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. 2020 Nov 25;20(1):559.
doi: 10.1186/s12888-020-02913-5.

Multi-level assessment of obsessive-compulsive disorder (OCD) reveals relations between neural and neurochemical levels

Kathrin Viol  1   2 , Günter Schiepek  3   4   5 , Martin Kronbichler  6   7 , Arnulf Hartl  8 , Carina Grafetstätter  8 , Peter Strasser  9 , Anna Kastinger  1   2 , Helmut Schöller  1   2 , Eva-Maria Reiter  10 , Sarah Said-Yürekli  6   7   11 , Lisa Kronbichler  6   7 , Brigitte Kravanja-Spannberger  2 , Barbara Stöger-Schmidinger  2 , Marc-Thorsten Hütt  12 , Wolfgang Aichhorn  1   2 , Benjamin Aas  13   14
Affiliations

Multi-level assessment of obsessive-compulsive disorder (OCD) reveals relations between neural and neurochemical levels

Kathrin Viol et al. BMC Psychiatry. .

Abstract

Background: While considerable progress has been made in exploring the psychological, the neural, and the neurochemical dimensions of OCD separately, their interplay is still an open question, especially their changes during psychotherapy.

Methods: Seventeen patients were assessed at these three levels by psychological questionnaires, fMRI, and venipuncture before and after inpatient psychotherapy. Seventeen controls were scanned at comparable time intervals. First, pre/post treatment changes were investigated for all three levels separately: symptom severity, whole-brain and regional activity, and the concentrations of cortisol, serotonin, dopamine, brain-derived neurotrophic factor (BDNF), and immunological parameters (IL-6, IL-10, TNFα). Second, stepwise linear modeling was used to find relations between the variables of the levels.

Results: The obsessive-compulsive, depressive, and overall symptom severity was significantly reduced after psychotherapy. At the neural level, the activity in the anterior cingulate cortex (ACC), in frontal regions, in the precuneus, and in the putamen had significantly decreased. No significant changes were found on the neurochemical level. When connecting the levels, a highly significant model was found that explains the decrease in neural activity of the putamen by increases of the concentrations of cortisol, IL-6, and dopamine.

Conclusion: Multivariate approaches offer insight on the influences that the different levels of the psychiatric disorder OCD have on each other. More research and adapted models are needed.

Keywords: Cortisol; Dopamine; IL-6; Multi-level; Neurochemistry; OCD; Psychotherapy process; Treatment outcome; fMRI.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study design of the multi-level assessment of patients with obsessive-compulsive disorder (OCD) before and after psychotherapy. The psychological level comprises the OCD symptom severity (Y-BOCS), depression symptom severity (BDI-II) and overall symptom severity (SCL-90). The neural level consists of the regions of the cortico-striato-thalamic-cortical network (CSTC). On the neurochemical level, the concentrations of the neurotransmitters dopamine and serotonin, inflammatory parameters (IL-6, IL-10, and TNF-α), cortisol, and the brain-derived neurotrophic factor (BDNF) were assessed. For all variables, the pre-post difference (Δ) was calculated and evaluated
Fig. 2
Fig. 2
Differences in neural activity before and after psychotherapy. a: Decreased activity of patients compared to controls for individual OCD > neutral pictures during treatment, p < 0.001 uncorrected for visualization [44]. b: Contrast estimates of the voxel at x = 0, y = 26, z = 34, which is part of the cluster whose neural activity was found to be significantly altered in the ANOVA for the group x time x condition interaction term, p < .05 FDR-corrected
Fig. 3
Fig. 3
Linear regression model predicting the decreased activity of the putamen by Δcortisol + ΔIL-6 + Δdopamine + constant for the 17 patients
See this image and copyright information in PMC

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References

    1. van den Heuvel MP, Scholtens LH, Kahn RS. Multiscale neuroscience of psychiatric disorders. Biol Psychiatry. 2019;86:512–522. doi: 10.1016/j.biopsych.2019.05.015. - DOI - PubMed
    1. Scarr E, Millan MJ, Bahn S, Bertolino A, Turck CW, Kapur S, et al. Biomarkers for psychiatry: the journey from fantasy to fact, a report of the 2013 CINP think tank. Int J Neuropsychopharmacol. 2015;18:1–9. doi: 10.1093/ijnp/pyv042. - DOI - PMC - PubMed
    1. McKay D, Sookman D, Neziroglu F, Wilhelm S, Stein DJ, Kyrios M, et al. Efficacy of cognitive-behavioral therapy for obsessive–compulsive disorder. Psychiatry Res. 2015;225:236–246. doi: 10.1016/j.psychres.2014.11.058. - DOI - PubMed
    1. Bandelow B, Baldwin D, Abelli M, Altamura C, Dell’Osso B, Domschke K, et al. Biological markers for anxiety disorders, OCD and PTSD – a consensus statement. Part I: neuroimaging and genetics. World J Biol Psychiatry. 2016;17:321–365. doi: 10.1080/15622975.2016.1181783. - DOI - PubMed
    1. Bandelow B, Baldwin D, Abelli M, Bolea-Alamanac B, Bourin M, Chamberlain SR, et al. Biological markers for anxiety disorders, OCD and PTSD: a consensus statement. Part II: neurochemistry, neurophysiology and neurocognition. World J Biol Psychiatry. 2017;18:162–214. doi: 10.1080/15622975.2016.1190867. - DOI - PMC - PubMed