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Chu L, Wu Y, Yin J, Zhang K, Zhong Y, Fan X, Wang G. Neurotransmitter system gene variants as biomarkers for the therapeutic efficacy of rTMS and SSRIs in obsessive-compulsive disorder. Front Psychiatry 2024; 15:1350978. [PMID: 38840948 PMCID: PMC11150660 DOI: 10.3389/fpsyt.2024.1350978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Purpose This study aims to examine the potential influence of RS4680 (COMT), RS16965628 (SLC6A4), and RS1019385 (GRIN2B) polymorphisms on the therapeutic response to repetitive transcranial magnetic stimulation (rTMS) and selective serotonin reuptake inhibitors (SSRIs) in individuals with obsessive-compulsive disorder (OCD). Patients and methods Thirty-six untreated outpatients diagnosed with OCD were recruited and allocated to active or sham rTMS groups for two weeks. The mean age of the participants was 31.61, with 17 males (47.22%) and 19 females (52.78%). Peripheral blood samples (5 mL) were collected from each participant using ethylenediaminetetraacetic acid (EDTA) vacuum tubes for genotyping purposes, clinical evaluation was taken place at baseline and second week. Results The A allele of RS4680, C allele of RS16965628, and GG allele of RS1019385 were identified as potential bio-markers for predicting treatment response to OCD treatments (rTMS & SSRIs). Conclusion Those genes may serve as bio-markers for the combined treatment of rTMS and SSRIs in OCD. The finding hold promise for further research and the potential implementation of precision treatment of OCD. Clinical trial registration https://www.chictr.org.cn, identifier ChiCTR1900023641.
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Affiliation(s)
- Lingjun Chu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Yidan Wu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Jiajun Yin
- Brain Science Basic Laboratory, The Affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, 64 Chaohu North Road, Hefei, Anhui, China
| | - Yiwen Zhong
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xiwang Fan
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Guoqiang Wang
- Brain Science Basic Laboratory, The Affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu, China
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2
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Gargano SP, Santos MG, Taylor SM, Pastis I. A closer look to neural pathways and psychopharmacology of obsessive compulsive disorder. Front Behav Neurosci 2023; 17:1282246. [PMID: 38033477 PMCID: PMC10687174 DOI: 10.3389/fnbeh.2023.1282246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
The intricate neural pathways involved in obsessive-compulsive disorder (OCD) affect areas of our brain that control executive functioning, organization, and planning. OCD is a chronic condition that can be debilitating, afflicting millions of people worldwide. The lifetime prevalence of OCD in the US is 2.3%. OCD is predominantly characterized by obsessions consisting of intrusive and unwanted thoughts, often with impulses that are strongly associated with anxiety. Compulsions with OCD encompass repetitive behaviors or mental acts to satisfy their afflicted obsessions or impulses. While these factors can be unique to each individual, it has been widely established that the etiology of OCD is complex as it relates to neuronal pathways, psychopharmacology, and brain chemistry involved and warrants further exploration.
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Affiliation(s)
- Steven P. Gargano
- East Carolina University Brody School of Medicine, Greenville, NC, United States
| | - Melody G. Santos
- Internal Medicine and Psychiatry Combined Program, Department of Psychiatry and Behavioral Medicine, East Carolina University, Greenville, NC, United States
| | - Sydney M. Taylor
- East Carolina University Brody School of Medicine, Greenville, NC, United States
| | - Irene Pastis
- Department of Psychiatry and Behavioral Medicine, East Carolina University, Greenville, NC, United States
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3
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Vreeland A, Calaprice D, Or-Geva N, Frye RE, Agalliu D, Lachman HM, Pittenger C, Pallanti S, Williams K, Ma M, Thienemann M, Gagliano A, Mellins E, Frankovich J. Postinfectious Inflammation, Autoimmunity, and Obsessive-Compulsive Disorder: Sydenham Chorea, Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection, and Pediatric Acute-Onset Neuropsychiatric Disorder. Dev Neurosci 2023; 45:361-374. [PMID: 37742615 DOI: 10.1159/000534261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023] Open
Abstract
Postinfectious neuroinflammation has been implicated in multiple models of acute-onset obsessive-compulsive disorder including Sydenham chorea (SC), pediatric acute-onset neuropsychiatric syndrome (PANS), and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). These conditions are associated with a range of autoantibodies which are thought to be triggered by infections, most notably group A streptococci (GAS). Based on animal models using huma sera, these autoantibodies are thought to cross-react with neural antigens in the basal ganglia and modulate neuronal activity and behavior. As is true for many childhood neuroinflammatory diseases and rheumatological diseases, SC, PANS, and PANDAS lack clinically available, rigorous diagnostic biomarkers and randomized clinical trials. In this review article, we outline the accumulating evidence supporting the role neuroinflammation plays in these disorders. We describe work with animal models including patient-derived anti-neuronal autoantibodies, and we outline imaging studies that show alterations in the basal ganglia. In addition, we present research on metabolites, which are helpful in deciphering functional phenotypes, and on the implication of sleep in these disorders. Finally, we encourage future researchers to collaborate across medical specialties (e.g., pediatrics, psychiatry, rheumatology, immunology, and infectious disease) in order to further research on clinical syndromes presenting with neuropsychiatric manifestations.
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Affiliation(s)
- Allison Vreeland
- Division of Child and Adolescent Psychiatry and Child Development, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, California, USA
- Stanford Children's Health, PANS Clinic and Research Program, Stanford University School of Medicine, Palo Alto, California, USA
| | | | - Noga Or-Geva
- Interdepartmental Program in Immunology, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, California, USA
| | - Richard E Frye
- Autism Discovery and Treatment Foundation, Phoenix, Arizona, USA
| | - Dritan Agalliu
- Department of Neurology, Pathology and Cell Biology, Columbia University Irving School of Medicine, New York, New York, USA
| | - Herbert M Lachman
- Departments of Psychiatry, Medicine, Genetics, and Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Christopher Pittenger
- Departments of Psychiatry and Psychology, Child Study Center and Center for Brain and Mind Health, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | - Kyle Williams
- Department of Psychiatry Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Meiqian Ma
- Stanford Children's Health, PANS Clinic and Research Program, Stanford University School of Medicine, Palo Alto, California, USA
- Division of Pediatric Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
| | - Margo Thienemann
- Division of Child and Adolescent Psychiatry and Child Development, Department of Psychiatry, Stanford University School of Medicine, Palo Alto, California, USA
- Stanford Children's Health, PANS Clinic and Research Program, Stanford University School of Medicine, Palo Alto, California, USA
| | - Antonella Gagliano
- Division of Child Neurology and Psychiatry, Pediatric Department of Policlinico G. Matino, University of Messina, Messina, Italy
| | - Elizabeth Mellins
- Department of Pediatrics, Program in Immunology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Jennifer Frankovich
- Stanford Children's Health, PANS Clinic and Research Program, Stanford University School of Medicine, Palo Alto, California, USA
- Division of Pediatric Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
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4
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Vreeland A, Thienemann M, Cunningham M, Muscal E, Pittenger C, Frankovich J. Neuroinflammation in Obsessive-Compulsive Disorder: Sydenham Chorea, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, and Pediatric Acute Onset Neuropsychiatric Syndrome. Psychiatr Clin North Am 2023; 46:69-88. [PMID: 36740356 DOI: 10.1016/j.psc.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Sydenham chorea (SC), pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS) are postinfectious neuroinflammatory diseases that involve the basal ganglia and have obsessive-compulsive disorder as a major manifestation. As is true for many childhood rheumatological diseases and neuroinflammatory diseases, SC, PANDAS and PANS lack clinically available, rigorous diagnostic biomarkers and randomized clinical trials. Research on the treatment of these disorders depend on three complementary modes of intervention including: treating the symptoms, treating the source of inflammation, and treating disturbances of the immune system. Future studies should aim to integrate neuroimaging, inflammation, immunogenetic, and clinical data (noting the stage in the clinical course) to increase our understanding and treatment of SC, PANDAS, PANS, and all other postinfectious/immune-mediated behavioral disorders.
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Affiliation(s)
- Allison Vreeland
- Division of Child and Adolescent Psychiatry and Child Development, Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA; Stanford Children's Health, PANS Clinic and Research Program, Stanford University School of Medicine, Stanford, CA, USA.
| | - Margo Thienemann
- Division of Child and Adolescent Psychiatry and Child Development, Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA; Stanford Children's Health, PANS Clinic and Research Program, Stanford University School of Medicine, Stanford, CA, USA
| | - Madeleine Cunningham
- Department of Microbiology and Immunology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Eyal Muscal
- Department of Rheumatology, Texas Children's Hospital, Houston, TX, USA
| | | | - Jennifer Frankovich
- Stanford Children's Health, PANS Clinic and Research Program, Stanford University School of Medicine, Stanford, CA, USA; Division of Pediatrics, Department of Allergy, Immunology, Rheumatology, Stanford University School of Medicine, Stanford, CA, USA
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Liu Y, Zhang L, Mei R, Ai M, Pang R, Xia D, Chen L, Zhong L. The Role of SliTrk5 in Central Nervous System. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4678026. [PMID: 35872846 PMCID: PMC9303146 DOI: 10.1155/2022/4678026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 06/06/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022]
Abstract
SLIT and NTRK-like protein-5 (SliTrk5) is one of the six members of SliTrk protein family, which is widely expressed in the central nervous system (CNS), regulating and participating in many essential steps of central nervous system development, including axon and dendritic growth, neuron differentiation, and synaptogenesis. SliTrk5, as a neuron transmembrane protein, contains two important conservative domains consisting of leucine repeats (LRRs) located at the amino terminal in the extracellular region and tyrosine residues (Tyr) located at the carboxyl terminal in the intracellular domains. These special structures make SliTrk5 play an important role in the pathological process of the CNS. A large number of studies have shown that SliTrk5 may be involved in the pathogenesis of CNS diseases, such as obsessive-compulsive-disorder (OCD), attention deficit/hyperactivity disorder (ADHD), glioma, autism spectrum disorders (ASDs), and Parkinson's disease (PD). Targeting SliTrk5 is expected to become a new target for the treatment of CNS diseases, promoting the functional recovery of CNS. The purpose of this article is to review the current research progression of the role of SliTrk5 in CNS and its potential mechanisms in CNS diseases.
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Affiliation(s)
- Yan Liu
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Linming Zhang
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
- Yunnan Provincial Clinical Research Center for Neurological Disease, Kunming, Yunnan 650032, China
| | - Rong Mei
- Department of Neurology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650034, China
| | - Mingda Ai
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Ruijing Pang
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Di Xia
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Ling Chen
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
- Yunnan Provincial Clinical Research Center for Neurological Disease, Kunming, Yunnan 650032, China
| | - Lianmei Zhong
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
- Department of Neurology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650034, China
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Zai G, Arnold PD, Richter MA, Hanna GL, Rosenberg D, Kennedy JL. An association of Myelin Oligodendrocyte Glycoprotein (MOG) gene variants with white matter volume in pediatric obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2021; 307:111231. [PMID: 33302097 PMCID: PMC7775903 DOI: 10.1016/j.pscychresns.2020.111231] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
An increasing number of neuroimaging studies have implicated alterations of white matter in obsessive-compulsive disorder (OCD). The myelin oligodendrocyte glycoprotein (MOG) gene plays a major role in myelination, and has previously demonstrated significant association with this disorder, thus variations in this gene may contribute to observed white matter alterations. The purpose of this study is to examine the relationship between white matter volume in OCD and genetic variations in the MOG gene. Two polymorphisms in the MOG gene, MOG(C1334T) and MOG(C10991T), were investigated for association with total white matter volume as measured using volumetric magnetic resonance imaging in 37 pediatric OCD patients. We compared white matter volumes between allele and genotype groups for each polymorphism using ANCOVA. A significant relationship was detected between genotype C/C of MOG(C10991T) and decreased total white matter volume (P = 0.016). Our results showed an association between a MOG genetic variant and white matter volume. This finding is intriguing in light of the posited role of white matter alteration in the etiology of at least some cases of childhood-onset OCD. Further investigation with larger samples and sub-regional white matter volume phenotypes is warranted.
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Affiliation(s)
- Gwyneth Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, AB T2N 4N1, Canada; Program in Genetics and Genomic Biology and Department of Psychiatry, The Hospital for Sick Children, Toronto ON M5G 1 × 8, Canada
| | - Margaret A Richter
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; Frederick W. Thompson Anxiety Disorders Centre, Department of Psychiatry, Sunnybrook Health Science Centre, Toronto ON M4N 3M5, Canada
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - David Rosenberg
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, Michigan 48201, United States
| | - James L Kennedy
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON M5T 1R8, Canada; Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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7
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Meram TD, Chowdury A, Easter P, Attisha T, Kallabat E, Hanna GL, Arnold P, Rosenberg DR, Diwadkar VA. Evoking network profiles of the dorsal anterior cingulate in youth with Obsessive-Compulsive Disorder during motor control and working memory. J Psychiatr Res 2021; 132:72-83. [PMID: 33068817 PMCID: PMC9351617 DOI: 10.1016/j.jpsychires.2020.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/04/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022]
Abstract
Interest in the pathology of Obsessive-Compulsive Disorder\has focused on brain network profiles of the dorsal Anterior Cingulate Cortex (dACC), given its role as a principal control region. Both motor control and working memory tasks induce dysfunctional dACC profiles in OCD. H H We contrasted dACC network profiles in OCD and age-comparable controls during both tasks (from data collected in the same participants). The motor task required participants to tap their right forefinger in response to a flashing white probe; the memory task was a standard n-back (2-Back) requiring participants to identify if a current stimulus was identical to the one presented two items before it in the sequence. Network interactions were modeled using Psychophysiological Interactions (PPI), a model of directional functional connectivity. Inter-group analyses indicated a) that the motor control task evoked greater dACC modulation than the working memory task, and b) that the modulatory effect was significantly greater in the OCD group. We also investigated the relationship between OCD symptom dimensions (lifetime obsession and lifetime compulsion measured using the CY-BOCS) and dACC network profiles in OCD. This analysis revealed a dichotomy between Obsessive-Compulsive symptom dimensions and the degree of dACC modulation: primarily increased obsessions predicted increased modulation during the motor control task, but primarily increased compulsions predicted increased modulation during the working memory task. These results re-emphasize the salience of the dACC in OCD, and the primacy of tasks of motor control in evoking dACC pathology in the disorder.
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Affiliation(s)
- Thomas D. Meram
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Asadur Chowdury
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Philip Easter
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Tyler Attisha
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Ellanya Kallabat
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Gregory L. Hanna
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Paul Arnold
- Department of Psychiatry & Medical Genetics, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - David R. Rosenberg
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Vaibhav A. Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
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Azriel A, Farrand S, Di Biase M, Zalesky A, Lui E, Desmond P, Evans A, Awad M, Moscovici S, Velakoulis D, Bittar RG. Tractography-Guided Deep Brain Stimulation of the Anteromedial Globus Pallidus Internus for Refractory Obsessive-Compulsive Disorder: Case Report. Neurosurgery 2020; 86:E558-E563. [PMID: 31313803 DOI: 10.1093/neuros/nyz285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 05/08/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND IMPORTANCE Obsessive-compulsive disorder (OCD) is a disabling psychiatric disorder, mainly treated with psychotherapy and pharmacotherapy. Surgical intervention may be appropriate for patients with treatment-refractory OCD. Deep brain stimulation (DBS) is an alternative for previously common ablative surgical procedures. Tractography has been proposed as a method for individualizing DBS treatment and may have the potential to improve efficacy. CLINICAL PRESENTATION We present a patient with treatment-refractory OCD previously treated with bilateral leucotomies, who underwent DBS surgery with targeting informed by tractography. Preoperative tractography to identify suitable DBS targets was undertaken. Structural images were also utilized for standard stereotactic surgical planning. The anteromedial globus pallidus internus (amGPi) was chosen as the target bilaterally after consideration of white matter projections to frontal cortical regions and neurosurgical approach. Bilateral amGPi DBS surgery was undertaken without adverse events. At 16-mo follow-up, there was a 48.5% reduction in OCD symptom severity as measured by the Yale-Brown Obsessive Compulsive Scale. CONCLUSION The amGPi can be a successful DBS target for OCD. This is the first known case to report on DBS surgery postleucotomies for OCD and highlights the utility of tractography for surgical planning in OCD.
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Affiliation(s)
- Amit Azriel
- Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, Australia.,Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Sarah Farrand
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia
| | - Maria Di Biase
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia.,Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia
| | - Elaine Lui
- Department of Radiology and Medicine, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Patricia Desmond
- Department of Radiology and Medicine, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Andrew Evans
- Department of Neurology, Royal Melbourne Hospital, Melbourne, Australia
| | - Mohammed Awad
- Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, Australia.,Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Samuel Moscovici
- Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, Australia.,Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Dennis Velakoulis
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia.,Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia
| | - Richard G Bittar
- Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, Australia.,Department of Surgery, The University of Melbourne, Melbourne, Australia.,Deakin University, Victoria, Australia.,Precision Brain Spine and Pain Centre, Kew, Victoria, Australia
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Sinopoli VM, Erdman L, Burton CL, Easter P, Rajendram R, Baldwin G, Peterman K, Coste J, Shaheen SM, Hanna GL, Rosenberg DR, Arnold PD. Serotonin system gene variants and regional brain volume differences in pediatric OCD. Brain Imaging Behav 2020; 14:1612-1625. [PMID: 31187473 PMCID: PMC10521965 DOI: 10.1007/s11682-019-00092-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Obsessive-compulsive disorder (OCD) is phenotypically heterogeneous and genetically complex. This study aimed to reduce heterogeneity using structural brain imaging to study putative intermediate phenotypes for OCD. We hypothesized that select serotonin gene variants would differ in their relationship with brain volume in specific regions of the cortico-striato-thalamo-cortical (CSTC) circuits between OCD patients and controls. In a total of 200 pediatric subjects, we genotyped candidate serotonin genes (SLC6A4, HTR2A, HTR1B, and HTR2C) and conducted structural magnetic resonance imaging (sMRI) to measure regional brain volumes within CSTC circuits. In males and females separately, we first tested the association between serotonin gene variants and OCD and the effect of serotonin gene variants on brain volume irrespective of diagnosis. We then carried out a series of analyses to assess the effect of genotype-diagnosis interaction on brain volume. In females, but not in males, we identified a statistically significant genotype-diagnosis interaction for two single nucleotide polymorphisms (SNPs) in HTR2C, rs12860460 (interaction term estimate of 5.45 cc and interaction P value of 9.70e-8) and rs12854485 (interaction term estimate of 4.28 cc and interaction P value of 2.07e-6). The tested allele in each SNP was associated with decreased anterior cingulate cortex (ACC) volume in controls and with increased ACC volume in OCD patients. Our findings suggest that, in females, sequence variation in HTR2C influences ACC volume in pediatric OCD. The variants may contribute to differences in ACC volume and to OCD in a sex-specific manner when acting together with other genetic, biological, and/or environmental factors.
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Affiliation(s)
- Vanessa M Sinopoli
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Lauren Erdman
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
| | - Christie L Burton
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Phillip Easter
- Department of Psychiatry, Wayne State University School of Medicine, Detroit, MI, USA
| | | | - Gregory Baldwin
- Department of Psychiatry, Wayne State University School of Medicine, Detroit, MI, USA
| | - Kelli Peterman
- Department of Psychiatry, Wayne State University School of Medicine, Detroit, MI, USA
| | - Julie Coste
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - S-M Shaheen
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, 4th floor, Teaching, Research and Wellness (TRW) Building, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, ON, Canada
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - David R Rosenberg
- Department of Psychiatry, Wayne State University School of Medicine, Detroit, MI, USA
| | - Paul D Arnold
- Program in Genetics & Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada.
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, 4th floor, Teaching, Research and Wellness (TRW) Building, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, ON, Canada.
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, ON, Canada.
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Mora S, Merchán A, Aznar S, Flores P, Moreno M. Increased amygdala and decreased hippocampus volume after schedule-induced polydipsia in high drinker compulsive rats. Behav Brain Res 2020; 390:112592. [PMID: 32417273 DOI: 10.1016/j.bbr.2020.112592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/04/2020] [Accepted: 02/25/2020] [Indexed: 02/08/2023]
Abstract
Fronto-limbic structures and serotonin 2A receptors (5-HT2A) have been implicated in the pathophysiology and treatment of compulsive spectrum disorders. Schedule-Induced Polydipsia (SIP), characterized by the development of excessive drinking under intermittent food reinforcement schedules, is a valid preclinical model for studying the compulsive phenotype. In the present study, we explored the individual differences and effect of SIP in brain volume and 5-HT2A receptor binding in fronto-limbic structures in rats selected according to their compulsive drinking behavior. Rats were divided into high (HD) and low drinkers (LD) by SIP (20 sessions); later, we analyzed the brains of HD and LD selected rats, in two different conditions: non-re-exposure (NRE) or re-exposure to SIP (RE), with four groups: LD-NRE, LD-RE, HD-NRE and HD-RE. Histological analyses were carried out for volumetric (stereology) and receptor binding (autoradiography) in the prelimbic and infralimbic cortex, dorsal hippocampus and basolateral amygdala. After SIP re-exposure, HD-RE showed an increased basolateral amygdala and a reduced hippocampus volume compared to HD-NRE rats, and also compared to LD-RE rats. No differences were found between HD and LD in NRE condition. Moreover, HD rats exhibit a lower 5-HT2A receptor binding in the basolateral amygdala, independently of SIP re-exposure, compared to LD rats. However, LD-RE showed a decreased 5-HT2A receptor binding in basolateral amygdala compared to LD-NRE. No differences were found in the remaining structures. These findings suggest that SIP might be differentially impacting HD and LD brains, pointing towards a possible explanation of how the latent vulnerability to compulsivity is triggered.
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Affiliation(s)
- Santiago Mora
- Department of Psychology & Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Ana Merchán
- Department of Psychology & Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Susana Aznar
- Research Laboratory for Stereology and Neuroscience, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
| | - Pilar Flores
- Department of Psychology & Health Research Centre (CEINSA), University of Almería, Almería, Spain
| | - Margarita Moreno
- Department of Psychology & Health Research Centre (CEINSA), University of Almería, Almería, Spain.
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11
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Mana S, Paillère Martinot ML, Martinot JL. Brain imaging findings in children and adolescents with mental disorders: A cross-sectional review. Eur Psychiatry 2020; 25:345-54. [PMID: 20620025 DOI: 10.1016/j.eurpsy.2010.04.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 04/08/2010] [Accepted: 04/22/2010] [Indexed: 01/18/2023] Open
Abstract
AbstractBackgroundWhile brain imaging studies of juvenile patients has expanded in recent years to investigate the cerebral neurophysiologic correlates of psychiatric disorders, this research field remains scarce. The aim of the present review was to cluster the main mental disorders according to the differential brain location of the imaging findings recently reported in children and adolescents reports. A second objective was to describe the worldwide distribution and the main directions of the recent magnetic resonance imaging (MRI) and positron tomography (PET) studies in these patients.MethodsA survey of 423 MRI and PET articles published between 2005 and 2008 was performed. A principal component analysis (PCA), then an activation likelihood estimate (ALE) meta-analysis, were applied on brain regional information retrieved from articles in order to cluster the various disorders with respect to the cerebral structures where alterations were reported. Furthermore, descriptive analysis characterized the literature production.ResultsTwo hundred and seventy-four articles involving children and adolescent patients were analyzed. Both the PCA and ALE methods clustered, three groups of diagnosed psychiatric disorders, according to the brain structural and functional locations: one group of affective disorders characterized by abnormalities of the frontal-limbic regions; a group of mental disorders with “cognition deficits” mainly related to cortex abnormalities; and one psychomotor condition associated with abnormalities in the basal ganglia. The descriptive analysis indicates a focus on attention deficit hyperactivity disorders and autism spectrum disorders, a general steady rise in the number of annual reports, and lead of US research.ConclusionThis cross-sectional review of child and adolescent mental disorders based on neuroimaging findings suggests overlaps of brain locations that allow to cluster the diagnosed disorders into three sets with respectively marked affective, cognitive, and psychomotor phenomenology. Furthermore, the brain imaging research effort was unequally distributed across disorders, and did not reflect their prevalence.
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Affiliation(s)
- S Mana
- Service hospitalier central de médecine nucléaire et neurospin, INSERM-CEA, Research Unit 1000 Neuroimaging & psychiatry, University Paris Sud and University Paris Descartes, 4, place Gl.-Leclerc, 91401 Orsay, France.
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12
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Evaluating accuracy of striatal, pallidal, and thalamic segmentation methods: Comparing automated approaches to manual delineation. Neuroimage 2018; 170:182-198. [DOI: 10.1016/j.neuroimage.2017.02.069] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 02/03/2017] [Accepted: 02/24/2017] [Indexed: 12/16/2022] Open
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13
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Naaijen J, Zwiers MP, Forde NJ, Williams SC, Durston S, Brandeis D, Glennon JC, The Tactics Consortium, Franke B, Lythgoe DJ, Buitelaar JK. Striatal structure and its association with N-Acetylaspartate and glutamate in autism spectrum disorder and obsessive compulsive disorder. Eur Neuropsychopharmacol 2018; 28:118-129. [PMID: 29169826 DOI: 10.1016/j.euroneuro.2017.11.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 10/11/2017] [Accepted: 11/03/2017] [Indexed: 12/19/2022]
Abstract
Autism spectrum disorders (ASD) and obsessive compulsive disorder (OCD) are often comorbid and are associated with changes in striatal volumes and N-Acetylaspartate (NAA) and glutamate levels. Here, we investigated the relation between dorsal striatal volume and NAA and glutamate levels. We additionally compared striatal volume and shape between ASD, OCD and controls. T1-weighted magnetic resonance (MR) images, proton spectra (1H-MRS) in the left striatum, and phenotypic information were collected from 54 children with ASD, 32 with OCD, and 56 controls (aged 8-13 years) in a four-site study. Dorsal striatal volume and shape were determined using the FMRIB integrated registration and segmentation tool (FIRST). Spectra were processed with Linear Combination Model. The relationship of left striatal volume with NAA and glutamate was investigated, and group comparisons were performed for NAA levels and for bilateral striatal volume and shape. NAA levels were lower in subjects with ASD compared with controls (t=2.86, p=0.005) and were associated with striatal volume (β=0.37, t=2.78, p=0.008). Glutamate levels were also associated with volume in the ASD group (β=0.38, t=2.46, p=0.018). No group differences were found for striatal volume or shape, but a post-hoc diagnosis-by-hemisphere interaction (F(2,129)=3.86, p=0.024) revealed greater asymmetry (right>left) in striatal volume for the disorder-groups compared with controls. Our findings show involvement of NAA and glutamate in striatal volume in ASD and suggest greater asymmetry in paediatric ASD and OCD compared with controls, pointing to overlapping subcortical abnormalities. The lower NAA in ASD reflects reduced neuronal integrity or impaired neuronal functioning.
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Affiliation(s)
- Jilly Naaijen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Marcel P Zwiers
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Natalie J Forde
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O Box 9101, 6500 HB Nijmegen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Steven Cr Williams
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Neuroimaging, London, United Kingdom
| | - Sarah Durston
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland; ETH Zurich, Zurich, Switzerland
| | - Jeffrey C Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O Box 9101, 6500 HB Nijmegen, The Netherlands
| | - The Tactics Consortium
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O Box 9101, 6500 HB Nijmegen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Neuroimaging, London, United Kingdom; NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland; Departments of Human Genetics and Psychiatry, Donders Institute of Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands; ETH Zurich, Zurich, Switzerland
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute of Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - David J Lythgoe
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Neuroimaging, London, United Kingdom
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, P.O Box 9101, 6500 HB Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
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Metabolic abnormality in the right dorsolateral prefrontal cortex in patients with obsessive-compulsive disorder: proton magnetic resonance spectroscopy. Acta Neuropsychiatr 2017; 29:164-169. [PMID: 27748207 DOI: 10.1017/neu.2016.48] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Proton magnetic resonance spectroscopy (1H-MRS) was used to evaluate metabolic changes in the dorsolateral prefrontal cortex (DLPFC) in patients with obsessive-compulsive disorder (OCD). METHODS In total, 14 OCD patients (mean age 28.9±7.2 years) and 14 healthy controls (mean age 32.6±7.1 years) with no history of neurological and psychiatric illness participated in this study. Brain metabolite concentrations were measured from a localised voxel on the right DLPFC using a 3-Tesla 1H-MRS. RESULTS The metabolic concentration of myo-inositol in patients with OCD increased significantly by 52% compared with the healthy controls, whereas glutamine/glutamate was decreased by 11%. However, there were no significant differences in N-acetylaspartate, choline, lactate and lipid between the two groups. CONCLUSION These findings would be helpful to understand the pathophysiology of OCD associated with the brain metabolic abnormalities in the right DLPFC.
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15
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1H magnetic resonance spectroscopy evidence for occipital involvement in treatment-naive paediatric obsessive-compulsive disorder. Acta Neuropsychiatr 2017; 29:179-190. [PMID: 27772535 DOI: 10.1017/neu.2016.52] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder leading to considerable distress and disability. Therapies are effective in a majority of paediatric patients, however, many only get partial response. It is therefore important to study the underlying pathophysiology of the disorder. METHODS 1H magnetic resonance spectroscopy (MRS) was used to study the concentration of brain metabolites in four different locations (cingulate gyrus and sulcus, occipital cortex, thalamus and right caudate nucleus). Treatment-naive children and adolescents with OCD (13 subjects) were compared with a group of healthy age- and gender-matched subjects (11 subjects). Multivariate analyses were performed on the concentration values. RESULTS No separation between controls and patients was found. However, a correlation between metabolite concentrations and symptom severity as measured with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) was found. Strongest was the correlation with the CY-BOCS obsession subscore and aspartate and choline in the caudate nucleus (positively correlated with obsessions), lipids at 2 and 0.9 ppm in thalamus, and occipital glutamate+glutamine, N-acetylaspartate and myo-inosytol (negatively correlated with obsessions). CONCLUSIONS The observed correlations between 1H MRS and CY-BOCS in treatment-naive patients further supports an occipital involvement in OCD. The results are consistent with our previous study on adult OCD patients. The 1H MRS data were not supportive of a separation between the patient and control groups.
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16
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Friedman AL, Burgess A, Ramaseshan K, Easter P, Khatib D, Chowdury A, Arnold PD, Hanna GL, Rosenberg DR, Diwadkar VA. Brain network dysfunction in youth with obsessive-compulsive disorder induced by simple uni-manual behavior: The role of the dorsal anterior cingulate cortex. Psychiatry Res 2017; 260:6-15. [PMID: 27992792 PMCID: PMC5302006 DOI: 10.1016/j.pscychresns.2016.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 12/09/2016] [Accepted: 12/10/2016] [Indexed: 10/20/2022]
Abstract
In an effort to elucidate differences in functioning brain networks between youth with obsessive-compulsive disorder and controls, we used fMRI signals to analyze brain network interactions of the dorsal anterior cingulate cortex (dACC) during visually coordinated motor responses. Subjects made a uni-manual response to briefly presented probes, at periodic (allowing participants to maintain a "motor set") or random intervals (demanding reactive responses). Network interactions were assessed using psycho-physiological interaction (PPI), a basic model of functional connectivity evaluating modulatory effects of the dACC in the context of each task condition. Across conditions, OCD were characterized by hyper-modulation by the dACC, with loci alternatively observed as both condition-general and condition-specific. Thus, dynamically driven task demands during simple uni-manual motor control induce compensatory network interactions in cortical-thalamic regions in OCD. These findings support previous research in OCD showing compensatory network interactions during complex memory tasks, but establish that these network effects are observed during basic sensorimotor processing. Thus, these patterns of network dysfunction may in fact be independent of the complexity of tasks used to induce brain network activity. Hypothesis-driven approaches coupled with sophisticated network analyses are a highly valuable approach in using fMRI to uncover mechanisms in disorders like OCD.
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Affiliation(s)
- Amy L Friedman
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Ashley Burgess
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Karthik Ramaseshan
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Phil Easter
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Dalal Khatib
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Asadur Chowdury
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Paul D Arnold
- Dept. of Psychiatry and Mathison Centre for Mental Health Research & Education, University of Calgary, Calgary, Alberta, Canada
| | - Gregory L Hanna
- Dept. of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - David R Rosenberg
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Vaibhav A Diwadkar
- Dept. of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
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17
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Cheng B, Cai W, Wang X, Lei D, Guo Y, Yang X, Wu Q, Gong J, Gong Q, Ning G. Brain Gray Matter Abnormalities in First-Episode, Treatment-Naive Children with Obsessive-Compulsive Disorder. Front Behav Neurosci 2016; 10:141. [PMID: 27445736 PMCID: PMC4927814 DOI: 10.3389/fnbeh.2016.00141] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 06/20/2016] [Indexed: 02/05/2023] Open
Abstract
Although several magnetic resonance imaging (MRI) studies have been conducted in children with obsessive-compulsive disorder (OCD), the brain structural abnormalities in OCD, especially in children, are not yet well characterized. We aimed to identify gray matter (GM) abnormalities in the early stage of pediatric OCD and examine the relationship between these structural abnormalities with clinical characteristics. Examinations of 30 first-episode, treatment-naive pediatric OCD patients without any comorbidities and 30 matched healthy controls (HCs) were performed with 3.0 T magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) following Diffeomorphic Anatomical Registration using Exponentiated Lie algebra (DARTEL) was used to conduct voxel-wise tests for group differences in regional gray matter volume (GMV). Compared to HCs, the patient group exhibited more GMV in the bilateral putamen and left orbitofrontal cortex (OFC) and less GMV in the left inferior parietal lobule (IPL). The GMV alternation in the right putamen of OCD patients was positively correlated with Hamilton Anxiety Rating Scale (HAM-A) scores, while the GMV alternation in the left IPL exhibited a trend to negatively correlate with HAM-A scores. Our current results suggest that the GM abnormalities were defined in the early stage of pediatric OCD. Moreover, these findings provided further evidence of brain GM abnormalities that are not only present in the classical fronto–striatal–thalamic circuit but also in the default mode network (DMN), which may represent the interaction of abnormally functional organization of both network in pediatric OCD.
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Affiliation(s)
- Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan UniversityChengdu, China; Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan UniversityChengdu, China
| | - Wu Cai
- Department of Radiology, The Second Affiliated Hospital of Soochow University Suzhou, China
| | - Xiuli Wang
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University Chengdu, China
| | - Du Lei
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London London, UK
| | - Yingkun Guo
- Department of Radiology, West China Second University Hospital of Sichuan University Chengdu, China
| | - Xun Yang
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan UniversityChengdu, China; School of Sociality and Psychology, Southwest University for NationalitiesChengdu, China
| | - Qizhu Wu
- Monash Biomedical Imaging, Monash University Clayton, VIC, Australia
| | - Jianping Gong
- Department of Radiology, The Second Affiliated Hospital of Soochow University Suzhou, China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University Chengdu, China
| | - Gang Ning
- Department of Radiology, West China Second University Hospital of Sichuan University Chengdu, China
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Dyster TG, Mikell CB, Sheth SA. The Co-evolution of Neuroimaging and Psychiatric Neurosurgery. Front Neuroanat 2016; 10:68. [PMID: 27445706 PMCID: PMC4916214 DOI: 10.3389/fnana.2016.00068] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/07/2016] [Indexed: 12/20/2022] Open
Abstract
The role of neuroimaging in psychiatric neurosurgery has evolved significantly throughout the field's history. Psychiatric neurosurgery initially developed without the benefit of information provided by modern imaging modalities, and thus lesion targets were selected based on contemporary theories of frontal lobe dysfunction in psychiatric disease. However, by the end of the 20th century, the availability of structural and functional magnetic resonance imaging (fMRI) allowed for the development of mechanistic theories attempting to explain the anatamofunctional basis of these disorders, as well as the efficacy of stereotactic neuromodulatory treatments. Neuroimaging now plays a central and ever-expanding role in the neurosurgical management of psychiatric disorders, by influencing the determination of surgical candidates, allowing individualized surgical targeting and planning, and identifying network-level changes in the brain following surgery. In this review, we aim to describe the coevolution of psychiatric neurosurgery and neuroimaging, including ways in which neuroimaging has proved useful in elucidating the therapeutic mechanisms of neuromodulatory procedures. We focus on ablative over stimulation-based procedures given their historical precedence and the greater opportunity they afford for post-operative re-imaging, but also discuss important contributions from the deep brain stimulation (DBS) literature. We conclude with a discussion of how neuroimaging will transition the field of psychiatric neurosurgery into the era of precision medicine.
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Affiliation(s)
- Timothy G. Dyster
- Functional and Cognitive Neurophysiology Laboratory, Department of Neurological Surgery, Columbia University Medical Center, New York Presbyterian HospitalNew York, NY, USA
| | - Charles B. Mikell
- Functional and Cognitive Neurophysiology Laboratory, Department of Neurological Surgery, Columbia University Medical Center, New York Presbyterian HospitalNew York, NY, USA
| | - Sameer A. Sheth
- Functional and Cognitive Neurophysiology Laboratory, Department of Neurological Surgery, Columbia University Medical Center, New York Presbyterian HospitalNew York, NY, USA
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Tang W, Huang X, Li B, Jiang X, Li F, Xu J, Yang Y, Gong Q. Structural brain abnormalities correlate with clinical features in patients with drug-naïve OCD: A DARTEL-enhanced voxel-based morphometry study. Behav Brain Res 2015; 294:72-80. [DOI: 10.1016/j.bbr.2015.07.061] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/27/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
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Levman J, Takahashi E. Multivariate analyses applied to fetal, neonatal and pediatric MRI of neurodevelopmental disorders. Neuroimage Clin 2015; 9:532-44. [PMID: 26640765 PMCID: PMC4625213 DOI: 10.1016/j.nicl.2015.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/23/2015] [Accepted: 09/25/2015] [Indexed: 01/15/2023]
Abstract
Multivariate analysis (MVA) is a class of statistical and pattern recognition methods that involve the processing of data that contains multiple measurements per sample. MVA can be used to address a wide variety of medical neuroimaging-related challenges including identifying variables associated with a measure of clinical importance (i.e. patient outcome), creating diagnostic tests, assisting in characterizing developmental disorders, understanding disease etiology, development and progression, assisting in treatment monitoring and much more. Compared to adults, imaging of developing immature brains has attracted less attention from MVA researchers. However, remarkable MVA research growth has occurred in recent years. This paper presents the results of a systematic review of the literature focusing on MVA technologies applied to neurodevelopmental disorders in fetal, neonatal and pediatric magnetic resonance imaging (MRI) of the brain. The goal of this manuscript is to provide a concise review of the state of the scientific literature on studies employing brain MRI and MVA in a pre-adult population. Neurological developmental disorders addressed in the MVA research contained in this review include autism spectrum disorder, attention deficit hyperactivity disorder, epilepsy, schizophrenia and more. While the results of this review demonstrate considerable interest from the scientific community in applications of MVA technologies in pediatric/neonatal/fetal brain MRI, the field is still young and considerable research growth remains ahead of us.
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Affiliation(s)
- Jacob Levman
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 1 Autumn Street #456, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
| | - Emi Takahashi
- Division of Newborn Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 1 Autumn Street #456, Boston, MA 02115, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
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Brennan E, Flessner C. An interrogation of cognitive findings in pediatric obsessive-compulsive and related disorders. Psychiatry Res 2015; 227:135-43. [PMID: 25912428 DOI: 10.1016/j.psychres.2015.03.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 02/23/2015] [Accepted: 03/08/2015] [Indexed: 10/23/2022]
Abstract
Current findings in the field of psychology have led to increased interest and a new conceptualization of disorders characterized by repetitive behaviors, namely the obsessive compulsive and related disorders (OCRDs). Scant research, however, has sought to collect and categorize the extant research on pediatric OCRDs. Particularly, no adequate review of the pediatric cognitive literature existed until now, despite the clear implication of abnormalities in neuroanatomical structures and cognitive functioning in adult samples. While evidence for cognitive dysfunction in pediatric samples is presented, this paper also suggests that differences in cognitive dysfunction may indeed exist between adults and youth with OCRDs. Specifically, those irregularities present in said youth at varying developmental stages may impact the origination and maintenance of OCRDs across time. Finally, this paper seeks to formulate potential future goals for the research field, particularly through transdiagnostic approaches to processes linked with symptom presentations. This is of particular importance as an improved understanding of the interaction of cognitive function and growth is key to further comprehension of the OCRDs.
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Affiliation(s)
- Elle Brennan
- Department of Psychological Sciences, Kent State University, Kent Hall, 600 Hilltop Drive, Kent, OH 442440, USA.
| | - Christopher Flessner
- Department of Psychological Sciences, Kent State University, Kent Hall, 600 Hilltop Drive, Kent, OH 442440, USA
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Güçlü B, Tanıdır C, Çanayaz E, Güner B, İpek Toz H, Üneri ÖŞ, Tommerdahl M. Tactile processing in children and adolescents with obsessive–compulsive disorder. Somatosens Mot Res 2015; 32:163-71. [DOI: 10.3109/08990220.2015.1023950] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Decreased thalamic glutamate level in unmedicated adult obsessive-compulsive disorder patients detected by proton magnetic resonance spectroscopy. J Affect Disord 2015; 178:193-200. [PMID: 25819113 DOI: 10.1016/j.jad.2015.03.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 03/05/2015] [Accepted: 03/05/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Previous neuroimaging studies implied that the dysfunction of cortico-striato-thalamo-cortical (CSTC) circuit served as the neural basis for the pathophysiology of obsessive-compulsive disorder (OCD). The imbalances in neuronal metabolite and neurotransmitter within CSTC circuit have been shown as the leading reasons of the OCD onset. The aim of this study is to investigate the metabolic alterations, especially the glutamatergic signal dysfunction within CSTC circuit, and the relationships between neural metabolites and the symptom severity of OCD patients. METHODS Single voxel magnetic resonance spectroscopy (MRS) was conducted in medial prefrontal cortex (mPFC) and bilateral thalamus areas for thirteen unmedicated adult OCD patients with age-, gender-, and education-matched healthy controls. Quantification and multivariate analysis were performed to identify vital metabolic biomarkers for patients and healthy controls group differentiation. Moreover, we performed Spearman׳s rank correlation analysis for OCD patients to examine the relationship between the metabolite concentration level and OCD symptomatology. RESULTS Patients with OCD showed significantly decreased glutamate level in mPFC (p=0.021) and right thalamus (p=0.039), and significantly increased choline compounds in left thalamus (p=0.044).The glutamate in right thalamus was shown as the most important metabolite for group separation from multivariate analysis (Q(2)=0.134) and was significantly correlated with the patients׳ compulsion scores (Spearman r=-0.674, p=0.016). LIMITATIONS Limited sample size, the use of creatine and phosphocreatine (Cr) ratios rather than absolute concentrations and unresolved glutamine (Gln) are limitations of the present study. CONCLUSION Our study results consolidated the hypothesis about glutamatergic signaling dysfunction in OCD. To our knowledge, it is the first finding about a reduced thalamic glutamate level in adult unmedicated OCD patients. The dysregulation of glutamate serves as a potential target for the OCD pharmacotherapy and the detailed mechanisms underlying the glutamate alterations within CSTC circuits merit further investigations.
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Kumar A, Williams MT, Chugani HT. Evaluation of basal ganglia and thalamic inflammation in children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection and tourette syndrome: a positron emission tomographic (PET) study using 11C-[R]-PK11195. J Child Neurol 2015; 30:749-56. [PMID: 25117419 DOI: 10.1177/0883073814543303] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 06/19/2014] [Indexed: 12/18/2022]
Abstract
We applied PET scanning with (11)C-[R]-PK11195 (PK) to evaluate neuroinflammatory changes in basal ganglia and thalamus in children with clinically diagnosed pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) and Tourette syndrome. Seventeen children with PANDAS (mean age: 11.4 ± 2.6 years; 13 males), 12 with Tourette syndrome (mean age: 11.0 ± 3.0 years; 10 males), and 15 normal adults (mean age: 28.7 ± 7.9 years; 8 males) underwent dynamic PK PET imaging and binding potential, a measure of ligand-TSPO receptor (expressed by activated microglia) binding, was calculated for basal ganglia and thalamus. Binding potential values, suggesting underlying activated microglia-mediated neuroinflammation, were found to be increased in bilateral caudate and bilateral lentiform nucleus in the PANDAS group and in bilateral caudate nuclei only in the Tourette syndrome group, compared to control group. These differences in the pattern and extent of neuroinflammation also signify a possible difference in pathophysiological etiology between PANDAS and Tourette syndrome patients.
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Affiliation(s)
- Ajay Kumar
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA Department of Radiology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA Department of Positron Emission Tomography Center, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA
| | - Mitchel T Williams
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA
| | - Harry T Chugani
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA Department of Positron Emission Tomography Center, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University School of Medicine, Detroit, MI, USA
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Gerardi DM, Casadonte J, Patel P, Murphy TK. PANDAS and comorbid Kleine-Levin syndrome. J Child Adolesc Psychopharmacol 2015; 25:93-8. [PMID: 25329605 PMCID: PMC4340647 DOI: 10.1089/cap.2014.0064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Diana M. Gerardi
- Division of Pediatric Neuropsychiatry, Rothman Center, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
| | - Joseph Casadonte
- Pediatric Neurology Associates, St. Petersburg, Florida.,Department of Neurology, All Children's Hospital, St. Petersburg, Florida
| | - Priyal Patel
- Division of Pediatric Neuropsychiatry, Rothman Center, Department of Pediatrics, University of South Florida, St. Petersburg, Florida
| | - Tanya K. Murphy
- Division of Pediatric Neuropsychiatry, Rothman Center, Department of Pediatrics, University of South Florida, St. Petersburg, Florida.,Department of Psychiatry, University of South Florida, Tampa, Florida
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Lázaro L, Ortiz AG, Calvo A, Ortiz AE, Moreno E, Morer A, Calvo R, Bargallo N. White matter structural alterations in pediatric obsessive-compulsive disorder: relation to symptom dimensions. Prog Neuropsychopharmacol Biol Psychiatry 2014; 54:249-58. [PMID: 24977330 DOI: 10.1016/j.pnpbp.2014.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 06/18/2014] [Accepted: 06/21/2014] [Indexed: 11/16/2022]
Abstract
UNLABELLED The aims of this study were to identify gray matter (GM) and white matter (WM) volume abnormalities in pediatric obsessive-compulsive patients, to examine their relationship between these abnormalities and the severity of disorder, and to explore whether they could be explained by the different symptom dimensions. METHODS 62 child and adolescent OCD patients (11-18years old) and 46 healthy subjects of the same gender and similar age and estimated intellectual quotient were assessed by means of psychopathological scales and magnetic resonance imaging (MRI). Axial three-dimensional T1-weighted images were obtained in a 3T scanner and analyzed using optimized voxel-based morphometry (VBM). RESULTS Compared with healthy controls, OCD patients showed lower white matter (WM) volume in the left dorsolateral and cingulate regions involving the superior and middle frontal gyri and anterior cingulate gyrus (t=4.35, p=0.049 FWE (family wise error)-corrected). There was no significant correlation between WM and the severity of obsessive-compulsive symptomatology. There were no regions with lower gray matter (GM) volume in OCD patients than in controls. Compared with healthy controls, only the "harm/checking" OCD dimension showed a cluster with a near significant decrease in WM volume in the right superior temporal gyrus extending into the insula (t=5.61, p=.056 FWE-corrected). CONCLUSION The evidence suggests that abnormalities in the dorsolateral prefrontal cortex, anterior cingulate cortex, temporal and limbic regions play a central role in the pathophysiology of OCD. Moreover, regional brain volumes in OCD may vary depending on specific OCD symptom dimensions, indicating the clinical heterogeneity of the condition.
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Affiliation(s)
- L Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain; IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Spain; CIBERSAM, Spain.
| | - A G Ortiz
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
| | - A Calvo
- Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain
| | - A E Ortiz
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
| | - E Moreno
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
| | - A Morer
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain; IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain; CIBERSAM, Spain
| | - R Calvo
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain; CIBERSAM, Spain
| | - N Bargallo
- CIBERSAM, Spain; Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain; Image Diagnostic Center, Hospital Clínic, Barcelona, Spain
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Huyser C, van den Heuvel OA, Wolters L, de Haan E, Lindauer R, Veltman DJ. A longitudinal VBM study in paediatric obsessive-compulsive disorder at 2-year follow-up after cognitive behavioural therapy. World J Biol Psychiatry 2014; 15:443-52. [PMID: 24125065 DOI: 10.3109/15622975.2013.819122] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To identify neurodevelopmental differences in regional brain volume between medication-free paediatric obsessive-compulsive disorder (OCD) patients and controls at 2-year follow-up after cognitive behavioural therapy. METHODS We assessed 17 medication-free paediatric OCD patients (mean age 13.8 years; SD = 2.8; range 8.2-19.0) and 20 controls, matched on age and gender, with T1-weighted MR scans in a repeated measures design at three time points with intervals of 6 months and 2 years. Voxel based morphometry (VBM) was used to test whole brain voxel-wise for the effects of diagnosis and time on regional grey matter (GM) and white matter volumes. RESULTS GM volume of the orbitofrontal cortex showed a group × time interaction effect, driven by an increase of GM volume over the whole time period in OCD patients and a decrease in controls. When splitting the groups in two age groups (8-12 and 13-19 years) this interaction effect was only seen in the youngest age group. CONCLUSIONS Neuroimaging findings in paediatric OCD after 6 months of CBT in the GM volume of the orbital frontal cortex are still present at 2-year follow-up.
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Affiliation(s)
- Chaim Huyser
- Department of Child and Adolescent Psychiatry, University of Amsterdam, AMC , Amsterdam , The Netherlands
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Goodman J, Marsh R, Peterson BS, Packard MG. Annual research review: The neurobehavioral development of multiple memory systems--implications for childhood and adolescent psychiatric disorders. J Child Psychol Psychiatry 2014; 55:582-610. [PMID: 24286520 PMCID: PMC4244838 DOI: 10.1111/jcpp.12169] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2013] [Indexed: 01/26/2023]
Abstract
Extensive evidence indicates that mammalian memory is organized into multiple brains systems, including a 'cognitive' memory system that depends on the hippocampus and a stimulus-response 'habit' memory system that depends on the dorsolateral striatum. Dorsal striatal-dependent habit memory may in part influence the development and expression of some human psychopathologies, particularly those characterized by strong habit-like behavioral features. The present review considers this hypothesis as it pertains to psychopathologies that typically emerge during childhood and adolescence. These disorders include Tourette syndrome, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, eating disorders, and autism spectrum disorders. Human and nonhuman animal research shows that the typical development of memory systems comprises the early maturation of striatal-dependent habit memory and the relatively late maturation of hippocampal-dependent cognitive memory. We speculate that the differing rates of development of these memory systems may in part contribute to the early emergence of habit-like symptoms in childhood and adolescence. In addition, abnormalities in hippocampal and striatal brain regions have been observed consistently in youth with these disorders, suggesting that the aberrant development of memory systems may also contribute to the emergence of habit-like symptoms as core pathological features of these illnesses. Considering these disorders within the context of multiple memory systems may help elucidate the pathogenesis of habit-like symptoms in childhood and adolescence, and lead to novel treatments that lessen the habit-like behavioral features of these disorders.
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Affiliation(s)
- Jarid Goodman
- The Department of Psychology, Texas A&M University, College Station, TX, USA
| | - Rachel Marsh
- The MRI Unit and Division of Child & Adolescent Psychiatry in the Department of Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Bradley S. Peterson
- The MRI Unit and Division of Child & Adolescent Psychiatry in the Department of Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Mark G. Packard
- The Department of Psychology, Texas A&M University, College Station, TX, USA
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Gruner P, Vo A, Argyelan M, Ikuta T, Degnan AJ, John M, Peters BD, Malhotra AK, Uluğ AM, Szeszko PR. Independent component analysis of resting state activity in pediatric obsessive-compulsive disorder. Hum Brain Mapp 2014; 35:5306-15. [PMID: 24867148 DOI: 10.1002/hbm.22551] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 04/11/2014] [Accepted: 05/06/2014] [Indexed: 01/31/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is an often severely disabling illness with onset generally in childhood or adolescence. Little is known, however, regarding the pattern of brain resting state activity in OCD early in the course of illness. We therefore examined differences in brain resting state activity in patients with pediatric OCD compared with healthy volunteers and their clinical correlates. Twenty-three pediatric OCD patients and 23 healthy volunteers (age range 9-17), matched for sex, age, handedness, and IQ completed a resting state functional magnetic resonance imaging exam at 3T. Patients completed the Children's Yale Brown Obsessive Scale. Data were decomposed into 36 functional networks using spatial group independent component analysis (ICA) and logistic regression was used to identify the components that yielded maximum group separation. Using ICA we identified three components that maximally separated the groups: a middle frontal/dorsal anterior cingulate network, an anterior/posterior cingulate network, and a visual network yielding an overall group classification of 76.1% (sensitivity = 78.3% and specificity = 73.9%). Independent component expression scores were significantly higher in patients compared with healthy volunteers in the middle frontal/dorsal anterior cingulate and the anterior/posterior cingulate networks, but lower in patients within the visual network. Higher expression scores in the anterior/posterior cingulate network correlated with greater severity of compulsions among patients. These findings implicate resting state fMRI abnormalities within the cingulate cortex and related control regions in the pathogenesis and phenomenology of OCD early in the course of the disorder and prior to extensive pharmacologic intervention.
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Affiliation(s)
- Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, Connecticut
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Abstract
INTRODUCTION This paper reviews the literature as it relates to perceptual processes in body dysmorphic disorder (BDD). METHODS A narrative-style review of the literature was undertaken to explore the relationship between BDD and obsessive-compulsive disorder, the empirical evidence for aberrant own-body perception in BDD, and the possible role of the parietal cortex in the disorder. RESULTS The extant literature appears to support the postulation that BDD is underpinned by a dysfunction in somatoperception-the process by which individuals formulate a sense of what they look like. CONCLUSIONS Investigation of somatoperceptive processes in BDD and related brain structures would provide important insight about the development and maintenance of this complex and often neglected psychiatric condition, and, in turn, help improve its treatment.
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Affiliation(s)
- Ryan A Kaplan
- a School of Psychology and Psychiatry , Monash University , Melbourne , Australia
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Segalàs C, Alonso P, Orbegozo A, Real E, Subirà M, López-Solà C, Martínez-Zalacaín I, Labad J, Harrison BJ, Pujol J, Menchón JM, Cardoner N, Soriano-Mas C. Brain structural imaging correlates of olfactory dysfunction in obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci 2014; 264:225-33. [PMID: 23995893 DOI: 10.1007/s00406-013-0439-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 08/17/2013] [Indexed: 12/19/2022]
Abstract
Olfactory dysfunction has been described in obsessive-compulsive disorder (OCD). Brain regions involved in smell processing partially overlap with structures included in the neurobiological models of OCD, although no previous studies have analyzed the neuroanatomical correlates of olfactory dysfunction in this disorder. The aim of our study was to examine the association between regional gray matter volume, as assessed by a voxel-based morphometry analysis of magnetic resonance images (MRI), and olfactory function, as assessed by the Sniffin' Sticks test (SST). Olfactory function was assessed in 19 OCD patients and 19 healthy volunteers. All participants were also scanned in a 1.5-T magnet to obtain T1-weighted anatomical MRIs, which were pre-processed and analyzed with SPM8. Three different correlation models were used to study the association between regional gray matter volumes and olfactory function in the domains assessed by the SST: detection threshold, discrimination, and identification. OCD patients showed a significant impairment in all the domains assessed by the SST. Voxel-based mapping revealed a positive association in healthy controls between detection threshold and the gray matter content of a left anterior cingulate cortex cluster. In OCD patients, a positive correlation was observed between identification errors and the gray matter volume of the left medial orbital gyrus. In a post hoc analysis, these two gray matter regions were shown to be enlarged in OCD patients. Our findings support the idea that olfactory dysfunction in OCD is associated with volumetric changes in brain areas typically implicated in the neurobiology of the disorder.
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Affiliation(s)
- Cinto Segalàs
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Bellvitge University Hospital, c/Feixa Llarga s/n, Hospitalet de Llobregat, 08907, Barcelona, Spain,
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Rodman AM, Milad MR, Deckersbach T, Im J, Chou T, Dougherty DD. Neuroimaging contributions to novel surgical treatments for intractable obsessive–compulsive disorder. Expert Rev Neurother 2014; 12:219-27. [DOI: 10.1586/ern.11.189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Koo MS, Kim EJ, Roh D, Kim CH. Role of dopamine in the pathophysiology and treatment of obsessive–compulsive disorder. Expert Rev Neurother 2014; 10:275-90. [DOI: 10.1586/ern.09.148] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hashimoto N, Nakaaki S, Kawaguchi A, Sato J, Kasai H, Nakamae T, Narumoto J, Miyata J, Furukawa TA, Mimura M. Brain structural abnormalities in behavior therapy-resistant obsessive-compulsive disorder revealed by voxel-based morphometry. Neuropsychiatr Dis Treat 2014; 10:1987-96. [PMID: 25349476 PMCID: PMC4208702 DOI: 10.2147/ndt.s69652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Although several functional imaging studies have demonstrated that behavior therapy (BT) modifies the neural circuits involved in the pathogenesis of obsessive-compulsive disorder (OCD), the structural abnormalities underlying BT-resistant OCD remain unknown. METHODS In this study, we examined the existence of regional structural abnormalities in both the gray matter and the white matter of patients with OCD at baseline using voxel-based morphometry in responders (n=24) and nonresponders (n=15) to subsequent BT. Three-dimensional T1-weighted magnetic resonance imaging was performed before the completion of 12 weeks of BT. RESULTS Relative to the responders, the nonresponders exhibited significantly smaller gray matter volumes in the right ventromedial prefrontal cortex, the right orbitofrontal cortex, the right precentral gyrus, and the left anterior cingulate cortex. In addition, relative to the responders, the nonresponders exhibited significantly smaller white matter volumes in the left cingulate bundle and the left superior frontal white matter. CONCLUSION These results suggest that the brain structures in several areas, including the orbitofrontal cortex, anterior cingulate cortex, and cingulate bundles, are related to the lack of a response to BT in patients with OCD. The use of a voxel-based morphometry approach may be advantageous to understanding differences in brain abnormalities between responders and nonresponders to BT.
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Affiliation(s)
- Nobuhiko Hashimoto
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shutaro Nakaaki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Kawaguchi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Junko Sato
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Harumasa Kasai
- Department of Central Radiology, Nagoya City University Hospital, Nagoya, Japan
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan ; Department of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Disorder-specific volumetric brain difference in adolescent major depressive disorder and bipolar depression. Brain Imaging Behav 2013; 8:119-27. [DOI: 10.1007/s11682-013-9264-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Narayanaswamy JC, Jose D, Kalmady S, Venkatasubramanian G, Reddy YCJ. Clinical correlates of nucleus accumbens volume in drug-naive, adult patients with obsessive-compulsive disorder. Aust N Z J Psychiatry 2013; 47:930-7. [PMID: 23737599 DOI: 10.1177/0004867413491153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Reward-processing deficits have been demonstrated in obsessive-compulsive disorder (OCD) and this has been linked to ventral striatal abnormalities. However, volumetric abnormalities of the nucleus accumbens (NAcc), a key structure in the reward pathway, have not been examined in OCD. We report on the volumetric abnormalities of NAcc and its correlation with illness severity in drug-naïve, adult patients with OCD. METHOD In this cross-sectional study of case-control design, the magnetic resonance imaging (MRI) 1.5-T (1-mm) volume of NAcc was measured using 3D Slicer software in drug-naïve OCD patients (n = 44) and age, sex and handedness-matched healthy controls (HCs) (n = 36) using a valid and reliable method. OCD symptoms were assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Symptom checklist and severity and the Clinical Global Impression-Severity (CGI-S) scale. RESULTS There was no significant difference in NAcc volumes on either side between OCD patients and HCs (F = 3.45, p = 0.07). However, there was significant negative correlation between the right NAcc volume and Y-BOCS compulsion score (r = -0.48, p = 0.001). CONCLUSIONS Study observations suggest involvement of the NAcc in the pathogenesis of OCD, indicating potential reward-processing deficits. Correlation between the right NAcc volume deficit and severity of compulsions offers further support for this region as a candidate for deep brain stimulation treatment in OCD.
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Affiliation(s)
- Janardhanan C Narayanaswamy
- Obsessive Compulsive Disorder Clinic & Translational Psychiatry Lab, Neurobiology Research Center at National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
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Patel SR, Aronson JP, Sheth SA, Eskandar EN. Lesion Procedures in Psychiatric Neurosurgery. World Neurosurg 2013; 80:S31.e9-16. [DOI: 10.1016/j.wneu.2012.11.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 10/23/2012] [Accepted: 11/09/2012] [Indexed: 10/27/2022]
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Structural changes in the gray matter of unmedicated patients with obsessive-compulsive disorder: a voxel-based morphometric study. Neurosci Bull 2013; 29:642-8. [PMID: 23990196 DOI: 10.1007/s12264-013-1370-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 02/06/2013] [Indexed: 10/26/2022] Open
Abstract
The aim of the current study was to use whole brain voxel-based morphometry (VBM) to assess the gray matter (GM) changes in unmedicated patients with obsessive-compulsive disorder (OCD) compared with normal controls. We compared the GM volumes in 28 patients with 22 matched healthy controls using a 1.5T MRI. Three-dimensional T1-weighted magnetic resonance images were obtained from all participants. VBM was performed to detect GM volume differences between the two groups. We detected increased regional GM volumes in the bilateral middle temporal gyri, bilateral middle occipital gyri, bilateral globus pallidus, right inferior parietal gyrus, left superior parietal gyrus, right parahippocampus, right supramarginal gyrus, right medial superior frontal gyrus, and left inferior frontal opercular cortex in the OCD patients relative to controls (P <0.001, uncorrected, cluster size >100 voxels). No decreased GM volume was found in the OCD group compared with normal controls. Our findings suggest that structural changes in the GM are not limited to fronto-striato-thalamic circuits in the pathogenesis of OCD. Temporo-parietal cortex may also play an important role.
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Chen J, Silk T, Seal M, Dally K, Vance A. Widespread decreased grey and white matter in paediatric obsessive-compulsive disorder (OCD): a voxel-based morphometric MRI study. Psychiatry Res 2013; 213:11-7. [PMID: 23701704 DOI: 10.1016/j.pscychresns.2013.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 02/05/2013] [Accepted: 02/07/2013] [Indexed: 01/01/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a chronic, relapsing anxiety disorder. To date, neuroimaging investigations of OCD have been variable and few studies have examined paediatric populations. Eight children with OCD and 12 typically developing children matched for age, gender, handedness and performance IQ underwent a high resolution T1-weighted structural magnetic resonance imaging (MRI) scan. A voxel-based morphometry (VBM) protocol (using DARTEL) compared the brains of the paediatric OCD children with those of typically developing children. Overall, children with OCD demonstrated significantly lower intra-cranial volume (ICV) and grey- and white-matter volumes. ICV was significantly reduced (∼9%) in the OCD group compared with the typically developing group. The VBM analysis demonstrated lower volumes in widespread grey matter in bilateral frontal, cingulate, temporal-parietal, occipital-frontal and right precuneus regions for OCD. Lower white matter volume was found bilaterally in the cingulate and occipital cortex, right frontal and parietal and left temporal regions, and the corpus callosum. In summary, this study provides further evidence of brain dysmorphology in paediatric OCD patients. In addition to fronto-striatal-thalamic neural networks, abnormalities in other brain regions, such as the parietal lobe and corpus callosum, were demonstrated. These brain regions may play an additional role in the pathophysiology of OCD.
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Affiliation(s)
- Jian Chen
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
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Huyser C, van den Heuvel OA, Wolters LH, de Haan E, Boer F, Veltman DJ. Increased orbital frontal gray matter volume after cognitive behavioural therapy in paediatric obsessive compulsive disorder. World J Biol Psychiatry 2013; 14:319-31. [PMID: 22746998 DOI: 10.3109/15622975.2012.674215] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Identify differences in regional brain volume between medication-free pediatric OCD patients and controls and examine changes after cognitive behavioural therapy. METHODS We assessed 29 medication-free paediatric OCD patients (Age: M = 13.78 years; SD = 2.58; range 8.2-19.0) and 29 controls, matched on age and gender, with T1-weighted MR scans in a repeated measures, pre-post treatment design. Voxel based morphometry (VBM) following diffeomorphic anatomical registration through exponential lie algebra (DARTEL) was used to test voxel-wise for the effects of diagnosis and treatment on regional gray matter (GM) and white matter (WM) volumes. RESULTS After cognitive behavioural therapy, orbitofrontal GM and capsula externa WM increased in paediatric OCD relative to controls. In patients, changes in symptom severity (delta CY-BOCS) correlated positively with GM volume in the orbitofrontal cortex after treatment. Furthermore, before treatment, paediatric OCD patients, compared to the controls, showed larger GM volume in left frontal pole and left parietal cortex and larger WM volume in cingulum and corpus callosum. CONCLUSIONS Our findings underscore the involvement of the ventral frontal-striatal circuit in paediatric OCD and the plasticity of this circuit in response to the modulatory effects of CBT. The possible relation to brain development is discussed.
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Affiliation(s)
- Chaim Huyser
- Department of Child and Adolescent Psychiatry, University of Amsterdam , AMC, Amsterdam , The Netherlands.
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Isoforms of the neuronal glutamate transporter gene, SLC1A1/EAAC1, negatively modulate glutamate uptake: relevance to obsessive-compulsive disorder. Transl Psychiatry 2013; 3:e259. [PMID: 23695234 PMCID: PMC3669922 DOI: 10.1038/tp.2013.35] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The SLC1A1 gene, which encodes the neuronal glutamate transporter, EAAC1, has consistently been implicated in obsessive-compulsive disorder (OCD) in genetic studies. Moreover, neuroimaging, biochemical and clinical studies support a role for glutamatergic dysfunction in OCD. Although SLC1A1 is an excellent candidate gene for OCD, little is known about its regulation at the genomic level. Here, we report the identification and characterization of three alternative SLC1A1/EAAC1 mRNAs: a transcript derived from an internal promoter, termed P2 to distinguish it from the transcript generated by the primary promoter (P1), and two alternatively spliced mRNAs: ex2skip, which is missing exon 2, and ex11skip, which is missing exon 11. All isoforms inhibit glutamate uptake from the full-length EAAC1 transporter. Ex2skip and ex11skip also display partial colocalization and interact with the full-length EAAC1 protein. The three isoforms are evolutionarily conserved between human and mouse, and are expressed in brain, kidney and lymphocytes under nonpathological conditions, suggesting that the isoforms are physiological regulators of EAAC1. Moreover, under specific conditions, all SLC1A1 transcripts were differentially expressed in lymphocytes derived from subjects with OCD compared with controls. These initial results reveal the complexity of SLC1A1 regulation and the potential clinical utility of profiling glutamatergic gene expression in OCD and other psychiatric disorders.
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Clinical correlates of caudate volume in drug-naïve adult patients with obsessive-compulsive disorder. Psychiatry Res 2013; 212:7-13. [PMID: 23489673 DOI: 10.1016/j.pscychresns.2012.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 10/05/2012] [Accepted: 10/24/2012] [Indexed: 11/24/2022]
Abstract
The neurobiological basis of obsessive-compulsive disorder (OCD) has been theorized to reflect a dysfunction of cortico-striato-thalamo-cortical circuits, of which the caudate nucleus forms a critical component. However, structural imaging studies of the caudate in OCD are relatively scarce. To ascertain the clinical correlates of caudate volume in OCD, we report magnetic resonance imaging findings in a large sample of drug-naïve OCD patients in comparison with group-matched healthy controls. In this study, caudate volume was measured in coronal magnetic resonance brain images (high resolution 1-mm slice thickness) of 49 DSM-IV OCD patients and compared with that of 39 matched healthy controls. The caudate volume was measured separately for the head and body of the caudate. Analysis of covariance (ANCOVA) did not reveal significant differences in caudate volume between OCD patients and controls (whole group), with age, sex and intracranial volume as covariates. However, on examining the sexual dimorphism in the volume differences, male patients compared to male controls had significantly larger right caudate volume. The volume of the left caudate body showed a significant negative correlation with the total severity score on the Yale-Brown Obsessive-Compulsive Scale (YBOCS) on partial correlation analysis. Our study failed to show significant differences in caudate volumes between OCD patients and controls. However, it demonstrated a robust relationship between volume of the left caudate body and the severity of OCD. Additionally, there was a sexual dimorphism in caudate volume in OCD.
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Wu K, Hanna GL, Easter P, Kennedy JL, Rosenberg DR, Arnold PD. Glutamate system genes and brain volume alterations in pediatric obsessive-compulsive disorder: a preliminary study. Psychiatry Res 2013; 211:214-20. [PMID: 23154099 PMCID: PMC4552325 DOI: 10.1016/j.pscychresns.2012.07.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 05/22/2012] [Accepted: 07/10/2012] [Indexed: 10/27/2022]
Abstract
Obsessive-compulsive disorder (OCD) has been associated with regional volumetric brain abnormalities, which provide promising intermediate phenotypes of the disorder. In this study, volumes of brain regions selected for a priori evidence of association with OCD (orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), thalamus, caudate, putamen, globus pallidus and pituitary) were measured using structural magnetic resonance imaging (MRI) in 20 psychotropic-naïve pediatric OCD patients. We examined the association between these regional brain volumes and a total of 519 single nucleotide polymorphisms (SNPs) from nine glutamatergic candidate genes (DLGAP1, DLGAP2, DLGAP3, GRIN2B, SLC1A1, GRIK2, GRIK3, SLITRK1 and SLITRK5). These genes were selected based on either previous reported association with OCD in humans or evidence from animal models of OCD. After correcting for multiple comparisons by permutation testing, no SNP remained significantly associated with volumetric changes. The strongest trend toward association was identified between two SNPs in DLGAP2 (rs6558484 and rs7014992) and OFC white matter volume. Our other top ranked association findings were with ACC, OFC and thalamus. These preliminary results suggest that sequence variants in glutamate candidate genes may be associated with structural neuroimaging phenotypes of OCD.
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Affiliation(s)
- Ke Wu
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada M5G 1X8,Michael G. DeGroote School of Medicine Class of 2014, McMaster University, Hamilton, ON, Canada
| | | | - Philip Easter
- Wayne State University, Detroit, MI, United States,The Children’s Hospital of Michigan, Detroit, MI, United States
| | - James L. Kennedy
- Neurogenetics Section, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - David R. Rosenberg
- Wayne State University, Detroit, MI, United States,The Children’s Hospital of Michigan, Detroit, MI, United States
| | - Paul D Arnold
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada M5G 1X8,Department of Psychiatry, 1st Floor Elm Wing, Hospital for Sick Children, Toronto, ON, Canada M5G 1X8
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Ahmed F, Ras J, Seedat S. Volumetric structural magnetic resonance imaging findings in pediatric posttraumatic stress disorder and obsessive compulsive disorder: a systematic review. Front Psychol 2012; 3:568. [PMID: 23272001 PMCID: PMC3530132 DOI: 10.3389/fpsyg.2012.00568] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 11/30/2012] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Structural magnetic resonance imaging (sMRI) studies of anxiety disorders in children and adolescents are limited. Posttraumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD) have been best studied in this regard. We systematically reviewed structural neuroimaging findings in pediatric PTSD and OCD. METHODS The literature was reviewed for all sMRI studies examining volumetric parameters using PubMed, ScienceDirect, and PsychInfo databases, with no limit on the time frame of publication. Nine studies in pediatric PTSD and six in OCD were suitable for inclusion. RESULTS Volumetric findings were inconsistent in both disorders. In PTSD, findings suggest increased as well as decreased volumes of the prefrontal cortex (PFC) and corpus callosum; whilst in OCD studies indicate volumetric increase of the putamen, with inconsistent findings for the anterior cingulate cortex (ACC) and frontal regions. CONCLUSIONS Methodological differences may account for some of this inconsistency and additional volume-based studies in pediatric anxiety disorders using more uniform approaches are needed.
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Affiliation(s)
- Fatima Ahmed
- Department of Psychiatry, Stellenbosch University Cape Town, South Africa
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Abstract
Obsessive-compulsive disorder (OCD) is a prevalent and often severely disabling illness with onset generally in childhood or adolescence. Although white matter deficits have been implicated in the neurobiology of OCD, few studies have been conducted in pediatric patients when the brain is still developing and have examined their functional correlates. In this study, 23 pediatric OCD patients and 23 healthy volunteers, between the ages of 9 and 17 years, matched for sex, age, handedness, and IQ, received a diffusion tensor imaging exam on a 3T GE system and a brief neuropsychological battery tapping executive functions. Patient symptom severity was assessed using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Patients with OCD exhibited significantly greater fractional anisotropy compared to matched controls in the left dorsal cingulum bundle, splenium of the corpus callosum, right corticospinal tract, and left inferior fronto-occipital fasciculus. There were no regions of significantly lower fractional anisotropy in patients compared to controls. Higher fractional anisotropy in the splenium was significantly correlated with greater obsession severity on the CY-BOCS in the subgroup of psychotropic drug-naïve patients. Among patients, there was a significant association between greater fractional anisotropy in the dorsal cingulum bundle and better performance on measures of response inhibition and cognitive control. The overall findings suggest a pattern of greater directional coherence of white matter tracts in OCD very early in the course of illness, which may serve a compensatory mechanism, at least for response inhibition functions typically subserved by the cingulum bundle.
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Venkatasubramanian G, Zutshi A, Jindal S, Srikanth SG, Kovoor JME, Kumar JK, Janardhan Reddy YC. Comprehensive evaluation of cortical structure abnormalities in drug-naïve, adult patients with obsessive-compulsive disorder: a surface-based morphometry study. J Psychiatr Res 2012; 46:1161-8. [PMID: 22770508 DOI: 10.1016/j.jpsychires.2012.06.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 05/21/2012] [Accepted: 06/11/2012] [Indexed: 10/28/2022]
Abstract
The study objective was to comprehensively evaluate drug-naïve, adult patients with Obsessive Compulsive Disorder (OCD) for cortical structure abnormalities in comparison with healthy controls. In this cross-sectional study of case-control design, Magnetic Resonance Imaging (1-mm) was performed in drug-naïve OCD patients (N = 50) & age- sex-, education- and handedness-matched healthy controls (N = 40). We examined cortical volume, thickness, surface area & local Gyrification Index (LGI) through a completely automated surface-based morphometric analysis using FreeSurfer software. OCD symptoms and insight were assessed using Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) check-list and severity scale. Illness severity was assessed using Clinical Global Impression Severity (CGI-S) Scale. OCD patients had significantly deficient volume, thickness and surface area of right anterior cingulate gyrus (ACG). Right lingual gyrus surface area was found to be significantly decreased in patients. Y-BOCS obsession score had significant negative correlation with left frontal pole volume. Y-BOCS compulsion score had significant negative correlations with right ACG volume and surface area and right lateral orbitofrontal cortex LGI. CGI-Severity score had significant negative correlations with right lingual gyrus volume, thickness and surface area as well as right lateral orbitofrontal area. Y-BOCS insight score showed a significant negative correlation with LGI of left medial OFC and left rostral ACG. Identification of novel deficits involving occipital brain regions and first-time observations of relevant correlations between various illness characteristics and cortical measures in OCD patients supports a network involving anterior cingulate, orbitofrontal and occipital brain regions in the pathogenesis of OCD.
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Blackford JU, Pine DS. Neural substrates of childhood anxiety disorders: a review of neuroimaging findings. Child Adolesc Psychiatr Clin N Am 2012; 21:501-25. [PMID: 22800991 PMCID: PMC3489468 DOI: 10.1016/j.chc.2012.05.002] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The development of fear is a normative process, and significant progress has been made in identifying fear neurocircuitry. The normal development of fear goes awry in children who develop anxiety disorders, and dysfunction in fear circuitry is likely. In this article, the authors present current knowledge about the neural basis of normal fear development and reviews findings from structural and functional neuroimaging studies of childhood anxiety disorders.
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Affiliation(s)
- Jennifer Urbano Blackford
- Psychiatric Neuroimaging Program, Department of Psychiatry, Vanderbilt University School of Medicine, 1601 23rd Avenue South, Nashville, TN 37212, USA.
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Hou J, Wu W, Lin Y, Wang J, Zhou D, Guo J, Gu S, He M, Ahmed S, Hu J, Qu W, Li H. Localization of cerebral functional deficits in patients with obsessive-compulsive disorder: a resting-state fMRI study. J Affect Disord 2012; 138:313-21. [PMID: 22331021 DOI: 10.1016/j.jad.2012.01.022] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 01/17/2012] [Accepted: 01/17/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Abnormality of orbitofronto-striatal circuits was postulated in obsessive-compulsive disorder (OCD). The aim of this study is to test the abnormality hypothesis of orbitofronto-striatal circuits and explore whether there are any other dysfunctional brain regions in OCD using a resting-state functional magnetic resonance imaging (fMRI), and further investigate the relationship between the whole-brain voxel-based spontaneous neuronal activity of patients with OCD and clinical characteristics. METHODS 23 patients with OCD and 23 age- and gender-matched normal controls were examined using resting-state fMRI, and amplitude of low-frequency fluctuation (ALFF) approach was used to analyze fMRI data. RESULTS Compared with normal controls, patients with OCD presented increased ALFF in the bilateral orbitofrontal cortex (OFC), anterior cingulate cortex (ACC) as well as decreased ALFF in the bilateral cerebellum and parietal cortex (P<0.01, corrected). Additionally, the ALFF values in bilateral OFC were positively correlated with total Y-BOCS scores (P<0.005, uncorrected). CONCLUSION Our findings added an expanding literature to the abnormality hypothesis of orbitofronto-striatal circuits and showed the changed spontaneous neuronal activity of the parietal cortex and cerebellum may also play an important role in the pathophysiology in patients with OCD.
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Affiliation(s)
- Jingming Hou
- Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China
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Circadian rhythms in obsessive–compulsive disorder. J Neural Transm (Vienna) 2012; 119:1077-83. [DOI: 10.1007/s00702-012-0805-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 04/12/2012] [Indexed: 11/25/2022]
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Neurobiological circuits regulating attention, cognitive control, motivation, and emotion: disruptions in neurodevelopmental psychiatric disorders. J Am Acad Child Adolesc Psychiatry 2012; 51:356-67. [PMID: 22449642 DOI: 10.1016/j.jaac.2012.01.008] [Citation(s) in RCA: 335] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 01/06/2012] [Accepted: 01/27/2012] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This article aims to review basic and clinical studies outlining the roles of prefrontal cortical (PFC) networks in the behavior and cognitive functions that are compromised in childhood neurodevelopmental disorders and how these map into the neuroimaging evidence of circuit abnormalities in these disorders. METHOD Studies of animals, normally developing children, and patients with neurodevelopmental disorders were reviewed, with focus on neuroimaging studies. RESULTS The PFC provides "top-down" regulation of attention, inhibition/cognitive control, motivation, and emotion through connections with posterior cortical and subcortical structures. Dorsolateral and inferior PFC regulate attention and cognitive/inhibitory control, whereas orbital and ventromedial structures regulate motivation and affect. PFC circuitries are very sensitive to their neurochemical environment, and small changes in the underlying neurotransmitter systems, e.g. by medications, can produce large effects on mediated function. Neuroimaging studies of children with neurodevelopmental disorders show altered brain structure and function in distinctive circuits respecting this organization. Children with attention-deficit/hyperactivity disorder show prominent abnormalities in the inferior PFC and its connections to striatal, cerebellar, and parietal regions, whereas children with conduct disorder show alterations in the paralimbic system, comprising ventromedial, lateral orbitofrontal, and superior temporal cortices together with specific underlying limbic regions, regulating motivation and emotion control. Children with major depressive disorder show alterations in ventral orbital and limbic activity, particularly in the left hemisphere, mediating emotions. Finally, children with obsessive-compulsive disorder appear to have a dysregulation in orbito-fronto-striatal inhibitory control pathways, but also deficits in dorsolateral fronto-parietal systems of attention. CONCLUSIONS Altogether, there is a good correspondence between anatomical circuitry mediating compromised functions and patterns of brain structure and function changes in children with neuropsychiatric disorders. Medications may optimize the neurochemical environment in PFC and associated circuitries, and improve structure and function.
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