Article

Brain structural abnormalities in obsessive-compulsive disorder: converging evidence from white matter and grey matter. Asian J Psychiatry 5:290-296

Center for Studies of Psychological Application, South China Normal University, China
Asian journal of psychiatry 12/2012; 5(4):290-6. DOI: 10.1016/j.ajp.2012.07.004
Source: PubMed

ABSTRACT Specific cortico-striato-thalamic circuits are hypothesised to underlie the aetiology of obsessive-compulsive disorder (OCD). However, findings from neuroimaging studies have been inconsistent. In the current study, we attempted to provide a complete overview of structural alterations in OCD by conducting signed differential mapping (SDM) meta-analysis on grey matter and white matter studies of patients with OCD based on voxel-based morphometry (VBM) studies and diffusion tensor imaging (DTI) studies.
Fifteen VBM and seven DTI case-control studies were included in this meta-analysis. SDM meta-analyses were performed to assess grey matter volume and white matter integrity changes in OCD patients and healthy controls.
We found that OCD patients had smaller grey matter volume than health controls in the frontal eye fields, medial frontal gyrus and anterior cingulate cortex. However, we showed that there was an increase in the grey matter volume in the lenticular nucleus, caudate nucleus and a small region in the right superior parietal lobule. OCD patients also had a lower fractional anisotropy (FA) in the cingulum bundles, inferior fronto-occipital fasciculus, and superior longitudinal fasciculus, while increased FA in the left uncinate fasciculus.
The current findings confirm the structural abnormalities of cortico-striato-thalamic circuits in OCD.

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    • "An earlier study reported reduced volumes of the left and right inferior frontal gyri, observed even as far as the anterior insula in individuals with OCD (Yoo et al., 2008), but this was inconsistent with others that found greater volumes (e.g., Rotge, Langbour, et al., 2009) or within the normal range (Peng et al., 2012; Pujol et al., 2004) volume of the inferior frontal cortex/anterior insula. So, de wit and colleagues (2014) finding of smaller medial and inferior frontal WM volumes bilaterally in individuals with OCD is important given previous reports that have been conflicting (e.g., Pujol et al., 2004; Togao et al., 2010; van den Heuvel et al., 2009) and is consistent with previous studies that have found alterations in the frontal–striatal WM microstructure in individuals with OCD (Peng et al., 2012). Impairments in cognitive functions are frequently exhibited in patients with OCD, which include impaired emotional regulation and cognitive control. "
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    ABSTRACT: This article will explore recent studies that have identified alterations in brain regions in individuals with obsessive–compulsive disorder (OCD). Specifically, alterations have been found in the cortical surface anatomy, the white matter, the gray matter, the cerebellum, the olfactory-processing structures, the temporal lobe, the prefrontal cortex, and the amygdala. Although some emerging data implicate these brain regions in OCD, the cortico–striatal–thalamic–cortical circuitry remains the prime focus of research. This article will also give an overview of studies that have found different symptom dimensions in individuals with OCD to have distinct neural correlates.
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    • "In addition to grey matter volume abnormalities, a recent meta-analysis also reported white matter abnormalities in the form of lower fractional anisotropy (FA) in the cingulum bundles, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, corpus callosum and the anterior limb of the internal capsule and increased FA in the left uncinate fasciculus in OCD patients, again suggesting abnormality of frontal cortex connections (Peng et al. 2012; Koch et al. 2014). Positron Emission Tomography (PET) studies reported increased metabolic rates in the orbitofrontal cortex (OFC) and cingulate cortex in patients with OCD (Baxter et al. 1990; Saxena et al. 2001; Saxena et al. 2004; Nordahl et al. 1989). "
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    • "Although only a small number of studies investigated OCD, their findings provide interesting insights into the genetic specificity of neural impairments. The OFC, ACC, striatal and thalamic regions have often been shown to be associated with OCD (Brem et al., 2012, 2014; Montigny et al., 2013; Peng et al., 2012; Radua et al., 2010). Regions of these cortico-striato-thalamic loops also seems to be sensitive to specific genetic variations (Fig. 1). "
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    ABSTRACT: Obsessive-compulsive disorder (OCD) occurs in ∼1-3% of the general population, and its often rather early onset causes major disabilities in the everyday lives of patients. Although the heritability of OCD is between 35-65%, many linkage, association, and genome-wide association studies have failed to identify single genes that exhibit high effect sizes. Several neuroimaging studies have revealed structural and functional alterations mainly in cortico-striato-thalamic loops. However, there is also marked heterogeneity across studies. These inconsistencies in genetic and neuroimaging studies may be due to the heterogeneous and complex phenotypes of OCD. Under the consideration that genetic variants may also influence neuroimaging in OCD, researchers have started to combine both domains in the field of imaging genetics. Here, we conducted a systematic search of PubMed and Google Scholar literature for articles that address genetic imaging in OCD and related disorders (published through March 2014). We selected 8 publications that describe the combination of imaging genetics with OCD, and extended it with 43 publications of comorbid psychiatric disorders. The most promising findings of this systematic review point to the involvement of variants in genes involved in the serotonergic (HTTLPR, HTR2A), dopaminergic (COMT, DAT), and glutamatergic (SLC1A1, SAPAP) systems. However, the field of imaging genetics must be further explored, best through investigations that combine multimodal imaging techniques with genetic profiling, particularly profiling techniques that employ polygenetic approaches, with much larger sample sizes than have been used up to now.
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