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Altered functional connectivity of the subthalamus and the bed nucleus of the stria terminalis in obsessive–compulsive disorder

Published online by Cambridge University Press:  22 August 2017

M. Cano ,
P. Alonso ,
I. Martínez-Zalacaín ,
M. Subirà ,
E. Real ,
C. Segalàs ,
J. Pujol ,
N. Cardoner ,
J. M. Menchón  and
C. Soriano-Mas
M. Cano
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain CIBERSAM, Carlos III Health Institute, Madrid, Spain
P. Alonso
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain CIBERSAM, Carlos III Health Institute, Madrid, Spain
I. Martínez-Zalacaín
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
M. Subirà
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain CIBERSAM, Carlos III Health Institute, Madrid, Spain
E. Real
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain CIBERSAM, Carlos III Health Institute, Madrid, Spain
C. Segalàs
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain CIBERSAM, Carlos III Health Institute, Madrid, Spain
J. Pujol
Affiliation:
CIBERSAM, Carlos III Health Institute, Madrid, Spain MRI Research Unit, Radiology Department, Hospital del Mar, Barcelona, Spain
N. Cardoner
Affiliation:
CIBERSAM, Carlos III Health Institute, Madrid, Spain Mental Health Department, Parc Taulí Sabadell, I3PT, Barcelona, Spain Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
J. M. Menchón
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain CIBERSAM, Carlos III Health Institute, Madrid, Spain
C. Soriano-Mas*
Affiliation:
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain CIBERSAM, Carlos III Health Institute, Madrid, Spain Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
*
*Address for correspondence: C. Soriano-Mas, Ph.D., Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain. (Email: [email protected])
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Abstract

Background

The assessment of inter-regional functional connectivity (FC) has allowed for the description of the putative mechanism of action of treatments such as deep brain stimulation (DBS) of the nucleus accumbens in patients with obsessive–compulsive disorder (OCD). Nevertheless, the possible FC alterations of other clinically-effective DBS targets have not been explored. Here we evaluated the FC patterns of the subthalamic nucleus (STN) and the bed nucleus of the stria terminalis (BNST) in patients with OCD, as well as their association with symptom severity.

Methods

Eighty-six patients with OCD and 104 healthy participants were recruited. A resting-state image was acquired for each participant and a seed-based analysis focused on our two regions of interest was performed using statistical parametric mapping software (SPM8). Between-group differences in FC patterns were assessed with two-sample t test models, while the association between symptom severity and FC patterns was assessed with multiple regression analyses.

Results

In comparison with controls, patients with OCD showed: (1) increased FC between the left STN and the right pre-motor cortex, (2) decreased FC between the right STN and the lenticular nuclei, and (3) increased FC between the left BNST and the right frontopolar cortex. Multiple regression analyses revealed a negative association between clinical severity and FC between the right STN and lenticular nucleus.

Conclusions

This study provides a neurobiological framework to understand the mechanism of action of DBS on the STN and the BNST, which seems to involve brain circuits related with motor response inhibition and anxiety control, respectively.

Keywords

Functional connectivityobsessive-compulsive disordersubthalamic nucleus and bed nucleus of the stria terminalis
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 6 , April 2018 , pp. 919 - 928
Copyright
Copyright © Cambridge University Press 2017 

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