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Expanding the heuristic neurocircuit-based taxonomy to guide treatment for OCD: reply to the commentary “Probing the genetic and molecular correlates of connectome alterations in obsessive-compulsive disorder”

Molecular Psychiatry volume 27, pages 3560–3561 (2022)Cite this article

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We recently proposed a heuristic neurocircuit-based taxonomy to guide treatment for obsessive-compulsive disorder (OCD) [1]. This model integrated findings from phenomenological reports of patients’ symptoms and empirical neuroimaging and neurocognitive studies into a coherent model of which neurocircuit alterations may be involved in different clinical profiles of OCD, leading to treatment options that target those neurocircuit-based profiles. This model was proposed as a first step toward linking heterogeneity of symptoms in OCD to distinct neurocircuit mechanisms, yet many limitations to the model exist, which we have described in a companion paper [2]. As pointed out in the commentary by Saraiva et al. [3], one limitation is that we did not consider the role of genetic and molecular factors in the neurocircuit alterations implicated in OCD.

This limitation is important because a plethora of evidence indicates that genetic factors are crucial to the development of neural structures and function [4]. Furthermore, studies using high-throughput techniques have revealed that a heterogeneous genetic architecture underlies OCD [5]. Therefore, future studies are warranted to investigate the genetic and molecular correlates of our proposed neurocircuit-based taxonomy of OCD [1], as well as other neurobiological models.

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Authors and Affiliations

  1. Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil

    Elizabeth Shephard, Daniel L. C. Costa, Marcelo C. Batistuzzo, Priscilla B. G. Godoy, Antonio C. Lopes, Andre R. Brunoni, Marcelo Q. Hoexter, Roseli G. Shavitt & Euripedes C. Miguel

  2. Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, UK

    Elizabeth Shephard

  3. Department of Psychiatry, The New York University School of Medicine, New York, NY, USA

    Emily R. Stern

  4. Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA

    Emily R. Stern

  5. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands

    Odile A. van den Heuvel

  6. Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands

    Odile A. van den Heuvel

  7. Department of Psychiatry OCD Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India

    Y. C. Janardhan Reddy

  8. SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa

    Christine Lochner

  9. SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa

    Dan J. Stein

  10. Center for OCD and Related Disorders, New York State Psychiatric Institute and the Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA

    H. Blair Simpson

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  1. Elizabeth Shephard
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  2. Emily R. Stern
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  3. Odile A. van den Heuvel
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  6. Priscilla B. G. Godoy
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  7. Antonio C. Lopes
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  8. Andre R. Brunoni
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  9. Marcelo Q. Hoexter
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  11. Y. C. Janardhan Reddy
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  12. Christine Lochner
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  13. Dan J. Stein
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  14. H. Blair Simpson
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  15. Euripedes C. Miguel
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Contributions

ES, ECM, ERS, OAVDH, CL, and HBS drafted the first draft of the correspondence. ES and ECM drafted the final version of the correspondence. All authors read and commented on the first draft and read and approved the final draft of the correspondence.

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Correspondence to Elizabeth Shephard.

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The authors declare no competing interests.

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Shephard, E., Stern, E.R., van den Heuvel, O.A. et al. Expanding the heuristic neurocircuit-based taxonomy to guide treatment for OCD: reply to the commentary “Probing the genetic and molecular correlates of connectome alterations in obsessive-compulsive disorder”. Mol Psychiatry 27, 3560–3561 (2022). https://doi.org/10.1038/s41380-022-01645-0

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