OBJECTIVE Foundational knowledge on neural circuitry underlying pediatric obsessive-compulsive disorder (OCD) and how it changes during standard treatment is needed to provide the basis for conceptualization and development of novel targeted treatments. This study explored the effects of sertraline, a selective serotonin reuptake inhibitor, on resting-state functional connectivity in cortico-striatal-thalamic-cortical circuits in pediatric OCD. METHOD Medication-free youths with OCD (n = 14) and healthy controls (n = 14) were examined at baseline and 12 weeks with resting-state functional magnetic resonance imaging. Between scan sessions, participants with OCD received 12 weeks of sertraline. For each scan, seed-based whole-brain resting-state functional connectivity analyses were conducted with 6 striatal seeds. Analysis of variance examined the interaction between group and time on striatal connectivity, including cluster-based thresholding to correct for multiple tests. Connectivity changes within circuits identified in group analyses were correlated with clinical change. RESULTS Two significant group-by-time effects in the OCD group showed increased striatal connectivity from baseline to 12 weeks compared with controls. Circuits demonstrating this pattern included the right putamen with the left frontal cortex and insula and the left putamen with the left frontal cortex and pre- and post-central cortices. Increase in connectivity in the left putamen circuit was significantly correlated with clinical improvement on the Children's Yale-Brown Obsessive-Compulsive Scale score (r = -0.58, p = .03). CONCLUSION Sertraline appears to affect specific striatal-based circuits in pediatric OCD, and these changes in part could account for clinical improvement. Future work is needed to confirm these preliminary findings, which would facilitate identification of circuit-based targets for novel treatment development. CLINICAL TRIAL REGISTRATION INFORMATION Effects of Sertraline on Brain Connectivity in Adolescents with OCD; https://clinicaltrials.gov/; NCT02797808.

中文翻译：

---

舍曲林对患有强迫症的年轻人纹状体静息状态功能连接的影响：一项初步研究。

目的需要有关小儿强迫症（OCD）的神经回路及其在标准治疗期间如何变化的基础知识，以为概念化和开发新型靶向治疗提供基础。这项研究探讨了舍曲林（一种选择性的5-羟色胺再摄取抑制剂）对小儿强迫症中皮质-纹状体-丘脑-皮质回路中静止状态功能连通性的影响。方法在基线和第12周时，采用静息状态功能磁共振成像检查了无药物治疗的强迫症（n = 14）和健康对照（n = 14）的青年。在两次扫描之间，患有强迫症的参与者接受了12周的舍曲林治疗。对于每次扫描，均使用6种纹状体种子进行了基于种子的全脑静止状态功能连接性分析。方差分析检查了组和时间在纹状体连通性上的相互作用，包括基于聚类的阈值校正多个测试。在组分析中确定的电路内的连通性变化与临床变化相关。结果在强迫症组中，有两个显着的按时间分组的影响，与对照组相比，从基线到12周的纹状体连通性增加。表现出这种模式的回路包括右额叶核和左额叶皮层和岛突，左额叶核和左额叶皮层以及中枢皮层和中央后皮层。儿童耶鲁-布朗强迫症量表评分的改善与左壳核回路的连接性显着相关（r = -0.58，p = .03）。结论舍曲林似乎影响小儿强迫症中特定的基于纹状体的回路，这些变化部分可解释临床改善。需要进一步的工作来确认这些初步发现，这将有助于为新治疗方法的开发确定基于回路的靶标。临床试验注册信息舍曲林对OCD青少年大脑连接性的影响；https://clinicaltrials.gov/; NCT02797808。//clinicaltrials.gov/ ;; NCT02797808。//clinicaltrials.gov/ ;; NCT02797808。