Abstract：
BACKGROUND: Individuals with obsessive-compulsive disorder (OCD) show persistent avoidance behaviors, often in the absence of actual threat. Quality-of-life costs and heterogeneity support the need for novel brain-behavior intervention targets. Informed by mechanistic and anatomical studies of persistent avoidance in rodents and nonhuman primates, our goal was to test whether connections within a hypothesized persistent avoidance-related network predicted OCD-related harm avoidance (HA), a trait measure of persistent avoidance. We hypothesized that 1) HA, not an OCD diagnosis, would be associated with altered endogenous connectivity in at least one connection in the network; 2) HA-specific findings would be robust to comorbid symptoms; and 3) reliable findings would replicate in a holdout testing subsample.
METHODS: Using resting-state functional connectivity magnetic resonance imaging, cross-validated elastic net for feature selection, and Poisson generalized linear models, we tested which connections significantly predicted HA in our training subsample (n = 73; 71.8% female; healthy control group n = 36, OCD group n = 37); robustness to comorbidities; and replicability in a testing subsample (n = 30; 56.7% female; healthy control group n = 15, OCD group n = 15).
RESULTS: Stronger inverse connectivity between the right dorsal anterior cingulate cortex and right basolateral amygdala and stronger positive connectivity between the right ventral anterior insula and left ventral striatum were associated with greater HA across groups. Network connections did not discriminate OCD diagnostic status or predict HA-correlated traits, suggesting sensitivity to trait HA. The dorsal anterior cingulate cortex-basolateral amygdala relationship was robust to controlling for comorbidities and medication in individuals with OCD and was also predictive of HA in our testing subsample.
CONCLUSIONS: Stronger inverse dorsal anterior cingulate cortex-basolateral amygdala connectivity was robustly and reliably associated with HA across groups and in OCD. Results support the relevance of a cross-species persistent avoidance-related network to OCD, with implications for precision-based approaches and treatment.
METHODS: Using resting-state functional connectivity magnetic resonance imaging, cross-validated elastic net for feature selection, and Poisson generalized linear models, we tested which connections significantly predicted HA in our training subsample (n = 73; 71.8% female; healthy control group n = 36, OCD group n = 37); robustness to comorbidities; and replicability in a testing subsample (n = 30; 56.7% female; healthy control group n = 15, OCD group n = 15).
RESULTS: Stronger inverse connectivity between the right dorsal anterior cingulate cortex and right basolateral amygdala and stronger positive connectivity between the right ventral anterior insula and left ventral striatum were associated with greater HA across groups. Network connections did not discriminate OCD diagnostic status or predict HA-correlated traits, suggesting sensitivity to trait HA. The dorsal anterior cingulate cortex-basolateral amygdala relationship was robust to controlling for comorbidities and medication in individuals with OCD and was also predictive of HA in our testing subsample.
CONCLUSIONS: Stronger inverse dorsal anterior cingulate cortex-basolateral amygdala connectivity was robustly and reliably associated with HA across groups and in OCD. Results support the relevance of a cross-species persistent avoidance-related network to OCD, with implications for precision-based approaches and treatment.
摘要：
背景：强迫症患者表现出持续的回避行为，通常是在没有实际威胁的情况下。生活质量成本和异质性支持对新型脑行为干预目标的需求。通过对啮齿动物和非人灵长类动物的持续回避的机械和解剖学研究，我们的目标是测试假设的持续回避相关网络中的连接是否预测OCD相关伤害回避(HA)，持续回避的特质度量。我们假设1)HA，不是强迫症诊断,将与网络中至少一个连接中的内源性连通性改变相关；2）HA特异性发现将对合并症症状具有鲁棒性；3）可靠的发现将在保留测试子样本中复制。
方法：使用静息状态功能连接磁共振成像，用于特征选择的交叉验证弹性网，和泊松广义线性模型，我们在训练子样本(n=73;71.8%为女性;健康对照组n=36,强迫症组n=37);对合并症的稳健性;以及测试子样本中的可复制性(n=30;56.7%为女性;健康对照组n=15,强迫症组n=15)中测试了哪些联系显著预测了HA.
结果：在各组中，右背前扣带回皮质和右基底外侧杏仁核之间更强的反向连接和右腹前岛和左腹侧纹状体之间更强的正连接与更高的HA相关。网络连接没有区分OCD诊断状态或预测HA相关特征，表明对性状HA的敏感性。背侧前扣带回皮质-基底外侧杏仁核的关系对于控制强迫症患者的合并症和药物治疗是稳健的，并且在我们的测试子样本中也可以预测HA。
结论：强迫症患者的背背前扣带回皮质-基底外侧杏仁核连接强健可靠地与HA相关。结果支持跨物种持续回避相关网络与强迫症的相关性，对基于精度的方法和治疗有影响。
方法：使用静息状态功能连接磁共振成像，用于特征选择的交叉验证弹性网，和泊松广义线性模型，我们在训练子样本(n=73;71.8%为女性;健康对照组n=36,强迫症组n=37);对合并症的稳健性;以及测试子样本中的可复制性(n=30;56.7%为女性;健康对照组n=15,强迫症组n=15)中测试了哪些联系显著预测了HA.
结果：在各组中，右背前扣带回皮质和右基底外侧杏仁核之间更强的反向连接和右腹前岛和左腹侧纹状体之间更强的正连接与更高的HA相关。网络连接没有区分OCD诊断状态或预测HA相关特征，表明对性状HA的敏感性。背侧前扣带回皮质-基底外侧杏仁核的关系对于控制强迫症患者的合并症和药物治疗是稳健的，并且在我们的测试子样本中也可以预测HA。
结论：强迫症患者的背背前扣带回皮质-基底外侧杏仁核连接强健可靠地与HA相关。结果支持跨物种持续回避相关网络与强迫症的相关性，对基于精度的方法和治疗有影响。
