Magnetic resonance brain imaging in women with obsessive-compulsive disorder and trichotillomania (original) (raw)
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Volumetric MRI assessment of brain regions in patients with refractory obsessive–compulsive disorder
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2006
No prior study to date has examined the comparisons of the structures that have been implicated in obsessive-compulsive disorder (OCD) in patients with refractory OCD, those who are treatment-responded and healthy controls concurrently. Therefore, we performed a volumetric MRI study in patients with refractory OCD, those with treatment responding OCD and healthy controls. Morphometric MRI was used to compare in thirty patients with OCD and ten healthy controls. Of the patient group, ten were first applying patients, ten were treatment-responded and the rest were refractory OCD patients. As a whole group, OCD patients had increased white matter volume than healthy controls. First applying patients had significantly smaller left and right orbito-frontal cortex (OFC) volumes compared with treatment-responded patients and healthy controls, with a significant difference between refractory patients and treatment-responded patients and with no significant difference was found between the volume of first applying patients compared to that of refractory patients. Anterior cingulate exhibited a near-significant difference only between first applying patients and healthy controls on left side. First applying patients had significantly greater left and right thalamus volumes compared with treatment-responded patients and healthy controls and there was a considerable difference in regard to thalamic volumes between refractory patients and treatment-responded patients. Taken together, our findings suggest that reductions in OFC and increase in thalamic volumes may be associated with refractoriness of OCD and may not be due to changes in cingulate and caudate regions.
Volumetric MRI study of key brain regions implicated in obsessive–compulsive disorder
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2007
Neuroanatomic abnormalities have been implicated in the pathophysiology of obsessive-compulsive disorder (OCD). To date, no study has measured the orbito-frontal cortex (OFC), anterior cingulate, caudate nucleus, and thalamus concurrently in first-episode patients. Thus, we performed a volumetric MRI study in patients who were treatment-naive and healthy controls focusing on the in vivo neuroanatomy of the whole brain, total gray and white matter volume, thalamus, caudate nucleus, anterior cingulate cortex, and OFC concurrently. The volumes of thalamus, caudate nucleus, anterior cingulate cortex, and OFC were measured in 12 OCD patients who were treatment-naive and 12 healthy control subjects. Anterior cingulate and OFC volumes included both white and gray matters. Volumetric measurements were made with T1-weighted coronal MRI images, with 1.5-mm-thick slices, at 1.5 T. The patients had increased white matter volume than healthy controls. The patient group had significantly smaller left and right OFC volumes and significantly greater left and right thalamus volumes compared with healthy controls. Anterior cingulate exhibited a near-significant difference between the patients and healthy controls on left side. Significant correlations were found between Y-BOCS scores and left OFC, and right OFC, and between Y-BOCS and left thalamus volumes in the patient group. In conclusion, our findings suggest that abnormalities in these areas may play an important role in the pathophysiology of OCD.
Psychiatry and Clinical Psychopharmacology, 2019
AIM: In the present study, we aimed to determine the volume differences in brain regions involved in cortical-striatal-thalamic-cortical circuit (CSTC) between healthy subjects and obsessive-compulsive disorder (OCD) patients. We also evaluated the potential relationship between volumes of region of interest and various illness parameters (duration and current severity OCD, and the influence of drug treatment). METHODS: We examined the volumetric differences in dorsolateral prefrontal cortex (DPFC), orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), thalamus and striatum between OCD patients (n = 21) and healthy controls (HCs) (n = 25). RESULTS: Patients with OCD had significantly larger total, right, and left DLPFC, and OFC volumes compared to HCs. Total, and left ACC, total, and left striatum volumes were significantly smaller in OCD patients than in HC. The thalamus volumes were not different between two groups. The most of volumetric correlations in HCs disappeared among OCD patients. Only, the correlation between the volumes of left striaum and left ACC volume remained significant. Fisher's r-to-z transformation tests indicated that correlation coefficients of brain volumes significantly differed between both groups for right ACC and left (z = 2.17, p = .03) and right OFC (z = 2.00, p = .04); left ACC and right OFC (z = 2.41, p = .01); right ACC and left (z = 2.94, p = .003), and right striatum (z = 2.43, p = .01). CONCLUSIONS: Our findings indicate the impaired connectivity of ACC, OFC, and striatum in the pathophysiology of OCD. Further research is needed to explore precisely which brain regions nuclei are specifically involved in the occurence of OCD symptoms.
Caudate nucleus abnormalities in obsessive-compulsive disorder: measurements of MRI signal intensity
Psychiatry Research-neuroimaging, 1993
A previous magnetic resonance imaging (MRI) study from our group reported increased size of the right caudate nucleus in obsessive-compulsive patients compared with control subjects. To test the hypothesis of a structural abnormality underlying such volume alteration, MRI signal intensity (SI), as an index of T1 relaxation values, was measured in the caudate nucleus of the same sampling data. Results showed higher SI values in the left caudate nucleus compared with the right in the patient group, whereas no asymmetry was found in the control group.
Twin Research and Human Genetics, 2013
Neuroimaging studies have indicated abnormalities in cortico-striato-thalamo-cortical circuits in obsessive–compulsive disorder patients, but results have not been consistent. Since there are significant sex differences in human brain anatomy and obsessive–compulsive symptomatology and its developmental trajectories tend to be distinct in males and females, we investigated whether sex is a potential source of heterogeneity in neuroimaging studies on obsessive–compulsive symptoms. We selected male and female twin pairs who were concordant for scoring either high or low for obsessive–compulsive symptoms and a group of discordant pairs where one twin scored high and the co-twin scored low. The design included 24 opposite-sex twin pairs. Magnetic resonance imaging scans of 31 males scoring high for obsessive–compulsive symptoms, 41 low-scoring males, 58 high-scoring females, and 73 low-scoring females were analyzed and the interaction of obsessive–compulsive symptoms by sex on gray matt...
Since the decade of the seventies, several neuropsychological abnormalities in very different cognitive domains have been described among patients with Obsessive-compulsive disorder (OCD). Due to the nature of these abnormalities, it was concluded that possibly the main dysfunction for this disorder was located in the right hemisphere, especially in the frontal cortex; nevertheless this particular brain region was found to be involved in other psychiatric disorders, so neuropsychological results were considered to be of limited precision and it was thought that the diversity in results was not due to the malfunction of one particular brain region. So it became evident that a new research methodology based in the information processing model with highly specific neuropsy-chological paradigms of frontal functioning was needed; as well as considering a subtypology based in the cognitive characteristics in patients with the same disorder and similar phenomenol-ogy. Regarding OCD it is well known that the dorsolateral prefron-tal cortex is in charge of the regulation of complex actions, executive functions and the elaboration of logical strategies in a problem solving task; so its dysfunction causes a failure in the creation of response patterns and perseverations due to the inability to change a pattern when an alternative response is needed. On the other hand, obsessions are associated mainly with the anterior cingulated cortex and the basal region of the corpus stria-tum and its connections with the limbic system, giving place to incapacity to select the relevant information from the environment , which makes the individual perceive irrelevant stimuli as threatening for physical integrity. By the way, some clinical subtypes have also been identified: contamination/washing, aggressiveness/checking, hoarding, sym-metry/order. There is also some evidence of different patterns of brain activation to several visual stimuli related to the obsessive or compulsive object in the clinical subtypes, as shown by functional magnetic resonance image in some regions of the frontal lobe, either dorsolateral, medial or basal and its connections with the basal ganglia, and in some cases thalamus or limbic system. In the face of all this evidence, the goal of the present study was to find if within this disorder it was possible, through several neuropsychological paradigms of frontal functioning, to find different patterns of execution, considering the clinical subtype and the severity of obsessions and compulsions. Fifty-eight patients with a diagnosis of OCD were studied; all patients were under treatment at the OCD clinic of the National Institute of Psychiatry Ramón de la Fuente in Mexico City. Two neuropsychological tests were administered: 1) Trail Making Test (TMT) and 2) Wisconsin Card Sorting Test (WCST). From the Target Symptom List, the clinical subtype was obtained. After the statistical analysis, we found no differences between the severity of obsessions and the severity of compulsions as measured by the Yale-Brown Scale. Also, we observed three factors concerning the neuropsychological tests, and patients were grouped in four different groups, each one with a distinct cogni-tive performance. Through the interpretation of results it was concluded that in a sample of 58 patients with OCD, different groups of neuropsy-chological functioning where distinguished. In their own, these groups where associated with different clinical subtypes. These results are in accordance with the neurobiological modular organization model of OCD, which sustains the existence of independent systems of cognitive dysfunction that regulate different symptomatic expressions. RESUMEN La metodología de investigación, a partir del modelo del procesamiento de información con paradigmas neuropsicológicos de funcionamiento del lóbulo frontal, permite un estudio más específico de los trastornos psiquiátricos con fenomenología parecida, lo que a su vez permite crear modelos basados en una subtipología de índole cognoscitiva y, por ende, lleva al
Reduced cortical thickness in non-medicated patients with obsessive-compulsive disorder
Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2012
Increasing evidence suggests the presence of grey matter volume abnormalities in patients with obsessivecompulsive disorder (OCD) and the mediation of the expression of different OCD symptoms by discrete neural systems of the brain. However, limited studies have investigated the abnormalities of cortical thickness, and their results are comparatively inconsistent, possibly owing to the inclusion of medicated patients. Therefore, this study investigated cortical thickness abnormalities using surface-based analysis to identify distinct neural correlates of each symptom dimension in non-medicated patients with OCD. Thirty nonmedicated patients with OCD and 30 age-and gender-matched healthy controls underwent magnetic resonance imaging. Group comparison of cortical thickness was performed using surface-based analysis. We also conducted correlation analysis between cortical thickness and each symptom dimension score. Compared to the healthy controls, the OCD patients had statistically significant reduction in cortical thickness in the cluster that contained the left superior temporal gyrus and posterior insular cortex (p b .05, corrected); no areas of the brain had significantly greater cortical thickness. Negative correlation was also found between cortical thickness and "cleaning" dimension scores in the left postcentral and right superior parietal gyri. The present results suggest that cortical thinning in the region that contains the left superior temporal gyrus and posterior insula may underlie pathophysiology of OCD and that discrete neural systems may mediate the "cleaning" symptom dimension.