neutralizing scores, whereas DMN-VN dFNC variability was positively correlated with CDI negative mood scores, and CDI total scores.

Adolescent OCD shows reduced intra-cerebellar dynamic connectivity flexibility and variability associated with obsessive-compulsive and depressive symptoms, suggesting impaired cerebellar reconfiguration.