Brain corticostriatal systems and the major clinical symptom dimensions of obsessive-compulsive disorder

Biol Psychiatry. 2013 Feb 15;73(4):321-8. doi: 10.1016/j.biopsych.2012.10.006. Epub 2012 Nov 28.


Background: Functional neuroimaging studies have provided consistent support for the idea that obsessive-compulsive disorder (OCD) is associated with disturbances of brain corticostriatal systems. However, in general, these studies have not sought to account for the disorder's prominent clinical heterogeneity.

Methods: To address these concerns, we investigated the influence of major OCD symptom dimensions on brain corticostriatal functional systems in a large sample of OCD patients (n = 74) and control participants (n = 74) examined with resting-state functional magnetic resonance imaging. We employed a valid method for mapping ventral and dorsal striatal functional connectivity, which supported both standard group comparisons and linear regression analyses with patients' scores on the Dimensional Yale-Brown Obsessive-Compulsive Scale.

Results: Consistent with past findings, patients demonstrated a common connectivity alteration involving the ventral striatum and orbitofrontal cortex that predicted overall illness severity levels. This common alteration was independent of the effect of particular symptom dimensions. Instead, we observed distinct anatomical relationships between the severity of symptom dimensions and striatal functional connectivity. Aggression symptoms modulated connectivity between the ventral striatum, amygdala, and ventromedial frontal cortex, while sexual/religious symptoms had a specific influence on ventral striatal-insular connectivity. Hoarding modulated the strength of ventral and dorsal striatal connectivity with distributed frontal regions.

Conclusions: Taken together, these results suggest that pathophysiological changes among orbitofrontal-striatal regions may be common to all forms of OCD. They suggest that a further examination of certain dimensional relationships will also be relevant for advancing current neurobiological models of the disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain / pathology*
  • Brain / physiopathology
  • Brain Mapping
  • Cerebral Cortex / pathology
  • Cerebral Cortex / physiopathology
  • Corpus Striatum / pathology
  • Corpus Striatum / physiopathology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nerve Net / pathology*
  • Nerve Net / physiopathology
  • Neural Pathways / pathology
  • Neural Pathways / physiopathology
  • Obsessive-Compulsive Disorder / pathology*
  • Obsessive-Compulsive Disorder / physiopathology