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Stable inhibition-related inferior frontal hypoactivation and fronto-limbic hyperconnectivity in obsessive-compulsive disorder after concentrated exposure therapy
NeuroImage: Clinical ( IF 4.2 ) Pub Date : 2020-10-13 , DOI: 10.1016/j.nicl.2020.102460
Anders Lillevik Thorsen 1 , Stella J de Wit 2 , Pernille Hagland 1 , Olga Therese Ousdal 3 , Bjarne Hansen 4 , Kristen Hagen 5 , Gerd Kvale 1 , Odile A van den Heuvel 6
Affiliation  

Response inhibition has previously been suggested as an endophenotype for obsessive-compulsive disorder (OCD), evidenced by studies showing worse task performance, and altered task-related activation and connectivity. However, it’s unclear if these measures change following treatment. In this study, 31 OCD patients and 28 healthy controls performed a stop signal task during 3T functional magnetic resonance imaging before treatment, while 24 OCD patients and 17 healthy controls were rescanned one week and three months after concentrated exposure and response prevention over four consecutive days using Bergen 4-Day Format. To study changes over time we performed a longitudinal analysis on stop signal reaction time and task-related activation and amygdala connectivity during successful and failed inhibition. Results showed that there was no group difference in task performance. Before treatment, OCD patients compared to controls showed less inhibition-related activation in the right inferior frontal gyrus, and increased functional connectivity between the right amygdala and the right inferior frontal gyrus and pre-supplementary motor area. During error-processing, OCD patients versus controls showed less activation in the pre-SMA before treatment. These group differences did not change after treatment. Pre-treatment task performance, brain activation, and connectivity were unrelated to the degree of symptom improvement after treatment. In conclusion, inferior frontal gyrus hypoactivation and increased fronto-limbic connectivity are likely trait markers of OCD that remain after effective exposure therapy.



中文翻译:

集中暴露疗法后强迫症中稳定的抑制相关的下部额叶下激活和额叶边缘性过度连接

响应抑制以前被认为是强迫症的内表型,研究表明,任务表现较差,与任务相关的激活和连通性发生了改变,从而证明了反应抑制。但是,目前尚不清楚这些措施在治疗后是否会改变。在这项研究中,有31名强迫症患者和28名健康对照者在治疗前进行3T功能磁共振成像期间执行了停止信号任务,而24次强迫症患者和17名健康对照者在集中暴露和连续4天预防反应后一周和三个月进行了重新扫描使用卑尔根4天格式。为了研究随时间的变化,我们对成功和失败抑制期间停止信号反应时间以及与任务相关的激活和杏仁核连接性进行了纵向分析。结果表明,任务绩效没有群体差异。在治疗前,与对照组相比,强迫症患者在右下额回中的抑制相关激活较少,并且右杏仁核和右下额回与补充运动前区之间的功能连接性增加。在错误处理期间,OCD患者与对照组的患者在治疗前在SMA前激活较少。这些群体差异在治疗后没有改变。治疗前的任务表现,大脑激活和连接性与治疗后症状改善的程度无关。总之,额下回活动不足和额-边缘连接性增加可能是有效暴露治疗后OCD的特征标记。与对照组相比,OCD患者在右下额回中抑制相关的激活较少,并且右杏仁核和右下额回与补充运动前区之间的功能连接性增加。在错误处理期间,OCD患者与对照组的患者在治疗前在SMA前激活较少。这些群体差异在治疗后没有改变。治疗前的任务表现,大脑激活和连接性与治疗后症状改善的程度无关。总之,在有效的暴露治疗后,额下回活动不足和额-缘连接性增加可能是强迫症的特征标志。与对照组相比,OCD患者在右下额回中抑制相关的激活较少,并且右杏仁核和右下额回与补充运动前区之间的功能连接性增加。在错误处理期间,OCD患者与对照组的患者在治疗前的SMA前激活较少。这些群体差异在治疗后没有改变。治疗前的任务表现,大脑激活和连接性与治疗后症状改善的程度无关。总之,在有效的暴露治疗后,额下回活动不足和额-缘连接性增加可能是强迫症的特征标志。以及右侧杏仁核与右侧下额回和辅助运动区之间的功能连接性增加。在错误处理期间,OCD患者与对照组的患者在治疗前在SMA前激活较少。这些群体差异在治疗后没有改变。治疗前的任务表现,大脑激活和连接性与治疗后症状改善的程度无关。总之,在有效的暴露治疗后,额下回活动不足和额-缘连接性增加可能是强迫症的特征标志。以及右侧杏仁核和右侧下额回和辅助运动区之间的功能连接性增加。在错误处理期间,OCD患者与对照组的患者在治疗前在SMA前激活较少。这些群体差异在治疗后没有改变。治疗前的任务表现,大脑激活和连接性与治疗后症状改善的程度无关。总之,在有效的暴露治疗后,额下回活动不足和额-缘连接性增加可能是强迫症的特征标志。这些群体差异在治疗后没有改变。治疗前的任务表现,大脑激活和连接性与治疗后症状改善的程度无关。总之,在有效的暴露治疗后,额下回活动不足和额-缘连接性增加可能是强迫症的特征标志。这些群体差异在治疗后没有改变。治疗前的任务表现,大脑激活和连接性与治疗后症状改善的程度无关。总之,额下回活动不足和额-边缘连接性增加可能是有效暴露治疗后OCD的特征标记。

更新日期:2020-10-13
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