Research Paper
Open Access

Resting-state functional connectivity of the amygdala subregions in unmedicated patients with obsessive–compulsive disorder before and after cognitive behavioural therapy

Jian Gao, Xiangyun Yang, Xiongying Chen, Rui Liu, Pengchong Wang, Fanqiang Meng, Zhanjiang Li and Yuan Zhou
J Psychiatry Neurosci November 01, 2021 46 (6) E628-E638; DOI: https://doi.org/10.1503/jpn.210084

Article Figures & Tables

Figures

  • Figure 1
    Figure 1

    Subregions of the amygdala. Red: left centromedial amygdala; green: left basolateral amygdala; yellow: left superficial amygdala; dark blue: right centromedial amygdala; violet: right basolateral amygdala; light blue: right superficial amygdala. Created using the SPM Anatomy toolbox and registered to Montreal Neurological Institute space.

  • Figure 2
    Figure 2

    Resting-state functional connectivity of the amygdala subregions that showed significant differences at baseline in patients with OCD compared to healthy controls. (A) Seed regions: left basolateral amygdala and right superficial amygdala. (B and C) Resting-state functional connectivity in (B) healthy controls and (C) patients with OCD. (D) Regions in which we found significant differences in resting-state functional connectivity with the seed region (cluster-level pFWE < 0.05). *Survived Bonferroni correction. BLA = basolateral amygdala; FWE = family-wise error; MFG = middle frontal gyrus; OCD = obsessive–compulsive disorder; SFA = superficial amygdala.

  • Figure 3
    Figure 3

    Altered resting-state functional connectivity of the amygdala subregions in patients with OCD who responded to CBT, before and after treatment (cluster-level pFWE < 0.05). The red regions are locations where functional connectivity with the amygdala subregions was increased in responders to CBT after treatment (compared to before treatment). The blue regions are locations where functional connectivity with the amygdala subregions was decreased in responders to CBT after treatment. BLA = basolateral amygdala; CBT = cognitive behavioural therapy; CMA = centromedial amygdala; FWE = family-wise error; IPL = inferior parietal lobule; ITG = inferior temporal gyrus; MOG = middle occipital gyrus; MTG = middle temporal gyrus; OCD = obsessive–compulsive disorder; SFA = superficial amygdala.

  • Figure 4
    Figure 4

    Correlations between changes in functional connectivity in amygdala subregions and symptom improvement in responders to CBT. (A) Positive correlation between changes in resting-state functional connectivity after CBT (right centromedial amygdala and left middle occipital gyrus) and a reduction in Y-BOCS compulsion score in responders to CBT. (B) Positive correlation between changes in resting-state functional connectivity after CBT (left basolateral amygdala and inferior temporal gyrus) and a reduction in Y-BOCS obsession score in responders to CBT. CBT = cognitive behavioural therapy; Y-BOCS, Yale–Brown Obsessive Compulsive Scale.

Tables

  • Table 1

    Demographic and clinical characteristics

    CharacteristicHealthy controls
    n = 40    		OCD
    n = 45
    Pre-CBTPost-CBT
    Age, yr28.9 ± 6.428.7 ± 6.7
    Female/male, n18/2220/25
    Education, yr13.8 ± 2.813.7 ± 2.9
    Illness duration, yr–7.3 ± 6.5
    HAM-D score–6.7 ± 4.25.8 ± 5.2
    Y-BOCS total score–23.6 ± 5.910.3 ± 5.6
    Y-BOCS obsession subscale score–12.2 ± 4.85.1 ± 3.2
    Y-BOCS compulsion subscale score–11.4 ± 3.85.2 ± 3.4

    • CBT = cognitive behavioural therapy; HAM-D = Hamilton Depression Rating Scale; OCD = obsessive–compulsive disorder; Y-BOCS = Yale–Brown Obsessive Compulsive Scale.

    • Values are mean + standard deviation, unless otherwise indicated.

  • Table 2

    Brain regions with significant differences in resting-state functional connectivity of the amygdala subregions before and after CBT in responders to CBT

    Amygdala seedBrain regionVoxelsBrodmann areaMNI coordinates, x, y, ztpFWE
    Pre-CBT > post-CBT
     Left centromedial amygdalaLeft middle temporal gyrus10737−50, −68, 25.130.009
     Right centromedial amygdalaLeft middle occipital gyrus12019−30, −82, 284.640.005*
     Left basolateral amygdalaLeft inferior temporal gyrus15819−50, −64, −64.460.001*
    Left middle temporal gyrus10539/19−38, −62, 145.450.011
    Left middle occipital gyrus42719/39−30, −78, 305.09< 0.001*
     Right basolateral amygdalaLeft middle occipital gyrus8539−34, −80, 284.590.034
     Right superficial amygdalaRight middle temporal gyrus8839−50, −60, 185.150.027
    Pre-CBT < post-CBT
     Left centromedial amygdalaRight inferior parietal lobule2914042, −44, 364.83< 0.001*
     Left superficial amygdalaRight inferior parietal lobule2194058, −48, 485.58< 0.001*
     Right superficial amygdalaRight inferior parietal lobule1254040, −46, 445.030.002*

    • CBT = cognitive behavioural therapy; FWE = family-wise error; MNI = Montreal Neurological Institute.

    • ↵* Survived Bonferroni correction.

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Resting-state functional connectivity of the amygdala subregions in unmedicated patients with obsessive–compulsive disorder before and after cognitive behavioural therapy
Jian Gao, Xiangyun Yang, Xiongying Chen, Rui Liu, Pengchong Wang, Fanqiang Meng, Zhanjiang Li, Yuan Zhou
J Psychiatry Neurosci Nov 2021, 46 (6) E628-E638; DOI: 10.1503/jpn.210084
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