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      Altered Functional Connectivity Between the Cerebellum and the Cortico-Striato-Thalamo-Cortical Circuit in Obsessive-Compulsive Disorder

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          Abstract

          Background: Altered resting-state functional connectivity of the cerebellum in obsessive-compulsive disorder (OCD) has been previously reported. However, the previous study investigating cerebellar–cerebral functional connectivity relied on a priori–defined seeds from specific networks. In this study, we aimed to explore the connectivity alterations of the cerebellum in OCD under resting-state conditions with a hypothesis-free approach.

          Methods: Thirty patients with OCD and 26 healthy controls (HCs) underwent functional magnetic resonance imaging (fMRI) scanning at resting state. Regional cerebral function was evaluated by measuring the fraction of amplitude of low-frequency fluctuation (fALFF). Regions with mean fALFF (mfALFF) alterations were used as seeds in seed correlation analysis (SCA). An independent samples t test was used to compare the differences in mfALFF and functional connection (FC) between the two groups. Pearson correlation analysis was performed to identify the association between functional neural correlates and OCD symptom severity evaluated using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).

          Results: Compared with the HC group, the OCD group showed significantly increased mfALFF values in bilateral cerebellar. The results of FC analysis showed weakened connectivity among the left Crus II, lobule VIII, and right striatum and between the right lobule VIII and the right striatum, and cingulate in the OCD group compared with the HC group. Some of the abovementioned results were associated with symptom severity.

          Conclusions: OCD patients showed abnormal spontaneous cerebellar activity and weakened functional connectivity between the cerebellum and the cortico-striato-thalamo-cortical (CSTC) circuit (striatum and cingulate), suggesting that the cerebellum may play an essential role in the pathophysiology of OCD.

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          Most cited references48

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          Parallel organization of functionally segregated circuits linking basal ganglia and cortex.

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            Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI.

            In children with attention deficit hyperactivity disorder (ADHD), functional neuroimaging studies have revealed abnormalities in various brain regions, including prefrontal-striatal circuit, cerebellum, and brainstem. In the current study, we used a new marker of functional magnetic resonance imaging (fMRI), amplitude of low-frequency (0.01-0.08Hz) fluctuation (ALFF) to investigate the baseline brain function of this disorder. Thirteen boys with ADHD (13.0+/-1.4 years) were examined by resting-state fMRI and compared with age-matched controls. As a result, we found that patients with ADHD had decreased ALFF in the right inferior frontal cortex, [corrected] and bilateral cerebellum and the vermis as well as increased ALFF in the right anterior cingulated cortex, left sensorimotor cortex, and bilateral brainstem. This resting-state fMRI study suggests that the changed spontaneous neuronal activity of these regions may be implicated in the underlying pathophysiology in children with ADHD.
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              The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication.

              Despite significant advances in the study of obsessive-compulsive disorder (OCD), important questions remain about the disorder's public health significance, appropriate diagnostic classification, and clinical heterogeneity. These issues were explored using data from the National Comorbidity Survey Replication, a nationally representative survey of US adults. A subsample of 2073 respondents was assessed for lifetime Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) OCD. More than one quarter of respondents reported experiencing obsessions or compulsions at some time in their lives. While conditional probability of OCD was strongly associated with the number of obsessions and compulsions reported, only small proportions of respondents met full DSM-IV criteria for lifetime (2.3%) or 12-month (1.2%) OCD. OCD is associated with substantial comorbidity, not only with anxiety and mood disorders but also with impulse-control and substance use disorders. Severity of OCD, assessed by an adapted version of the Yale-Brown Obsessive Compulsive Scale, is associated with poor insight, high comorbidity, high role impairment, and high probability of seeking treatment. The high prevalence of subthreshold OCD symptoms may help explain past inconsistencies in prevalence estimates across surveys and suggests that the public health burden of OCD may be greater than its low prevalence implies. Evidence of a preponderance of early onset cases in men, high comorbidity with a wide range of disorders, and reliable associations between disorder severity and key outcomes may have implications for how OCD is classified in DSM-V.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                24 July 2019
                2019
                : 10
                : 522
                Affiliations
                [1] 1The Second Affiliated Hospital of Xinxiang Medical University , Xinxiang, China
                [2] 2Xinxiang Key Laboratory of Multimodal Brain Imaging , Xinxiang, China
                [3] 3School of Psychology, Xinxiang Medical University , Xinxiang, China
                [4] 4Henan Key Lab of Biological Psychiatry of Xinxiang Medical University , Xinxiang, China
                [5] 5International Joint Research Laboratory for Psychiatry and Neuroscience of Henan , Xinxiang, China
                Author notes

                Edited by: Feng Liu, Tianjin Medical University General Hospital, China

                Reviewed by: Hao Yan, Peking University, China; Yiqun Guo, Chongqing University of Posts and Telecommunications, China

                *Correspondence: Haisan Zhang, zhs386@ 123456163.com ; Hongxing Zhang, zhx166666@ 123456163.com

                This article was submitted to Neuroimaging and Stimulation, a section of the journal Frontiers in Psychiatry

                †These authors have contributed equally to this work.

                Article
                10.3389/fpsyt.2019.00522
                6667674
                31396115
                f731decc-4939-41e1-a3b0-76bdf43caada
                Copyright © 2019 Zhang, Wang, Li, Wang, Li, Zhu, Zhao, Yang, Lv, Zhang and Zhang

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 27 December 2018
                : 02 July 2019
                Page count
                Figures: 4, Tables: 3, Equations: 0, References: 65, Pages: 8, Words: 3569
                Funding
                Funded by: National Natural Science Foundation of China 10.13039/501100001809
                Award ID: 31600927, 81071091, 81571315
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                obsessive-compulsive disorder,cerebellum,cortico-striato-thalamo-cortical circuit,functional magnetic resonance imaging,fc

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