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Study Finds Reduced Brain Connectivity in Hoarding Disorder

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Recent research has uncovered significant differences in brain connectivity between individuals with hoarding disorder (HD) and healthy controls (HCs). The study, conducted by a team of neuroscientists from Kyushu University in Japan, found that patients with HD exhibit reduced resting-state functional connectivity (rsFC) between specific brain regions, which may contribute to the cognitive and emotional challenges associated with the disorder. The findings were published in the journal Frontiers in Psychiatry.

Hoarding disorder is characterised by persistent difficulty in discarding or parting with possessions, regardless of their actual value. This behaviour often leads to the accumulation of clutter that disrupts living spaces and causes significant distress or impairment. While hoarding was once considered a subtype of obsessive-compulsive disorder (OCD), it is now recognised as a distinct condition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Previous research has indicated that individuals with HD may experience impairments in cognitive control functions such as response inhibition, working memory, and attention. Emotional dysregulation, including intolerance of uncertainty, and biased decision-making patterns have also been observed. However, the neurobiological underpinnings of these symptoms have remained largely unclear.

The study involved 55 participants, including 24 patients with HD and 31 healthy controls. Using resting-state functional magnetic resonance imaging (rs-fMRI), the researchers examined the functional connectivity of the insula and anterior cingulate cortex (ACC) with other brain regions. The goal was to identify any differences in brain activity that could be linked to the symptoms of HD.

Participants’ brain activity was measured while they were at rest, without engaging in any specific tasks. This approach allows for the assessment of intrinsic brain connectivity, providing insights into the brain’s functional architecture that are not influenced by external stimuli or task performance.

The results revealed that individuals with HD had significantly lower functional connectivity between the right insula and two specific brain regions: the right inferior frontal gyrus (IFG) and the left superior temporal gyrus (STG). These findings suggest that HD may be associated with altered communication between these areas of the brain, which are involved in cognitive control and emotional regulation.

The insula plays a crucial role in identifying salient stimuli and facilitating information processing, while the IFG is important for cognitive control, particularly in regulating emotions through reappraisal. The reduced connectivity between the insula and IFG observed in HD patients aligns with previous research indicating impairments in these regions during tasks related to cognitive control and decision-making.

Similarly, the STG is involved in semantic processing, which underlies various cognitive control functions. Previous studies have shown that the STG is associated with the neurobiological basis of HD, particularly in tasks involving decisions to acquire or discard possessions. The reduced connectivity between the insula and STG in HD patients adds new evidence to the understanding of the disorder’s neurobiological basis.

Although the study did not find a direct correlation between the observed connectivity differences and the severity of HD symptoms, the findings provide valuable insights into the brain regions that may be implicated in the disorder. The lack of correlation suggests that while these brain alterations are significant, they may not directly translate to symptom severity or may interact with other factors in complex ways.

The researchers emphasise that further studies are needed to explore the clinical implications of these findings and to determine how they may inform treatment strategies for HD. For instance, understanding the specific brain networks involved in HD could help develop targeted interventions that aim to improve connectivity and, consequently, cognitive and emotional functioning in affected individuals.

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