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Distinct neural networks associated with obsession and delusion: a connectome-wide association study

Published online by Cambridge University Press:  30 January 2020

Tae Young Lee
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
Wi Hoon Jung
Department of Psychology, Daegu University, Gyeongsan, Republic of Korea
Yoo Bin Kwak
Department of Brain and Cognitive Science, Seoul National University College of Natural Science, Seoul, Republic of Korea
Youngwoo B. Yoon
Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
Junhee Lee
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
Minah Kim
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
Euitae Kim
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
Jun Soo Kwon*
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea Department of Brain and Cognitive Science, Seoul National University College of Natural Science, Seoul, Republic of Korea
Author for correspondence: Jun Soo Kwon, E-mail:



Obsession and delusion are theoretically distinct from each other in terms of reality testing. Despite such phenomenological distinction, no extant studies have examined the identification of common and distinct neural correlates of obsession and delusion by employing biologically grounded methods. Here, we investigated dimensional effects of obsession and delusion spanning across the traditional diagnostic boundaries reflected upon the resting-state functional connectivity (RSFC) using connectome-wide association studies (CWAS).


Our study sample comprised of 96 patients with obsessive–compulsive disorder, 75 patients with schizophrenia, and 65 healthy controls. A connectome-wide analysis was conducted to examine the relationship between obsession and delusion severity and RFSC using multivariate distance-based matrix regression.


Obsession was associated with the supplementary motor area, precentral gyrus, and superior parietal lobule, while delusion was associated with the precuneus. Follow-up seed-based RSFC and modularity analyses revealed that obsession was related to aberrant inter-network connectivity strength. Additional inter-network analyses demonstrated the association between obsession severity and inter-network connectivity between the frontoparietal control network and the dorsal attention network.


Our CWAS study based on the Research Domain Criteria (RDoC) provides novel evidence for the circuit-level functional dysconnectivity associated with obsession and delusion severity across diagnostic boundaries. Further refinement and accumulation of biomarkers from studies embedded within the RDoC framework would provide useful information in treating individuals who have some obsession or delusion symptoms but cannot be identified by the category of clinical symptoms alone.

Original Articles
Copyright © Cambridge University Press 2020

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Both authors contributed equally to this work.


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