- Cognitive fusion modulates enhanced structural covariance in fronto-parieto-cerebellar circuits, notably coupling between left angular gyrus and right middle temporal and medial superior frontal gyri.
- Baseline GMV in left dorsolateral superior frontal gyrus predicts cognitive fusion improvement independent of overall symptom reduction.
- Spatial transcriptomics link left SFGdl GMV pattern to glutamatergic synapse and calcium signalling pathways, suggesting molecular substrates for treatment response.
Psychol Med. 2026 Oct 1;56:e309. doi: 10.1017/S0033291726105583.
ABSTRACT
BACKGROUND: Cognitive fusion (CF), a core maladaptive process in obsessive-compulsive disorder (OCD), describes overidentification with intrusive thoughts. While implicated in symptom maintenance, its neuroanatomical basis and treatment prediction utility remain poorly understood.
METHODS: We enrolled 80 first-episode, drug-naïve OCD patients and 70 matched healthy controls. All participants underwent structural magnetic resonance imaging and clinical assessment. Patients received 8-week selective serotonin reuptake inhibitors treatment with endpoint reevaluation. Using multimodal neuroimaging, we examined group differences in gray matter volume (GMV) and structural covariance network (SCN), tested whether CF levels modulated connectivity, and evaluated baseline features for predicting treatment response. Transcriptomic analysis linked the findings to the Allen Human Brain Atlas data.
RESULTS: OCD patients showed GMV reductions in frontal-limbic regions and increases in parietal/inferior frontal areas. SCN analysis revealed enhanced structural covariance within fronto-parieto-cerebellar circuits. Higher CF scores were associated with stronger structural coupling between the left angular gyrus and the right middle temporal/medial superior frontal gyri. Baseline GMV in the left dorsolateral superior frontal gyrus (SFGdl) positively correlated with CF improvement, remaining significant after controlling for overall symptom reduction. Transcriptomic analysis indicated the left SFGdl GMV patterns spatially associated with glutamatergic synapse and calcium signaling pathways.
CONCLUSIONS: CF in OCD links to altered structural integration between large-scale networks, with the left SFGdl emerging as a potential CF-specific treatment predictor. This multiscale study highlights combining neuroimaging with psychological constructs to understand treatment-relevant changes in OCD.
PMID:42817483 | DOI:10.1017/S0033291726105583
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