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. 2011 Sep;50(9):938-948.e3.
doi: 10.1016/j.jaac.2011.06.011. Epub 2011 Jul 31.

Developmental alterations of frontal-striatal-thalamic connectivity in obsessive-compulsive disorder

Kate Dimond Fitzgerald  1 , Robert C Welsh, Emily R Stern, Mike Angstadt, Gregory L Hanna, James L Abelson, Stephan F Taylor
Affiliations

Developmental alterations of frontal-striatal-thalamic connectivity in obsessive-compulsive disorder

Kate Dimond Fitzgerald et al. J Am Acad Child Adolesc Psychiatry. 2011 Sep.

Abstract

Objective: Pediatric obsessive-compulsive disorder is characterized by abnormalities of frontal-striatal-thalamic circuitry that appear near illness onset and persist over its course. Distinct frontal-striatal-thalamic loops through cortical centers for cognitive control (anterior cingulate cortex) and emotion processing (ventral medial frontal cortex) follow unique maturational trajectories, and altered connectivity within distinct loops may be differentially associated with OCD at specific stages of development.

Method: Altered development of striatal and thalamic connectivity to medial frontal cortex was tested in 60 OCD patients compared with 61 healthy control subjects at child, adolescent, and adult stages of development, using resting-state functional connectivity MRI.

Results: OCD in the youngest patients was associated with reduced connectivity of dorsal striatum and medial dorsal thalamus to rostral and dorsal anterior cingulate cortex, respectively. Increased connectivity of dorsal striatum to ventral medial frontal cortex was observed in patients at all developmental stages. In child patients, reduced connectivity between dorsal striatum and rostral anterior cingulate cortex correlated with OCD severity.

Conclusions: Frontal-striatal-thalamic loops involved in cognitive control are hypoconnected in young patients near illness onset, whereas loops implicated in emotion processing are hyperconnected throughout the illness.

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Figures

Figure 1
Figure 1
Striatal and thalamic seed placement (column 1) are shown next to functional connectivity maps for healthy control (HC, column 2) and obsessive compulsive disorder (OCD, column 3) subjects for each seed: ventral striatum (A), dorsal striatum (B) and medial thalamus (C). Note: Displayed in standard neuroanatomical space (Montreal Neurological Institute) at a threshold of pFDR < .05, whole brain corrected.
Figure 2
Figure 2
A group effect for left dorsal striatum (A, column 1) connectivity with rostral anterior cingulate cortex (rACC; A, column 2) was driven by reduced connectivity in obsessive compulsive disorder patients (OCD) compared to healthy controls (HC). Note: A group × age interaction was also observed for left dorsal striatal connectivity to nearby region of the rostral anterior cingulate cortex (A, column 3), driven by reduced connectivity in the youngest patients to matched controls (B). Left dorsal striatal connectivity to rostral anterior cingulate cortex inversely correlated with symptom severity in child patients (C). Group differences and group × age interactions displayed in standard neuroanatomical space (Montreal Neurological Institute) at a threshold of p < .005, uncorrected. CYBOCS P: Children's Yale-Brown Obsessive Compulsive Scale, Present score.
Figure 3
Figure 3
For the right medial thalamus (A, column 1), a group × age interaction on connectivity with dorsal anterior cingulate cortex (dACC; A, column 2) was driven by reduced connectivity in the child obsessive compulsive disorder patients (OCD) compared to child healthy controls (HC; A, column 3). Note: For the left medial thalamus (B, column 1) a group × age interaction on connectivity with left dorsal anterior cingulate cortex (B, column 2) was driven by reduced connectivity in child patients, but increased connectivity in adolescent patients compared to matched healthy controls (B, column 3). Group × age interactions displayed in standard neuroanatomical space (Montreal Neurological Institute) at a threshold of p < .005, uncorrected.
Figure 4
Figure 4
A group effect for right dorsal striatum connectivity to medial frontal pole was driven by increased connectivity for obsessive compulsive disorder patients (OCD) compared to healthy controls (HC). Note: Group differences and group × age interactions displayed in standard neuroanatomical space (Montreal Neurological Institute) at a threshold of p < .005, uncorrected.
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