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Peer-reviewedCC BY-NCNeuropsychiatric Disease and Treatment

Sex-Related Differences in Regional Homogeneity and Intolerance of Uncertainty in Obsessive-Compulsive Disorder: A Resting-State fMRI Study

  • Anzhen Wang1,2
  • Shuai Zhao1
  • Qihui Guo3,4
  • Jinling Wu1
  • Wenmei Fang1
  • Shuang Zheng1
  • Chunyan Zhu2,5,6
  • Xiangyang Zhang1,3,4
6 affiliations
  1. 1Affiliated Psychological Hospital of Anhui Medical University, Anhui Medical University, Hefei, People's Republic of China.
  2. 2School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, People's Republic of China.
  3. 3State Key Laboratory of Cognitive Science and Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People's Republic of China.
  4. 4Department of Psychology, University of Chinese Academy of Sciences, Beijing, People's Republic of China.
  5. 5Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, People's Republic of China.
  6. 6Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People's Republic of China.
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Abstract

Anzhen Wang,1,2 Shuai Zhao,1 Qihui Guo,3,4 Jinling Wu,1 Wenmei Fang,1 Shuang Zheng,1 Chunyan Zhu,2,5,6 Xiangyang Zhang1,3,41Affiliated Psychological Hospital of Anhui Medical University, Anhui Medical University, Hefei, People’s Republic of China; 2School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, People’s Republic of China; 3State Key Laboratory of Cognitive Science and Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People’s Republic of China; 4Department of Psychology, University of Chinese Academy of Sciences, Beijing, People’s Republic of China; 5Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, People’s Republic of China; 6Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People’s Republic of ChinaCorrespondence: Chunyan Zhu, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, People’s Republic of China, Email [email protected]; Xiangyang Zhang, State Key Laboratory of Cognitive Science and Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People’s Republic of China, Email [email protected]: Intolerance of uncertainty (IU) is a cognitive vulnerability associated with symptom severity in obsessive-compulsive disorder (OCD). Evidence also suggests that IU and OCD symptom profiles may differ by sex; however, the neural correlates of IU in male and female patients with OCD remain insufficiently characterized.Methods: In this cross-sectional observational study, 63 patients with OCD and 40 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. Regional homogeneity (ReHo) was used to examine diagnosis- and sex-related differences in intrinsic brain activity. Imaging data were analyzed using a full-factorial model in SPM, with diagnosis and sex as factors and age, years of education, and mean framewise displacement (FD) as covariates. Statistical significance was defined using a voxel-level threshold of p < 0.001 followed by cluster-level family-wise error (FWE) correction at p < 0.05. Significant effects were characterized using post hoc contrasts. Four exploratory partial correlations controlling for age, years of education, and mean FD were examined; their p values were not corrected for multiple comparisons.Results: The final sample comprised 63 patients with OCD (37 males and 26 females) and 40 HCs (25 males and 15 females). Patients with OCD showed lower ReHo in visual processing regions, including the right calcarine cortex and right middle occipital gyrus, compared with HCs. Across diagnostic groups, the whole-brain factorial analysis revealed a significant main effect of sex, with males showing higher ReHo in visual and sensorimotor regions and females showing higher ReHo in prefrontal regions. No significant diagnosis-by-sex interaction was observed. Exploratory partial correlations showed that higher IU was associated with lower ReHo in the left inferior frontal gyrus in the female OCD, and that lower ReHo in the right middle occipital gyrus was associated with greater obsession severity in the overall OCD sample. These uncorrected associations are preliminary and hypothesis-generating.Conclusions: These findings suggest potential sex-related differences in regional neural synchrony in OCD and identify an exploratory association between IU and left inferior frontal gyrus ReHo within the female OCD subgroup. Given the cross-sectional observational design, these findings should be interpreted as associative and hypothesis-generating rather than as evidence of distinct sex-specific neural mechanisms.Keywords: obsessive-compulsive disorder, intolerance of uncertainty, sex difference, regional homogeneity, resting-state fMRI

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Cite

BibTeXRIS
BibTeX
@article{wang2026sexrelated,
  title = {{Sex-Related Differences in Regional Homogeneity and Intolerance of Uncertainty in Obsessive-Compulsive Disorder: A Resting-State fMRI Study}},
  author = {Anzhen Wang and Shuai Zhao and Qihui Guo and Jinling Wu and Wenmei Fang and Shuang Zheng and Chunyan Zhu and Xiangyang Zhang},
  journal = {Neuropsychiatric Disease and Treatment},
  year = {2026},
  month = oct,
  doi = {10.2147/ndt.s632649},
  url = {https://www.dovepress.com/sex-related-differences-in-regional-homogeneity-and-intolerance-of-unc-peer-reviewed-fulltext-article-NDT},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Sex-Related Differences in Regional Homogeneity and Intolerance of Uncertainty in Obsessive-Compulsive Disorder: A Resting-State fMRI Study
AU  - Anzhen Wang
AU  - Shuai Zhao
AU  - Qihui Guo
AU  - Jinling Wu
AU  - Wenmei Fang
AU  - Shuang Zheng
AU  - Chunyan Zhu
AU  - Xiangyang Zhang
PY  - 2026
DA  - 2026/10/25
JO  - Neuropsychiatric Disease and Treatment
DO  - 10.2147/ndt.s632649
UR  - https://www.dovepress.com/sex-related-differences-in-regional-homogeneity-and-intolerance-of-unc-peer-reviewed-fulltext-article-NDT
AB  - Anzhen Wang,1,2 Shuai Zhao,1 Qihui Guo,3,4 Jinling Wu,1 Wenmei Fang,1 Shuang Zheng,1 Chunyan Zhu,2,5,6 Xiangyang Zhang1,3,41Affiliated Psychological Hospital of Anhui Medical University, Anhui Medical University, Hefei, People’s Republic of China; 2School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, People’s Republic of China; 3State Key Laboratory of Cognitive Science and Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People’s Republic of China; 4Department of Psychology, University of Chinese Academy of Sciences, Beijing, People’s Republic of China; 5Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, People’s Republic of China; 6Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, People’s Republic of ChinaCorrespondence: Chunyan Zhu, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, People’s Republic of China, Email [email protected]; Xiangyang Zhang, State Key Laboratory of Cognitive Science and Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, People’s Republic of China, Email [email protected]: Intolerance of uncertainty (IU) is a cognitive vulnerability associated with symptom severity in obsessive-compulsive disorder (OCD). Evidence also suggests that IU and OCD symptom profiles may differ by sex; however, the neural correlates of IU in male and female patients with OCD remain insufficiently characterized.Methods: In this cross-sectional observational study, 63 patients with OCD and 40 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. Regional homogeneity (ReHo) was used to examine diagnosis- and sex-related differences in intrinsic brain activity. Imaging data were analyzed using a full-factorial model in SPM, with diagnosis and sex as factors and age, years of education, and mean framewise displacement (FD) as covariates. Statistical significance was defined using a voxel-level threshold of p < 0.001 followed by cluster-level family-wise error (FWE) correction at p < 0.05. Significant effects were characterized using post hoc contrasts. Four exploratory partial correlations controlling for age, years of education, and mean FD were examined; their p values were not corrected for multiple comparisons.Results: The final sample comprised 63 patients with OCD (37 males and 26 females) and 40 HCs (25 males and 15 females). Patients with OCD showed lower ReHo in visual processing regions, including the right calcarine cortex and right middle occipital gyrus, compared with HCs. Across diagnostic groups, the whole-brain factorial analysis revealed a significant main effect of sex, with males showing higher ReHo in visual and sensorimotor regions and females showing higher ReHo in prefrontal regions. No significant diagnosis-by-sex interaction was observed. Exploratory partial correlations showed that higher IU was associated with lower ReHo in the left inferior frontal gyrus in the female OCD, and that lower ReHo in the right middle occipital gyrus was associated with greater obsession severity in the overall OCD sample. These uncorrected associations are preliminary and hypothesis-generating.Conclusions: These findings suggest potential sex-related differences in regional neural synchrony in OCD and identify an exploratory association between IU and left inferior frontal gyrus ReHo within the female OCD subgroup. Given the cross-sectional observational design, these findings should be interpreted as associative and hypothesis-generating rather than as evidence of distinct sex-specific neural mechanisms.Keywords: obsessive-compulsive disorder, intolerance of uncertainty, sex difference, regional homogeneity, resting-state fMRI
SN  - 1178-2021
SN  - 1176-6328
ER  -