Gray matter structural alterations in obsessive–compulsive disorder: Relationship to neuropsychological functions

Abstract

Numerous magnetic resonance (MR) studies have examined gray matter structural alterations in patients with obsessive-compulsive disorder (OCD). Few, however, have used automated, highly reliable techniques such as voxel-based morphometry (VBM) to examine the entire brain in contrast to selected regions of interest. Moreover, few studies have examined the functional correlates of gray matter abnormalities in OCD. We used VBM to evaluate regional gray matter differences between 21 OCD patients and 21 age-and sex-matched healthy volunteers. All patients had comprehensive neuropsychological assessments. MR images were normalized to a customized template and segmented using optimized VBM. OCD patients had significantly (P < 0.001; uncorrected) more gray matter in the left thalamus compared to healthy volunteers. OCD patients without major depression had significantly more gray matter in the thalamus (bilaterally) and left orbitofrontal cortex as well as an unpredicted region of more right dorsolateral prefrontal gray matter, which remained significant after correction for multiple comparisons, compared to healthy volunteers. In the subgroup of patients without depression greater right hemisphere thalamic and dorsolateral prefrontal gray matter correlated significantly with worse motor functioning and processing speed, respectively. In this subgroup there was also a tendency for more gray matter in the left orbitofrontal cortex and right dorsolateral prefrontal cortex to be associated with greater symptom severity. Our findings provide additional support for involvement of cortical-striatal-thalamic circuits in the pathophysiology of OCD and preliminary evidence that a defect involving the dorsolateral prefrontal cortex may also be implicated. Moreover, our data suggest that gray matter structural alterations in OCD have neuropsychological correlates, which may be useful in further characterizing structurefunction relations in this disorder.

Gray Matter Alterations in Obsessive–Compulsive Disorder: An Anatomic Likelihood Estimation Meta-Analysis

“…These studies included 343 OCD patients (80 children and 263 adults) and 318 HC (69 children and 249 adults) (Pujol et al, 2004;Valente et al, 2005, Carmona et al, 2007Christian et al, 2008;Szeszko et al, 2008;Gilbert et al, 2008a, b;Yoo et al, 2008;Lázaro et al, 2009;Van den Heuvel et al, 2009). Study selection was performed by one author (J-YR) and independently verified by another (NL).…”

“…However, results from VBM studies have remained inconsistent and controversial. For example, some studies have found that OCD patients have greater OFC compared with control subjects (Valente et al, 2005;Szeszko et al, 2008;Yoo et al, 2008), and some other studies reported a smaller OFC in OCD patients (Pujol et al, 2004;Christian et al, 2008;Lázaro et al, 2009). Thus, a quantitative overview of VBM findings in OCD is necessary.…”

Structural and Diffusion Property Alterations in Unaffected Siblings of Patients with Obsessive-Compulsive Disorder

“…Several structural magnetic resonance imaging (MRI) studies, employing voxel-based morphometry (VBM), support this model [5], [6], [7], [8], [9]. For instance, Valente et al reported that patients with OCD showed increased grey matter in the left posterior orbitofrontal cortex, anterior insula, bilateral parahippocampal gyrus, and right fusiform gyrus, and decreased grey matter in the left anterior cingulate gyrus and medial frontal gyrus, compared with healthy controls [6].…”

Greater regional cortical gray matter thickness in obsessive-compulsive disorder

“…The neurobiology of OCD has been hypothesized to lie within a framework involving the orbitofrontal-striatal circuit [2,3]. A number of voxel-based morphometry (VBM) studies conducted using statistical parametric mapping generally support this model, although findings have been inconsistent [4–7]. Valente and colleagues [7] found that OCD patients had more gray matter in the left posterior orbitofrontal cortex (OFC) and parahippocampal regions and less gray matter in the left anterior cingulate compared with matched controls.…”