Li, Ningfei ORCID: 0000-0003-3315-3591, Hollunder, Barbara ORCID: 0000-0003-0104-6927, Baldermann, Juan Carlos, Kibleur, Astrid, Treu, Svenja, Akram, Harith, Al-Fatly, Bassam, Strange, A. Bryan, Barcia, A. Juan, Zrinzo, Ludvic, Joyce, M. Eileen, Chabardes, Stephan, Visser-Vandewalle, Veerle, Polosan, Mircea, Kuhn, Jens, Kuehn, A. Andrea and Horn, Andreas ORCID: 0000-0002-0695-6025 (2021). A Unified Functional Network Target for Deep Brain Stimulation in Obsessive-Compulsive Disorder. Biol. Psychiatry, 90 (10). S. 701 - 714. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1873-2402

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Abstract

BACKGROUND: Multiple deep brain stimulation (DBS) targets have been proposed for treating intractable obsessivecompulsive disorder (OCD). Here, we investigated whether stimulation effects of different target sites would be mediated by one common or several segregated functional brain networks. METHODS: First, seeding from active electrodes of 4 OCD patient cohorts (N = 50) receiving DBS to anterior limb of the internal capsule or subthalamic nucleus zones, optimal functional connectivity profiles for maximal Yale-Brown Obsessive Compulsive Scale improvements were calculated and cross-validated in leave-one-cohort-out and leave-one-patient-out designs. Second, we derived optimal target-specific connectivity patterns to determine brain regions mutually predictive of clinical outcome for both targets and others predictive for either target alone. Functional connectivity was defined using resting-state functional magnetic resonance imaging data acquired in 1000 healthy participants. RESULTS: While optimal functional connectivity profiles showed both commonalities and differences between target sites, robust cross-predictions of clinical improvements across OCD cohorts and targets suggested a shared network. Connectivity to the anterior cingulate cortex, insula, and precuneus, among other regions, was predictive regardless of stimulation target. Regions with maximal connectivity to these commonly predictive areas included the insula, superior frontal gyrus, anterior cingulate cortex, and anterior thalamus, as well as the original stereotactic targets. CONCLUSIONS: Pinpointing the network modulated by DBS for OCD from different target sites identified a set of brain regions to which DBS electrodes associated with optimal outcomes were functionally connected-regardless of target choice. On these grounds, we establish potential brain areas that could prospectively inform additional or alternative neuromodulation targets for obsessive-compulsive disorder.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Li, NingfeiUNSPECIFIEDorcid.org/0000-0003-3315-3591UNSPECIFIED
Hollunder, BarbaraUNSPECIFIEDorcid.org/0000-0003-0104-6927UNSPECIFIED
Baldermann, Juan CarlosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kibleur, AstridUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Treu, SvenjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Akram, HarithUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Al-Fatly, BassamUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Strange, A. BryanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barcia, A. JuanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zrinzo, LudvicUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Joyce, M. EileenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chabardes, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Visser-Vandewalle, VeerleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Polosan, MirceaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuhn, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuehn, A. AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Horn, AndreasUNSPECIFIEDorcid.org/0000-0002-0695-6025UNSPECIFIED
URN: urn:nbn:de:hbz:38-602585
DOI: 10.1016/j.biopsych.2021.04.006
Journal or Publication Title: Biol. Psychiatry
Volume: 90
Number: 10
Page Range: S. 701 - 714
Date: 2021
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1873-2402
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ANTERIOR CINGULATE CORTEX; STRUCTURAL CONNECTIVITY; NUCLEUS; ACTIVATION; ORGANIZATION; CAPSULOTOMY; PROVOCATION; IMPULSIVITY; CIRCUITS; SCALEMultiple languages
Neurosciences; PsychiatryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60258

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