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BMC Psychiatry
Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Altered intrinsic insular activity predicts symptom severity in unmedicated obsessive-compulsive disorder patients: a resting state functional magnetic resonance imaging study

Authors: Yajing Zhu, Qing Fan, Haiyin Zhang, Jianyin Qiu, Ling Tan, Zeping Xiao, Shanbao Tong, Jue Chen, Yao Li

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Previous neuroimaging data indicated that the dysfunction in cortico-striato-thalamo-cortical (CSTC) circuit contributed to the neuropathological mechanism of obsessive-compulsive disorder (OCD). Whereas, emerging work has shown that the pathophysiology of OCD might be related to more widely distributed large-scale brain systems including limbic system and the salience network. This study aims to investigate the aberrant spontaneous neuronal activity within the whole brain, and its association with the symptom severity for unmedicated OCD patients.

Method

Twenty-eight unmedicated OCD adults and twenty-eight matched healthy controls were recruited for a resting state functional magnetic resonance imaging (fMRI) study. The amplitude of low-frequency fluctuation (ALFF) analysis over whole brain was performed to examine the intrinsic cerebral activity of subjects. In addition, we conducted the voxel-based Pearson’s correlative analysis to probe into the relationship between ALFF values and symptom severity for OCD patients.

Results

Our results showed that OCD patients had increased ALFF measures in the left frontopolar cortex and left orbital frontal cortex (OFC), with decreased ALFF values in the right insula. Moreover, the right insular intrinsic activity was significantly correlated with total YBOCS score (r = 0.611, p = 0.002) and compulsion score (r = 0.640, p = 0.001) for OCD patients.

Conclusion

The results showed abnormal intrinsic neuronal activity within CSTC circuit and salience network of OCD patients. Our finding of aberrant insular activity advanced the understanding of OCD pathophysiology beyond the traditional CSTC circuit. To the best of our knowledge, it is the first finding about a reduced insular activity at the resting state for unmedicated OCD patients, which might serve as an informative biomarker for OCD pathophysiology.
Literature
1.
Calkins AW, Berman NC, Wilhelm S. Recent advances in research on cognition and emotion in OCD: a review. Curr Psychiatry Rep. 2013;15(5):1–7.CrossRef
2.
Yoldascan E, Ozenli Y, Kutlu O, Topal K, Bozkurt AI. Prevalence of obsessive-compulsive disorder in Turkish university students and assessment of associated factors. BMC Psychiatry. 2009;9(1):40.CrossRefPubMedPubMedCentral
3.
Pauls DL, Abramovitch A, Rauch SL, Geller DA. Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective. Nat Rev Neurosci. 2014;15(6):410–24.CrossRefPubMed
4.
Saxena S, Rauch SL. Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Psychiatr Clin N Am. 2000;23(3):563–86.CrossRef
5.
Rotge J-Y, Guehl D, Dilharreguy B, Tignol J, Bioulac B, Allard M, Burbaud P, Aouizerate B. Meta-analysis of brain volume changes in obsessive-compulsive disorder. Biol Psychiatry. 2009;65(1):75–83.CrossRefPubMed
6.
Nakao T, Nakagawa A, Yoshiura T, Nakatani E, Nabeyama M, Yoshizato C, Kudoh A, Tada K, Yoshioka K, Kawamoto M. Brain activation of patients with obsessive-compulsive disorder during neuropsychological and symptom provocation tasks before and after symptom improvement: a functional magnetic resonance imaging study. Biol Psychiatry. 2005;57(8):901–10.CrossRefPubMed
7.
Simon D, Adler N, Kaufmann C, Kathmann N. Amygdala hyperactivation during symptom provocation in obsessive–compulsive disorder and its modulation by distraction. NeuroImage Clin. 2014;4:549–57.CrossRefPubMedPubMedCentral
8.
Britton JC, Stewart SE, Killgore WD, Rosso IM, Price LM, Gold AL, Pine DS, Wilhelm S, Jenike MA, Rauch SL. Amygdala activation in response to facial expressions in pediatric obsessive–compulsive disorder. Depress Anxiety. 2010;27(7):643–51.CrossRefPubMedPubMedCentral
9.
Glahn A, Prell T, Grosskreutz J, Peschel T, Müller-Vahl KR. Obsessive-compulsive disorder is a heterogeneous disorder: evidence from diffusion tensor imaging and magnetization transfer imaging. BMC Psychiatry. 2015;15(1):135.CrossRefPubMedPubMedCentral
10.
Seeley WW, Menon V, Schatzberg AF, Keller J, Glover GH, Kenna H, Reiss AL, Greicius MD. Dissociable intrinsic connectivity networks for salience processing and executive control. J Neurosci. 2007;27(9):2349–56.CrossRefPubMedPubMedCentral
11.
Jung WH, Kang D-H, Kim E, Shin KS, Jang JH, Kwon JS. Abnormal corticostriatal-limbic functional connectivity in obsessive–compulsive disorder during reward processing and resting-state. NeuroImage Clin. 2013;3:27–38.CrossRefPubMedPubMedCentral
12.
Harrison BJ, Pujol J, Cardoner N, Deus J, Alonso P, López-Solà M, Contreras-Rodríguez O, Real E, Segalàs C, Blanco-Hinojo L. Brain corticostriatal systems and the major clinical symptom dimensions of obsessive-compulsive disorder. Biol Psychiatry. 2013;73(4):321–8.CrossRefPubMed
13.
Shapira NA, Liu Y, He AG, Bradley MM, Lessig MC, James GA, Stein DJ, Lang PJ, Goodman WK. Brain activation by disgust-inducing pictures in obsessive-compulsive disorder. Biol Psychiatry. 2003;54(7):751–6.CrossRefPubMed
14.
Stern ER, Welsh RC, Fitzgerald KD, Gehring WJ, Lister JJ, Himle JA, Abelson JL, Taylor SF. Hyperactive error responses and altered connectivity in ventromedial and frontoinsular cortices in obsessive-compulsive disorder. Biol Psychiatry. 2011;69(6):583–91.CrossRefPubMedPubMedCentral
15.
Remijnse PL, Nielen MM, van Balkom AJ, Cath DC, van Oppen P, Uylings HB, Veltman DJ. Reduced orbitofrontal-striatal activity on a reversal learning task in obsessive-compulsive disorder. Arch Gen Psychiatry. 2006;63(11):1225–36.CrossRefPubMed
16.
Fox MD, Snyder AZ, Vincent JL, Corbetta M, Van Essen DC, Raichle ME. The human brain is intrinsically organized into dynamic, anticorrelated functional networks. Proc Natl Acad Sci U S A. 2005;102(27):9673–8.CrossRefPubMedPubMedCentral
17.
Biswal B, Yetkin FZ, Haughton VM, Hyde JS. Functional connectivity in the motor cortex of resting human brain using echo-planar MRI. Magn Reson Med. 1995;34(4):537–41.CrossRefPubMed
18.
Fitzgerald KD, Welsh RC, Stern ER, Angstadt M, Hanna GL, Abelson JL, Taylor SF. Developmental alterations of frontal-striatal-thalamic connectivity in obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry. 2011;50(9):938–48. e933.CrossRefPubMedPubMedCentral
19.
Jang JH, Kim J-H, Jung WH, Choi J-S, Jung MH, Lee J-M, Choi C-H, Kang D-H, Kwon JS. Functional connectivity in fronto-subcortical circuitry during the resting state in obsessive-compulsive disorder. Neurosci Lett. 2010;474(3):158–62.CrossRefPubMed
20.
Sakai Y, Narumoto J, Nishida S, Nakamae T, Yamada K, Nishimura T, Fukui K. Corticostriatal functional connectivity in non-medicated patients with obsessive-compulsive disorder. Eur Psychiatry. 2011;26(7):463–9.CrossRefPubMed
21.
Harrison BJ, Soriano-Mas C, Pujol J, Ortiz H, López-Solà M, Hernández-Ribas R, Deus J, Alonso P, Yücel M, Pantelis C. Altered corticostriatal functional connectivity in obsessive-compulsive disorder. Arch Gen Psychiatry. 2009;66(11):1189–200.CrossRefPubMed
22.
Fox MD, Raichle ME. Spontaneous fluctuations in brain activity observed with functional magnetic resonance imaging. Nat Rev Neurosci. 2007;8(9):700–11.CrossRefPubMed
23.
Zou Q-H, Zhu C-Z, Yang Y, Zuo X-N, Long X-Y, Cao Q-J, Wang Y-F, Zang Y-F. An improved approach to detection of amplitude of low-frequency fluctuation (ALFF) for resting-state fMRI: fractional ALFF. J Neurosci Methods. 2008;172(1):137–41.CrossRefPubMedPubMedCentral
24.
Hoptman MJ, Zuo X-N, Butler PD, Javitt DC, D'Angelo D, Mauro CJ, Milham MP. Amplitude of low-frequency oscillations in schizophrenia: a resting state fMRI study. Schizophr Res. 2010;117(1):13–20.CrossRefPubMedPubMedCentral
25.
Liu F, Guo W, Liu L, Long Z, Ma C, Xue Z, Wang Y, Li J, Hu M, Zhang J. Abnormal amplitude low-frequency oscillations in medication-naive, first-episode patients with major depressive disorder: a resting-state fMRI study. J Affect Disord. 2013;146(3):401–6.CrossRefPubMed
26.
Cui Y, Jin Z, Chen X, He Y, Liang X, Zheng Y. Abnormal baseline brain activity in drug-naïve patients with Tourette syndrome: a resting-state fMRI study. Front Hum Neurosci. 2013;7:913.PubMedCentral
27.
Hou J, Wu W, Lin Y, Wang J, Zhou D, Guo J, Gu S, He M, Ahmed S, Hu J. Localization of cerebral functional deficits in patients with obsessive–compulsive disorder: a resting-state fMRI study. J Affect Disord. 2012;138(3):313–21.CrossRefPubMed
28.
Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS. The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006–11.CrossRefPubMed
29.
Chao-Gan Y, Yu-Feng Z. DPARSF: a MATLAB toolbox for “pipeline” data analysis of resting-state fMRI. Front Syst Neurosci. 2010;4:13.PubMedPubMedCentral
30.
Friston KJ, Frith CD, Frackowiak RS, Turner R. Characterizing dynamic brain responses with fMRI: a multivariate approach. Neuroimage. 1995;2(2PA):166–72.CrossRefPubMed
31.
Yu-Feng Z, Yong H, Chao-Zhe Z, Qing-Jiu C, Man-Qiu S, Meng L, Li-Xia T, Tian-Zi J, Yu-Feng W. Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI. Brain Dev. 2007;29(2):83–91.CrossRef
32.
33.
Ledberg A, Åkerman S, Roland PE. Estimation of the probabilities of 3D clusters in functional brain images. Neuroimage. 1998;8(2):113–28.CrossRefPubMed
34.
Cox RW. AFNI: software for analysis and visualization of functional magnetic resonance neuroimages. Comput Biomed Res. 1996;29(3):162–73.CrossRefPubMed
35.
Nishida S, Narumoto J, Sakai Y, Matsuoka T, Nakamae T, Yamada K, Nishimura T, Fukui K. Anterior insular volume is larger in patients with obsessive–compulsive disorder. Prog Neuro-Psychopharmacol Biol Psychiatry. 2011;35(4):997–1001.CrossRef
36.
Kim J-J, Lee MC, Kim J, Kim IY, Kim SI, Han MH, Chang K-H, Kwon JS. Grey matter abnormalities in obsessive—compulsive disorder. Br J Psychiatry. 2001;179(4):330–4.CrossRefPubMed
37.
Yoo SY, Roh M-S, Choi J-S, Kang D-H, Ha TH, Lee J-M, Kim IY, Kim SI, Kwon JS. Voxel-based morphometry study of gray matter abnormalities in obsessive-compulsive disorder. J Korean Med Sci. 2008;23(1):24–30.CrossRefPubMedPubMedCentral
38.
Starck G, Ljungberg M, Nilsson M, Jonsson L, Lundberg S, Ivarsson T, Ribbelin S, Ekholm S, Carlsson A, Forssell-Aronsson E, et al. A 1H magnetic resonance spectroscopy study in adults with obsessive compulsive disorder: relationship between metabolite concentrations and symptom severity. J Neural Transm. 2008;115(7):1051–62.CrossRefPubMed
39.
Stern ER, Fitzgerald KD, Welsh RC, Abelson JL, Taylor SF. Resting-state functional connectivity between fronto-parietal and default mode networks in obsessive-compulsive disorder. PLoS One. 2012;7(5):e36356.CrossRefPubMedPubMedCentral
40.
Burgess PW, Dumontheil I, Gilbert SJ. The gateway hypothesis of rostral prefrontal cortex (area 10) function. Trends Cogn Sci. 2007;11(7):290–8.CrossRefPubMed
41.
Rauch SL, Shin LM, Dougherty DD, Alpert NM, Fischman AJ, Jenike MA. Predictors of fluvoxamine response in contamination-related obsessive compulsive disorder: a PET symptom provocation study. Neuropsychopharmacology. 2002;27(5):782–91.CrossRefPubMed
42.
Kwon JS, Kim J-J, Lee DW, Lee JS, Lee DS, Kim M-S, Lyoo IK, Cho MJ, Lee MC. Neural correlates of clinical symptoms and cognitive dysfunctions in obsessive–compulsive disorder. Psychiatry Res Neuroimaging. 2003;122(1):37–47.CrossRefPubMed
43.
den Braber A, van't Ent D, Blokland GA, van Grootheest DS, Cath DC, Veltman DJ, De Ruiter MB, Boomsma DI. An fMRI study in monozygotic twins discordant for obsessive–compulsive symptoms. Biol Psychol. 2008;79(1):91–102.CrossRef
44.
Posner J, Marsh R, Maia TV, Peterson BS, Gruber A, Simpson HB. Reduced functional connectivity within the limbic cortico‐striato‐thalamo‐cortical loop in unmedicated adults with obsessive‐compulsive disorder. Hum Brain Mapp. 2014;35(6):2852–60.CrossRefPubMedPubMedCentral
45.
Milad MR, Rauch SL. Obsessive-compulsive disorder: beyond segregated cortico-striatal pathways. Trends Cogn Sci. 2012;16(1):43–51.CrossRefPubMed
46.
Piras F, Piras F, Chiapponi C, Girardi P, Caltagirone C, Spalletta G. Widespread structural brain changes in OCD: a systematic review of voxel-based morphometry studies. Cortex. 2015;62:89–108.CrossRefPubMed
47.
Whiteside SP, Port JD, Abramowitz JS. A meta–analysis of functional neuroimaging in obsessive–compulsive disorder. Psychiatry Res Neuroimaging. 2004;132(1):69–79.CrossRefPubMed
48.
Maltby N, Tolin DF, Worhunsky P, O'Keefe TM, Kiehl KA. Dysfunctional action monitoring hyperactivates frontal–striatal circuits in obsessive–compulsive disorder: an event-related fMRI study. Neuroimage. 2005;24(2):495–503.CrossRefPubMed
49.
Rauch SL, Wedig MM, Wright CI, Martis B, McMullin KG, Shin LM, Cannistraro PA, Wilhelm S. Functional magnetic resonance imaging study of regional brain activation during implicit sequence learning in obsessive–compulsive disorder. Biol Psychiatry. 2007;61(3):330–6.CrossRefPubMed
50.
Baxter LR. Basal ganglia systems in ritualistic social displays: reptiles and humans; function and illness. Physiol Behav. 2003;79(3):451–60.CrossRefPubMed
Metadata
Title
Altered intrinsic insular activity predicts symptom severity in unmedicated obsessive-compulsive disorder patients: a resting state functional magnetic resonance imaging study
Authors
Yajing Zhu
Qing Fan
Haiyin Zhang
Jianyin Qiu
Ling Tan
Zeping Xiao
Shanbao Tong
Jue Chen
Yao Li
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0806-9

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