Obsessive-compulsive disorder (OCD) presented with repetitive obsessions and/or compulsions were associated with disrupted resting-state functional connectivity (rs-FC). To investigate the pharmacological treatment effect on rs-FC changes in OCD patients we conducted the seed-to-voxel FC analyses using dorsal attention network (DAN), default mode network (DMN), salience network (SN) and frontoparietal network (FPN) and basal ganglia seeds. Twenty-two healthy subjects and twenty-four unmedicated OCD patients underwent resting-state functional magnetic resonance imaging. Patients were rescanned after 12 weeks of escitalopram treatment. We found increased FC both within the DAN and between the DAN and the FPN which was ameliorated after medication and correlated significantly with the clinical improvement in obsession scores. We also observed an anticorrelation between the left caudate and the supplementary motor area in unmedicated OCD patients which also normalized with treatment. Results further showed treatment related normalization of orbitofrontal cortex hyperconnectivity with DMN and hypoconnectivity with DAN whereas aberrant FC between the SN and visual areas appears to be a medication effect. We suggest that DAN to FPN hyperconnectivity which is positively correlated with clinical improvement in obsession scores at pre-treatment stage in present study has a potential for being a neuroimaging marker to predict the treatment response in OCD.

表现为重复性强迫观念和/或强迫行为的强迫症（OCD）与静息态功能连接（rs-FC）中断有关。为了研究药物治疗对 OCD 患者 rs-FC 变化的效果，我们使用背侧注意网络 (DAN)、默认模式网络 (DMN)、显着网络 (SN) 和额顶网络 (FPN) 进行种子到体素 FC 分析和基底神经节种子。二十二名健康受试者和二十四名未接受药物治疗的强迫症患者接受了静息态功能磁共振成像。接受艾司西酞普兰治疗 12 周后，对患者进行了重新扫描。我们发现 DAN 内以及 DAN 和 FPN 之间的 FC 均有所增加，用药后有所改善，并且与痴迷评分的临床改善显着相关。我们还观察到未接受药物治疗的强迫症患者的左侧尾状核和辅助运动区之间存在反相关性，这种相关性也随着治疗而正常化。结果进一步显示，治疗相关的眶额皮层与 DMN 的高连接性和与 DAN 的连接性低下的正常化，而 SN 和视觉区域之间的异常 FC 似乎是药物效应。我们认为，在本研究中，DAN 与 FPN 的超连接与治疗前阶段强迫症评分的临床改善呈正相关，有可能成为预测 OCD 治疗反应的神经影像标记。