Objective:To explore the differences in resting-state brain functional activity in obsessive-compulsive disorder (OCD) patients with and without sensory phenomena (SP).Methods:Clinical data from 102 OCD patients (60 males, 42 females; age 18-50(27±8) years) who visited the OCD outpatient clinic at the Affiliated Brain Hospital of Nanjing Medical University between August 2021 and December 2022 were prospectively collected. Based on the presence of sensory phenomena, patients were categorized into 70 cases with sensory phenomena (Sensory Phenomena Group) and 32 cases without sensory phenomena (Non-Sensory Phenomena Group). Additionally, 50 age-matched healthy controls (Control Group, 24 males, 26 females; age 18-49(25±6) years) were recruited. Resting-state functional magnetic resonance imaging (rs-fMRI) was analyzed using the amplitude of low-frequency fluctuations (ALFF) and functional connectivity (FC) between differential brain regions. One-way ANOVA and post-hoc tests were used to compare group differences. Spearman correlation and binary logistic stepwise regression were applied to analyze the associations between SP and brain functional activity.Results:Compared to healthy controls, OCD patients showed decreased ALFF in bilateral middle frontal gyri, left superior frontal gyrus, right angular gyrus, and right supramarginal gyrus ( F=17.29-32.99, all P<0.05). The SP group exhibited increased ALFF in the right triangular part of the inferior frontal gyrus ( F=23.47, P<0.05) and decreased ALFF in the left superior parietal gyrus and left postcentral gyrus ( F=18.80, 15.04; both P<0.05). The non-SP group demonstrated increased ALFF in the left supramarginal gyrus and left postcentral gyrus ( F=19.64, 15.04; both P<0.05) and decreased ALFF in the left superior frontal gyrus, right middle frontal gyrus, and left angular gyrus ( F=17.29-35.52, all P<0.05). Reduced FC was observed between the left middle frontal gyrus and left angular gyrus, left middle frontal gyrus and right angular gyrus and left and right angular gyri ( F=17.29-23.47, all P<0.05). The SP group showed lower FC between the left middle frontal and left angular gyrus than the non-SP group ( F=23.47, P<0.05). Positive correlations with SP were found for ALFF in the right triangular part of the inferior frontal gyrus, left superior frontal gyrus, and right middle frontal gyrus (r=0.40, 0.35, 0.31; all P<0.05). Negative correlations were observed for ALFF in the left supramarginal gyrus, left superior parietal gyrus, and left postcentral gyrus (r=-0.38, -0.47, -0.52; all P<0.05) and FC between the left middle frontal gyrus-left angular gyrus and left middle frontal gyrus-right angular gyrus (r=-0.24, -0.21; both P<0.05). OCD patients with increased ALFF in the left superior frontal gyrus and right middle frontal gyrus, along with decreased ALFF in the left supramarginal gyrus, left superior parietal gyrus, left postcentral gyrus, and reduced FC between the left middle frontal gyrus-right angular gyrus, had a higher likelihood of SP (log OR (95% CI)=8.5(4.0-14.2), 8.0(1.7-16.4), -8.9(-15.2--4.4), -5.2 (-9.1--2.3), -4.1(-6.9--1.7), -7.0(-13.2--1.8); all P<0.05). Conclusion:Altered functional activity in the left superior frontal gyrus, right middle frontal gyrus, left supramarginal gyrus, left superior parietal gyrus, left postcentral gyrus, and abnormal FC between the left middle frontal gyrus and right angular gyrus represent key neuroimaging features of OCD patients with SP.

Objective:To explore the differences in resting-state brain functional activity in obsessive-compulsive disorder (OCD) patients with and without sensory phenomena (SP).Methods:Clinical data from 102 OCD patients (60 males, 42 females; age 18-50(27±8) years) who visited the OCD outpatient clinic at the Affiliated Brain Hospital of Nanjing Medical University between August 2021 and December 2022 were prospectively collected. Based on the presence of sensory phenomena, patients were categorized into 70 cases with sensory phenomena (Sensory Phenomena Group) and 32 cases without sensory phenomena (Non-Sensory Phenomena Group). Additionally, 50 age-matched healthy controls (Control Group, 24 males, 26 females; age 18-49(25±6) years) were recruited. Resting-state functional magnetic resonance imaging (rs-fMRI) was analyzed using the amplitude of low-frequency fluctuations (ALFF) and functional connectivity (FC) between differential brain regions. One-way ANOVA and post-hoc tests were used to compare group differences. Spearman correlation and binary logistic stepwise regression were applied to analyze the associations between SP and brain functional activity.Results:Compared to healthy controls, OCD patients showed decreased ALFF in bilateral middle frontal gyri, left superior frontal gyrus, right angular gyrus, and right supramarginal gyrus ( F=17.29-32.99, all P<0.05). The SP group exhibited increased ALFF in the right triangular part of the inferior frontal gyrus ( F=23.47, P<0.05) and decreased ALFF in the left superior parietal gyrus and left postcentral gyrus ( F=18.80, 15.04; both P<0.05). The non-SP group demonstrated increased ALFF in the left supramarginal gyrus and left postcentral gyrus ( F=19.64, 15.04; both P<0.05) and decreased ALFF in the left superior frontal gyrus, right middle frontal gyrus, and left angular gyrus ( F=17.29-35.52, all P<0.05). Reduced FC was observed between the left middle frontal gyrus and left angular gyrus, left middle frontal gyrus and right angular gyrus and left and right angular gyri ( F=17.29-23.47, all P<0.05). The SP group showed lower FC between the left middle frontal and left angular gyrus than the non-SP group ( F=23.47, P<0.05). Positive correlations with SP were found for ALFF in the right triangular part of the inferior frontal gyrus, left superior frontal gyrus, and right middle frontal gyrus (r=0.40, 0.35, 0.31; all P<0.05). Negative correlations were observed for ALFF in the left supramarginal gyrus, left superior parietal gyrus, and left postcentral gyrus (r=-0.38, -0.47, -0.52; all P<0.05) and FC between the left middle frontal gyrus-left angular gyrus and left middle frontal gyrus-right angular gyrus (r=-0.24, -0.21; both P<0.05). OCD patients with increased ALFF in the left superior frontal gyrus and right middle frontal gyrus, along with decreased ALFF in the left supramarginal gyrus, left superior parietal gyrus, left postcentral gyrus, and reduced FC between the left middle frontal gyrus-right angular gyrus, had a higher likelihood of SP (log OR (95% CI)=8.5(4.0-14.2), 8.0(1.7-16.4), -8.9(-15.2--4.4), -5.2 (-9.1--2.3), -4.1(-6.9--1.7), -7.0(-13.2--1.8); all P<0.05). Conclusion:Altered functional activity in the left superior frontal gyrus, right middle frontal gyrus, left supramarginal gyrus, left superior parietal gyrus, left postcentral gyrus, and abnormal FC between the left middle frontal gyrus and right angular gyrus represent key neuroimaging features of OCD patients with SP.

BackgroundThe obsessive-compulsive disorder （OCD） features complexity in etiological factors and high heterogeneity in clinical manifestations. OCD patients with different ages of onset vary in clinical symptoms and etiology. However， current studies on inpatients with early- and late-onset OCD are limited. ObjectiveTo explore the differences in clinical characteristics between early- and late-onset OCD inpatients as well as the factors affecting the onset age of OCD， so as to provide references for early screening and treatment of OCD patients. MethodsThis study was based on collected medical records of 540 patients with OCD who received inpatient treatments at the Affiliated Brain Hospital of Nanjing Medical University between March 2012 and March 2023. Patients with onset age above 18 were placed into early-onset group （n=310） and the others into late-onset group （n=230）. Then differences in demographic data and clinical symptoms between two groups of patients were compared. Binary logistic regression was used to analyze the factors that affect the onset age of OCD. ResultsObserving the demographic data， there were significant differences between the two groups in the results in gender， marital status， family history of mental illness， ratio of comorbidities with other mental illnesses， occupational composition， education level and types of obsessive-compulsive symptoms （χ²=22.302、170.556， 9.224， 13.624， 242.277， 59.791， 7.231， P<0.05 or 0.01）. Also， the results in ages of onset and hospitalization between two groups were significantly different （Z=-19.915， 16.831， P<0.01）. In terms of clinical symptoms， the early onset group had a higher proportion of symptoms including obsessive thinking （χ²=11.998， P<0.05）， ordering （χ²=7.731， P<0.05） and rituals （χ²=7.714， P<0.05）， while the proportion of obsessive checking （χ²=8.204， P<0.05） and washing （χ²=7.506， P<0.05） symptoms were relatively low. In terms of risk factors， there were several independent risk factors that influence the onset age of OCD inpatients， including comorbid neurodevelopmental disorder， comorbid affective disorder， family history of schizophrenia and family history of affective disorder （OR=19.587， 1.830， 3.065， 4.431， P<0.05）. Among them， comorbid neurodevelopmental disorder was the core influencing factor， and female gender was a protective factor for early-onset patients （OR=0.417， P<0.01）. ConclusionThere are differences in demographic data and clinical symptom characteristics between early- and late-onset OCD inpatients， and comorbid neurodevelopmental disorder plays as a core risk factor affecting the onset age of OCD inpatients. ［Funded by Jiangsu Province Key Research and Development Plan for Social Development Special Project（number， BE2021616） ； Jiangsu Province Social Development General Project （number， BE2022678）； Key Project of Nanjing Medical Science and Technology Development Fund （number， ZKX20029）］