Poster No:
378
Submission Type:
Abstract Submission
Authors:
Kiana Bunnell1, Daniela Garcia1, Elijah Baughan1, Michael Ferguson2, Jared Nielsen1
Institutions:
1Brigham Young University, Provo, UT, 2Neurospirituality Lab, Center for Brain Circuit Therapeutics, Boston, MA 02115, USA, Boston, MA
First Author:
Co-Author(s):
Michael Ferguson, Ph.D
Neurospirituality Lab, Center for Brain Circuit Therapeutics, Boston, MA 02115, USA
Boston, MA
Introduction:
Obsessive-compulsive disorder (OCD) is an often-debilitating psychiatric disorder involving a pattern of obsessive thoughts and compensatory compulsions. Attempts at using traditional lesion-symptom mapping to identify a focal lesion location that leads to obsessive-compulsive symptoms have been unsuccessful. Lesion network mapping (LNM), a recent method, can be used to identify those brain regions that are functionally connected to each individual lesion. It is expected that the LNM results from a small cohort of patients with varying manifestations of OCD will align with an accepted model of OCD circuitry-the cortical-striatal-thalamic-cortical (CSTC) circuit.
Methods:
A literature review was conducted to identify case studies with the following sequelae of brain injury: (1) the onset of obsessive-compulsive symptoms (N=9), and (2) the reduction of symptoms in individuals with pre-existing obsessive-compulsive disorder (N=7). Lesions visible in MR images from the case studies were traced onto a template brain and verified by a neurologist. Functional networks for each patient were then generated with their lesion as the seed region, utilizing a large dataset (N=1,000) of resting-state fMRI scans of healthy brains. The individual functional networks were then overlapped to identify brain regions functionally connected to each lesion. See Fox et al. (2018) for more detail.
Results:
The lesion network mapping analyses identified that the lesions from all 9 OCD-onset patients were functionally connected to a localized region of left dorsolateral prefrontal cortex (dlPFC), and 7 of the 9 were connected to bilateral thalamus. All 7 lesions causing relief from OCD symptoms were functionally connected to a highly discrete region of the orbital portion of inferior frontal gyrus (pars orbitalis) in the right hemisphere.
Conclusions:
The OCD-onset LNM results align well with existing cortical-striatal circuitry models of OCD. In particular, these findings are in harmony with the proposed associative circuit of OCD-which links dlPFC, caudate, and thalamus-and is implicated in executive function (e.g., planning) The OCD-relief results also echo existing OCD circuitry models. The right pars orbitalis falls within the proposed sensorimotor circuit that connects anterolateral orbitofrontal cortex, anterior putamen, and thalamus. This CSTC circuit is theorized to be involved with response inhibition and motor preparation.
Disorders of the Nervous System:
Psychiatric (eg. Depression, Anxiety, Schizophrenia) 1
Modeling and Analysis Methods:
Activation (eg. BOLD task-fMRI)
Other Methods 2
Keywords:
FUNCTIONAL MRI
Obessive Compulsive Disorder
Psychiatric Disorders
Other - Lesion Network Mapping (LNM)
1|2Indicates the priority used for review
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Please indicate below if your study was a "resting state" or "task-activation” study.
Task-activation
Healthy subjects only or patients (note that patient studies may also involve healthy subjects):
Patients
Was this research conducted in the United States?
Yes
Are you Internal Review Board (IRB) certified?
Please note: Failure to have IRB, if applicable will lead to automatic rejection of abstract.
Yes, I have IRB or AUCC approval
Were any human subjects research approved by the relevant Institutional Review Board or ethics panel?
NOTE: Any human subjects studies without IRB approval will be automatically rejected.
Yes
Were any animal research approved by the relevant IACUC or other animal research panel?
NOTE: Any animal studies without IACUC approval will be automatically rejected.
Not applicable
Please indicate which methods were used in your research:
Functional MRI
Other, Please specify
-
Lesion Network Mapping (LNM)
For human MRI, what field strength scanner do you use?
3.0T
Which processing packages did you use for your study?
SPM
FSL
Free Surfer
Provide references using APA citation style.
Figee, M., Wielaard, I., Mazaheri, A., & Denys, D. (2013). Neurosurgical targets for
compulsivity: what can we learn from acquired brain lesions?. Neuroscience & Biobehavioral Reviews, 37(3), 328-339. https://doi.org/10.1016/j.neubiorev.2013.01.005
Fox, M. D. (2018). Mapping symptoms to brain networks with the human connectome. New
England Journal of Medicine, 379(23), 2237-2245.
van den Heuvel, O. A., van Wingen, G., Soriano-Mas, C., Alonso, P., Chamberlain, S. R.,
Nakamae, T., ... & Veltman, D. J. (2016). Brain circuitry of compulsivity. European
Neuropsychopharmacology, 26(5), 810-827. https://doi.org/10.1016/j.euroneuro.2015.12.005
No