Article

Developmental Alterations of Frontal-Striatal-Thalamic Connectivity in Obsessive-Compulsive Disorder

University of Michigan Medical School, MI, USA.
Journal of the American Academy of Child and Adolescent Psychiatry (Impact Factor: 6.35). 09/2011; 50(9):938-948.e3. DOI: 10.1016/j.jaac.2011.06.011
Source: PubMed

ABSTRACT Pediatric obsessive-compulsive disorder is characterized by abnormalities of frontal-striatal-thalamic circuitry that appear near illness onset and persist over its course. Distinct frontal-striatal-thalamic loops through cortical centers for cognitive control (anterior cingulate cortex) and emotion processing (ventral medial frontal cortex) follow unique maturational trajectories, and altered connectivity within distinct loops may be differentially associated with OCD at specific stages of development.
Altered development of striatal and thalamic connectivity to medial frontal cortex was tested in 60 OCD patients compared with 61 healthy control subjects at child, adolescent, and adult stages of development, using resting-state functional connectivity MRI.
OCD in the youngest patients was associated with reduced connectivity of dorsal striatum and medial dorsal thalamus to rostral and dorsal anterior cingulate cortex, respectively. Increased connectivity of dorsal striatum to ventral medial frontal cortex was observed in patients at all developmental stages. In child patients, reduced connectivity between dorsal striatum and rostral anterior cingulate cortex correlated with OCD severity.
Frontal-striatal-thalamic loops involved in cognitive control are hypoconnected in young patients near illness onset, whereas loops implicated in emotion processing are hyperconnected throughout the illness.

1 Follower
 · 
174 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The inconsistent nature of the neuropsychology literature pertaining to obsessive-compulsive disorder (OCD) has long been recognized. However, individual studies, systematic reviews, and recent meta-analytic reviews were unsuccessful in establishing a consensus regarding a disorder-specific neuropsychological profile. In an attempt to identify methodological factors that may contribute to the inconsistency that is characteristic of this body of research, a systematic review of methodological factors in studies comparing OCD patients and non-psychiatric controls on neuropsychological tests was conducted. This review covered 115 studies that included nearly 3500 patients. Results revealed a range of methodological weaknesses. Some of these weaknesses have been previously noted in the broader neuropsychological literature, while some are more specific to psychiatric disorders, and to OCD. These methodological shortcomings have the potential to hinder the identification of a specific neuropsychological profile associated with OCD as well as to obscure the association between neurocognitive dysfunctions and contemporary neurobiological models. Rectifying these weaknesses may facilitate replicability, and promote our ability to extract cogent, meaningful, and more unified inferences regarding the neuropsychology of OCD. To that end, we present a set of methodological recommendations to facilitate future neuropsychology research in psychiatric disorders in general, and in OCD in particular. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research 04/2015; DOI:10.1016/j.psychres.2015.04.025 · 2.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Retrospective reports have consistently demonstrated that many psychiatric disorders have their onset in childhood and adolescence. Childhood onset symptomology typically exhibits a chronic, unremitting course and is related to adverse social, psychological and physical health outcomes. Whilst treatment programs in adulthood aim to reconstruct dysfunctional patterns of behaviors established and maintained over years of experience, early childhood interventions promote healthy beliefs at an age where individuals are more adaptable. This article will provide a rationale for the development and promotion of prevention programs for preschool-aged children by reviewing the prevalence and outcomes of early onset symptomology. This will be followed by an overview of the factors required to develop a framework for prevention programs including risk factors and strengths of preschool-aged children, levels of prevention, and intervention settings. Three commonly utilized treatment approaches will be reviewed prior to the introduction of a proposed model of prevention for working with preschool-aged children. The article concludes with discussion of challenges in prevention research and future directions.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Brain network dysfunction is emerging as a central biomarker of interest in psychiatry, in large part, because psychiatric conditions are increasingly seen as disconnection syndromes. Understanding dysfunctional brain network profiles in task-active states provides important information on network engagement in an experimental context. This in turn may be predictive of many of the cognitive and behavioral deficits associated with complex behavioral phenotypes. Here we investigated brain network profiles in youth with obsessive-compulsive disorder (OCD), contrasting them with a group of age-comparable controls. Network interactions were assessed during simple working memory: in particular, we focused on the modulation by the dorsal anterior cingulate cortex (dACC) of cortical, striatal, and thalamic regions. The focus on the dACC was motivated by its hypothesized role in the pathophysiology of OCD. However, its task-active network signatures have not been investigated before. Network interactions were modeled using psychophysiological interaction, a simple directional model of seed to target brain interactions. Our results indicate that OCD is characterized by significantly increased dACC modulation of cortical, striatal, and thalamic targets during working memory, and that this aberrant increase in OCD patients is maintained regardless of working memory demand. The results constitute compelling evidence of dysfunctional brain network interactions in OCD and suggest that these interactions may be related to a combination of network inefficiencies and dACC hyper-activity that has been associated with the phenotype.
    Frontiers in Human Neuroscience 03/2015; 9:149. DOI:10.3389/fnhum.2015.00149 · 2.90 Impact Factor