Abnormal resting-state functional connectivity of the insula in medication-free patients with obsessive-compulsive disorder

Abstract

Abstract Background The function of insula has been increasingly mentioned in the neurocircuitry models of obsessive-compulsive disorder (OCD) for its role in affective processing and regulating anxiety and its wide interactions with classic cortico-striato-thalamo-cortical circuit. However, the insular resting-state functional connectivity patterns in OCD remains unclear. Therefore, we aimed to investigate characteristic intrinsic connectivity alterations of insula in OCD and their associations with clinical features. Methods We obtained the resting-state functional magnetic resonance imaging data from 85 drug-free OCD patients and 85 age- and sex-matched healthy controls (HC). We performed the general linear model to compare the whole-brain intrinsic functional connectivity maps of the bilateral insula between OCD and HC groups. In addition, we further explored the relationship between the intrinsic functional connectivity alterations of insula and clinical features using partial correlation analysis. Results Compared with HC, patients with OCD exhibited the increased intrinsic connectivity between the bilateral insula and bilateral precuneus gyrus extending to inferior parietal lobule and supplementary motor area. While we only found the decreased intrinsic connectivity between the right insula and bilateral lingual gyrus in OCD patients relative to HC subjects, which was negatively correlated with the severity of anxiety and depression symptoms in the OCD group. Conclusions In the current study, we identified the impaired insular intrinsic connectivity in OCD patients, and the dysconnectivity of right insula and bilateral lingual gyrus was associated with the anxiety and depressive severity of OCD. These findings provide the neuroimaging evidence for the involvement of insula in OCD and emphasize its considerable role in the anxiety or depressive symptoms of OCD.