Resting-State Functional Connectivity Alterations in Obsessive-Compulsive Disorder: Relationships Between Connectivity and Clinical Profiles in the Global OCD Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Obsessive-compulsive disorder (OCD) has been associated with altered resting-state functional connectivity (FC), but findings are inconsistent and associations with clinical characteristics are unclear. The Global OCD study collected harmonized imaging, demographic, and clinical data across 5 sites and continents, with the aim of identifying consistent OCD-related alterations in FC. METHODS: We included 263 unmedicated adults with OCD (56% naïve to psychotropic medications) and 254 healthy control (HC) participants and estimated FC from resting-state functional magnetic resonance imaging. Between-group differences in and associations of clinical characteristics with FC were analyzed through general linear models adjusted for gender, age, and years of education. We investigated seed-based FC of the amygdala, posterior putamen, nucleus accumbens, and ventral and dorsal caudate nuclei and FC between and within atlas-based subnetworks, global network measures (global efficiency, modularity), and performed network-based statistics (NBS). RESULTS: Seed-based analysis showed weaker FC between the nucleus accumbens and left cerebellum in OCD versus HC groups, while NBS revealed a network of widespread hypoconnectivity spanning 249 regions. In OCD, FC was associated with previous use of selective serotonin/norepinephrine reuptake inhibitors, comorbid major depressive disorder, severity of anxiety, and sexual/religious and contamination symptoms. In particular, anxiety symptoms were linked to widespread stronger FC, while sexual/religious symptoms were linked to stronger sensorimotor FC. CONCLUSIONS: Individuals with OCD showed widespread hypoconnectivity compared with HC participants, with considerable interindividual variation within the OCD group related to previous medication use, comorbid depression, severity of anxiety, and specific OCD symptoms.
Authors: Anders Lillevik Thorsen, Niels T. de Joode, Petra J.W. Pouwels, Céline N. Dietz, Feng Liu, Maria C.G. Otaduy, Bruno Pastorello, Frances C. Robertson, Jonathan Ipser, Seonjoo Lee, Dianne M. Hezel, Marcelo C. Batistuzzo, Marcelo Q. Hoexter, Marco A.N. Echevarria, Karthik Sheshachala, Janardhanan C. Narayanaswamy, Ganesan Venkatasubramanian, Christine Lochner, Euripedes C. Miguel, Y.C. Janardhan Reddy, Roseli G. Shavitt, Dan J. Stein, Melanie Wall, Odile A. van den Heuvel, Helen Blair Simpson, Chris Vriend
Institutions: Haukeland University Hospital, Amsterdam University Medical Centers, Senter for Krisepsykologi, University of Bergen, Vrije Universiteit Amsterdam, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam Neuroscience, University of Amsterdam, Columbia University Irving Medical Center, New York State Psychiatric Institute, Columbia University, Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, University of Cape Town, South African Medical Research Council, Pontifícia Universidade Católica de São Paulo, National Institute of Mental Health and Neurosciences, Deakin University, Stellenbosch University
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $4,050
OpenAlex ID: W4412772761