Common and separable neurofunctional dysregulations characterize obsessive compulsive, substance use, and gaming disorders – evidence from an activation likelihood meta-analysis of functional imaging studies
Compulsivity and loss of behavioral control represent core symptoms in obsessive-compulsive disorder (OCD), substance use disorder (SUD), and internet gaming disorder (IGD). Despite elaborated animal models suggesting that compulsivity is mediated by cortico-striatal circuits and a growing number of neuroimaging case-control studies common and distinct neurofunctional alterations in these disorders have not been systematically examined. The present activation likelihood estimation (ALE)
... ation (ALE) meta-analysis capitalized on previous case-control fMRI studies to determine shared and disorder-specific neurofunctional alterations among the three disorders. Task-based fMRI studies employing case-control designs in individuals with SUD, OCD or IGD were obtained. Coordinate-based meta-analyses (ALE) were performed within each disorder. Next subtraction and conjunction meta-analyses were performed to determine differential and common neurofunctional alterations between the disorders. Task-paradigm classes were group according to RDoC domains to determine contributions of underlying behavioral domains. 144 articles were included representing data from individuals (SUD=2418, controls=2332; IGD=361, controls=360; OCD=715, controls=711) from case-control. Comparative and conjunction meta-analyses revealed shared alterations in insular-prefrontal circuits in SUD and OCD, with SUD exhibiting additionally pronounced dorsal striatal alterations as compared to both, OCD and IGD. IGD and SUD exhibited shared prefrontal alterations, with IGD demonstrating pronounced temporal alterations compared to both, SUD and OCD. No robust overlap between IGD and OCD was observed. Across the disorders, neurofunctional alterations were mainly contributed to by the cognitive systems and positive valence RDoC domains. The present findings indicate that neurofunctional dysregulations in prefrontal regions engaged in regulatory control represent shared neurofunctional alterations across substance and behavioral addictions, while neurofunctional dysregulations in the anterior insula may mediate compulsivity substance addiction and obsessive-compulsive disorders.