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Alterations interfere with higher\u2010order cognitive processes, and are common to several psychiatric and neurological conditions. A few studies examining the structural connectome in obsessive\u2013compulsive disorder (OCD) suggest lower efficiency of information transfer across the brain. However, it remains unclear whether this is due to alterations in rich\u2010club organization. In the current study, the structural connectome of 28 unmedicated OCD patients, 8 of their unaffected siblings and 28 healthy controls was reconstructed by means of diffusion\u2010weighted imaging and probabilistic tractography. Topological and weighted measures of rich\u2010club organization and connectivity were computed, alongside global and nodal measures of network integration and segregation. The relationship between clinical scores and network properties was explored. Compared to healthy controls, OCD patients displayed significantly lower topological and weighted rich\u2010club organization, allocating a smaller fraction of all connection weights to the rich\u2010club core. Global clustering coefficient, local efficiency, and clustering of nonrich club nodes were significantly higher in OCD patients. Significant three\u2010group differences emerged, with siblings displaying highest and lowest values in different measures. No significant correlation with any clinical score was found. Our results suggest weaker structural connectivity between rich\u2010club nodes in OCD patients, possibly resulting in lower network integration in favor of higher network segregation. We highlight the need of looking at network\u2010based alterations in brain organization and function when investigating the neurobiological basis of this disorder, and stimulate further research into potential familial protective factors against the development of OCD.<\/jats:p>","DOI":"10.1002\/hbm.25984","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T09:46:06Z","timestamp":1655977566000},"page":"4699-4709","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Abnormal white\u2010matter rich\u2010club organization in obsessive\u2013compulsive disorder"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3384-247X","authenticated-orcid":false,"given":"Samantha","family":"Baldi","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Neuropsychology School for Mental Health and Neuroscience, Maastricht University  Maastricht Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3930-8646","authenticated-orcid":false,"given":"Stijn","family":"Michielse","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery School for Mental Health and Neuroscience, Maastricht University  Maastricht Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3111-1304","authenticated-orcid":false,"given":"Chris","family":"Vriend","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Neurosciences Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience  Amsterdam Netherlands"},{"name":"Department of Psychiatry Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1570-1195","authenticated-orcid":false,"given":"Martijn P.","family":"van den Heuvel","sequence":"additional","affiliation":[{"name":"Department of Complex Trait Genetics Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9804-7653","authenticated-orcid":false,"given":"Odile A.","family":"van den Heuvel","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Neurosciences Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience  Amsterdam Netherlands"},{"name":"Department of Psychiatry Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience  Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0134-406X","authenticated-orcid":false,"given":"Koen R. 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