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Fang K, Hou Y, Niu L, Han S, Zhang W. Individualized gray matter morphological abnormalities uncover two robust transdiagnostic biotypes. J Affect Disord 2024; 365:193-204. [PMID: 39173920 DOI: 10.1016/j.jad.2024.08.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/22/2024] [Accepted: 08/19/2024] [Indexed: 08/24/2024]
Abstract
Psychiatric disorders exhibit a shared neuropathology, yet the diverse presentations among patients necessitate the identification of transdiagnostic subtypes to enhance diagnostic and treatment strategies. This study aims to unveil potential transdiagnostic subtypes based on personalized gray matter morphological abnormalities. A total of 496 patients with psychiatric disorders and 255 healthy controls (HCs) from three distinct datasets (one for discovery and two for validation) were enrolled. Individualized gray matter morphological abnormalities were determined using normative modeling to identify transdiagnostic subtypes. In the discovery dataset, two transdiagnostic subtypes with contrasting patterns of structural abnormalities compared to HCs were identified. Reproducibility and generalizability analyses demonstrated that these subtypes could be generalized to new patients and even to new disorders in the validation datasets. These subtypes were characterized by distinct disease epicenters. The gray matter abnormal pattern in subtype 1 was mainly linked to excitatory receptors, whereas subtype 2 showed a predominant association with inhibitory receptors. Furthermore, we observed that the gray matter abnormal pattern in subtype 2 was correlated with transcriptional profiles of inflammation-related genes, while subtype 1 did not show this association. Our findings reveal two robust transdiagnostic biotypes, offering novel insights into psychiatric nosology.
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Affiliation(s)
- Keke Fang
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, China; Henan Engineering Research Center for Tumor Precision Medicine and Comprehensive Evaluation, Henan Cancer Hospital, China; Henan Provincial Key Laboratory of Anticancer Drug Research, Henan Cancer Hospital, China
| | - Ying Hou
- Department of ultrasound, the affiliated cancer hospital of Zhengzhou University & Henan Cancer Hospital, China
| | - Lianjie Niu
- Department of Breast Disease, Henan Breast Cancer Center, the affiliated Cancer Hidospital of Zhengzhou University & Henan Cancer Hospital, China.
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Henan Province, China.
| | - Wenzhou Zhang
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, China; Henan Engineering Research Center for Tumor Precision Medicine and Comprehensive Evaluation, Henan Cancer Hospital, China; Henan Provincial Key Laboratory of Anticancer Drug Research, Henan Cancer Hospital, China.
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2
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Han S, Xu Y, Fang K, Guo HR, Wei Y, Liu L, Wen B, Liu H, Zhang Y, Cheng J. Mapping the neuroanatomical heterogeneity of OCD using a framework integrating normative model and non-negative matrix factorization. Cereb Cortex 2023:7153879. [PMID: 37150510 DOI: 10.1093/cercor/bhad149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/09/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a spectrum disorder with high interindividual heterogeneity. We propose a comprehensible framework integrating normative model and non-negative matrix factorization (NMF) to quantitatively estimate the neuroanatomical heterogeneity of OCD from a dimensional perspective. T1-weighted magnetic resonance images of 98 first-episode untreated patients with OCD and matched healthy controls (HCs, n = 130) were acquired. We derived individualized differences in gray matter morphometry using normative model and parsed them into latent disease factors using NMF. Four robust disease factors were identified. Each patient expressed multiple factors and exhibited a unique factor composition. Factor compositions of patients were significantly correlated with severity of symptom, age of onset, illness duration, and exhibited sex differences, capturing sources of clinical heterogeneity. In addition, the group-level morphological differences obtained with two-sample t test could be quantitatively derived from the identified disease factors, reconciling the group-level and subject-level findings in neuroimaging studies. Finally, we uncovered two distinct subtypes with opposite morphological differences compared with HCs from factor compositions. Our findings suggest that morphological differences of individuals with OCD are the unique combination of distinct neuroanatomical patterns. The proposed framework quantitatively estimating neuroanatomical heterogeneity paves the way for precision medicine in OCD.
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Affiliation(s)
- Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province
- Henan Engineering Research Center of Brain Function Development and Application
| | - Yinhuan Xu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province
- Henan Engineering Research Center of Brain Function Development and Application
| | - Keke Fang
- Department of Pharmacy, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University
| | - Hui-Rong Guo
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province
- Henan Engineering Research Center of Brain Function Development and Application
| | - Liang Liu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province
- Henan Engineering Research Center of Brain Function Development and Application
| | - Baohong Wen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province
- Henan Engineering Research Center of Brain Function Development and Application
| | - Hao Liu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province
- Henan Engineering Research Center of Brain Function Development and Application
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province
- Henan Engineering Research Center of Brain Function Development and Application
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province
- Henan Engineering Research Center of Brain Function Development and Application
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Han S, Xue K, Chen Y, Xu Y, Li S, Song X, Guo HR, Fang K, Zheng R, Zhou B, Chen J, Wei Y, Zhang Y, Cheng J. Identification of shared and distinct patterns of brain network abnormality across mental disorders through individualized structural covariance network analysis. Psychol Med 2023; 53:1-12. [PMID: 36876493 DOI: 10.1017/s0033291723000302] [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: 03/07/2023]
Abstract
BACKGROUND Mental disorders, including depression, obsessive compulsive disorder (OCD), and schizophrenia, share a common neuropathy of disturbed large-scale coordinated brain maturation. However, high-interindividual heterogeneity hinders the identification of shared and distinct patterns of brain network abnormalities across mental disorders. This study aimed to identify shared and distinct patterns of altered structural covariance across mental disorders. METHODS Subject-level structural covariance aberrance in patients with mental disorders was investigated using individualized differential structural covariance network. This method inferred structural covariance aberrance at the individual level by measuring the degree of structural covariance in patients deviating from matched healthy controls (HCs). T1-weighted anatomical images of 513 participants (105, 98, 190 participants with depression, OCD and schizophrenia, respectively, and 130 age- and sex-matched HCs) were acquired and analyzed. RESULTS Patients with mental disorders exhibited notable heterogeneity in terms of altered edges, which were otherwise obscured by group-level analysis. The three disorders shared high difference variability in edges attached to the frontal network and the subcortical-cerebellum network, and they also exhibited disease-specific variability distributions. Despite notable variability, patients with the same disorder shared disease-specific groups of altered edges. Specifically, depression was characterized by altered edges attached to the subcortical-cerebellum network; OCD, by altered edges linking the subcortical-cerebellum and motor networks; and schizophrenia, by altered edges related to the frontal network. CONCLUSIONS These results have potential implications for understanding heterogeneity and facilitating personalized diagnosis and interventions for mental disorders.
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Affiliation(s)
- Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Kangkang Xue
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yinhuan Xu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Shuying Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui-Rong Guo
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Keke Fang
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Ruiping Zheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Bingqian Zhou
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Jingli Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Zhengzhou, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Zhengzhou, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Zhengzhou, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Zhengzhou, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China
- Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, Zhengzhou, China
- Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
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4
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Han S, Xu Y, Guo HR, Fang K, Wei Y, Liu L, Cheng J, Zhang Y, Cheng J. Two distinct subtypes of obsessive compulsive disorder revealed by a framework integrating multimodal neuroimaging information. Hum Brain Mapp 2022; 43:4254-4265. [PMID: 35726798 PMCID: PMC9435007 DOI: 10.1002/hbm.25951] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/14/2022] [Accepted: 05/06/2022] [Indexed: 12/03/2022] Open
Abstract
Patients with obsessive compulsive disorder (OCD) exhibit tremendous heterogeneity in structural and functional neuroimaging aberrance. However, most previous studies just focus on group‐level aberrance of a single modality ignoring heterogeneity and multimodal features. On that account, we aimed to uncover OCD subtypes integrating structural and functional neuroimaging features with the help of a multiview learning method and examined multimodal aberrance for each subtype. Ninety‐nine first‐episode untreated patients with OCD and 104 matched healthy controls (HCs) undergoing structural and functional MRI were included in this study. Voxel‐based morphometric and amplitude of low‐frequency fluctuation (ALFF) were adopted to assess gray matter volumes (GMVs) and the spontaneous neuronal fluctuations respectively. Structural/functional distance network was obtained by calculating Euclidean distance between pairs of regional GMVs/ALFF values across patients. Similarity network fusion, one of multiview learning methods capturing shared and complementary information from multimodal data sources, was used to fuse multimodal distance networks into one fused network. Then spectral clustering was adopted to categorize patients into subtypes. As a result, two robust subtypes were identified. These two subtypes presented opposite GMV aberrance and distinct ALFF aberrance compared with HCs while shared indistinguishable clinical and demographic features. In addition, these two subtypes exhibited opposite structure–function difference correlation reflecting distinct adaptive modifications between multimodal aberrance. Altogether, these results uncover two objective subtypes with distinct multimodal aberrance and provide a new insight into taxonomy of OCD.
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Affiliation(s)
- Shaoqiang Han
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China.,Henan Engineering Research Center of Brain Function Development and Application, China
| | - Yinhuan Xu
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China.,Henan Engineering Research Center of Brain Function Development and Application, China
| | - Hui-Rong Guo
- Department of Psychiatry, the First Affiliated Hospital of Zhengzhou University, China
| | - Keke Fang
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China.,Henan Engineering Research Center of Brain Function Development and Application, China
| | - Liang Liu
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China.,Henan Engineering Research Center of Brain Function Development and Application, China
| | - Junying Cheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China.,Henan Engineering Research Center of Brain Function Development and Application, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China.,Henan Engineering Research Center of Brain Function Development and Application, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, China.,Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research Medicine of Henan Province, China.,Henan Engineering Research Center of Brain Function Development and Application, China
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5
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Han S, Xu Y, Guo H, Fang K, Wei Y, Liu L, Cheng J, Zhang Y, Cheng J. Two distinct subtypes of obsessive compulsive disorder revealed by heterogeneity through discriminative analysis. Hum Brain Mapp 2022; 43:3037-3046. [PMID: 35384125 PMCID: PMC9188970 DOI: 10.1002/hbm.25833] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 01/31/2023] Open
Abstract
Neurobiological heterogeneity in obsessive compulsive disorder (OCD) is understudied leading to conflicting neuroimaging findings. Therefore, we investigated objective neuroanatomical subtypes of OCD by adopting a newly proposed method based on gray matter volumes (GMVs). GMVs were derived from T1‐weighted anatomical images of patients with OCD (n = 100) and matched healthy controls (HCs; n = 106). We first inquired whether patients with OCD presented higher interindividual variability HCs in terms of GMVs. Then, we identified distinct subtypes of OCD by adopting heterogeneity through discriminative analysis (HYDRA), where regional GMVs were treated as features. Patients with OCD presented higher interindividual variability than HCs, suggesting a high structural heterogeneity of OCD. HYDRA identified two distinct robust subtypes of OCD presenting opposite neuroanatomical aberrances compared with HCs, while sharing indistinguishable clinical and demographic features. Specifically, Subtype 1 exhibited widespread increased GMVs in cortical and subcortical regions, including the orbitofrontal gyrus, right anterior insula, bilateral hippocampus, and bilateral parahippocampus and cerebellum. Subtype 2 demonstrated overall decreased GMVs in regions such as the orbitofrontal gyrus, right anterior insula, and precuneus. When mixed together, none of patients presented significant differences compared with HCs. In addition, the total intracranial volume of Subtype 2 was significantly correlated with the total score of the Yale–Brown Obsessive Compulsive Scale while that of Subtype 1 was not. These results identified two distinct neuroanatomical subtypes, providing a possible explanation for conflicting neuroimaging findings, and proposed a potential objective taxonomy contributing to precise clinical diagnosis and treatment in OCD.
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Klugah-Brown B, Jiang C, Agoalikum E, Zhou X, Zou L, Yu Q, Becker B, Biswal B. Common abnormality of gray matter integrity in substance use disorder and obsessive-compulsive disorder: A comparative voxel-based meta-analysis. Hum Brain Mapp 2021; 42:3871-3886. [PMID: 34105832 PMCID: PMC8288096 DOI: 10.1002/hbm.25471] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/28/2022] Open
Abstract
The objective of the current study is to determine robust transdiagnostic brain structural markers for compulsivity by capitalizing on the increasing number of case‐control studies examining gray matter volume (GMV) alterations in substance use disorders (SUD) and obsessive‐compulsive disorder (OCD). Voxel‐based meta‐analysis within the individual disorders and conjunction analysis were employed to reveal common GMV alterations between SUDs and OCD. Meta‐analytic coordinates and signed brain volumetric maps determining directed (reduced/increased) GMV alterations between the disorder groups and controls served as the primary outcome. The separate meta‐analysis demonstrated that SUD and OCD patients exhibited widespread GMV reductions in frontocortical regions including prefrontal, cingulate, and insular. Conjunction analysis revealed that the left inferior frontal gyrus (IFG) consistently exhibited decreased GMV across all disorders. Functional characterization suggests that the IFG represents a core hub in the cognitive control network and exhibits bidirectional (Granger) causal interactions with the striatum. Only OCD showed increased GMV in the dorsal striatum with higher changes being associated with more severe OCD symptomatology. Together the findings demonstrate robustly decreased GMV across the disorders in the left IFG, suggesting a transdiagnostic brain structural marker. The functional characterization as a key hub in the cognitive control network and casual interactions with the striatum suggest that deficits in inhibitory control mechanisms may promote compulsivity and loss of control that characterize both disorders.
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Affiliation(s)
- Benjamin Klugah-Brown
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Chenyang Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Elijah Agoalikum
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Xinqi Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Liye Zou
- Exercise & Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen, China
| | - Qian Yu
- Exercise & Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen, China
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Bharat Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.,Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA
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7
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Trambaiolli LR, Biazoli CE, Balardin JB, Hoexter MQ, Sato JR. The relevance of feature selection methods to the classification of obsessive-compulsive disorder based on volumetric measures. J Affect Disord 2017; 222:49-56. [PMID: 28672179 DOI: 10.1016/j.jad.2017.06.061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 06/01/2017] [Accepted: 06/26/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND Magnetic resonance images (MRI) show detectable anatomical and functional differences between individuals with obsessive-compulsive disorder (OCD) and healthy subjects. Moreover, machine learning techniques have been proposed as tools to identify potential biomarkers and, ultimately, to support clinical diagnosis. However, few studies to date have investigated feature selection (FS) influences in OCD MRI-based classification. METHODS Volumes of cortical and subcortical structures, from MRI data of 38 OCD patients (split into two groups according symptoms severity) and 36 controls, were submitted to seven feature selection algorithms. FS aims to select the most relevant and less redundant features which discriminate between two classes. Then, a classification step was applied, from which the classification performances before and after different FS were compared. For the performance evaluation, leave-one-subject-out accuracies of Support Vector Machine classifiers were considered. RESULTS Using different FS algorithms, performance improvement was achieved for Controls vs. All OCD discrimination (19.08% of improvement reducing by 80% the amount of features), Controls vs. Low OCD (20.10%, 75%), Controls vs. High OCD (17.32%, 85%) and Low OCD vs. High OCD (10.53%, 75%). Furthermore, all algorithms pointed out classical cortico-striato-thalamo-cortical circuitry structures as relevant features for OCD classification. LIMITATIONS Limitations include the sample size and using only filter approaches for FS. CONCLUSIONS Our results suggest that FS positively impacts OCD classification using machine-learning techniques. Complementarily, FS algorithms were able to select biologically plausible features automatically.
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Affiliation(s)
- Lucas R Trambaiolli
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Rua Santa Adélia, 166, Santo André, SP 09210-170, Brazil.
| | - Claudinei E Biazoli
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Rua Santa Adélia, 166, Santo André, SP 09210-170, Brazil
| | - Joana B Balardin
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Rua Santa Adélia, 166, Santo André, SP 09210-170, Brazil
| | - Marcelo Q Hoexter
- Department and Institute of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo 01060-970, SP, Brazil
| | - João R Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Rua Santa Adélia, 166, Santo André, SP 09210-170, Brazil
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8
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Carlisi CO, Norman LJ, Lukito SS, Radua J, Mataix-Cols D, Rubia K. Comparative Multimodal Meta-analysis of Structural and Functional Brain Abnormalities in Autism Spectrum Disorder and Obsessive-Compulsive Disorder. Biol Psychiatry 2017; 82:83-102. [PMID: 27887721 DOI: 10.1016/j.biopsych.2016.10.006] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 10/03/2016] [Accepted: 10/05/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) share inhibitory control deficits possibly underlying poor control over stereotyped and repetitive and compulsive behaviors, respectively. However, it is unclear whether these symptom profiles are mediated by common or distinct neural profiles. This comparative multimodal meta-analysis assessed shared and disorder-specific neuroanatomy and neurofunction of inhibitory functions. METHODS A comparative meta-analysis of 62 voxel-based morphometry and 26 functional magnetic resonance imaging (fMRI) studies of inhibitory control was conducted comparing gray matter volume and activation abnormalities between patients with ASD (structural MRI: 911; fMRI: 188) and OCD (structural MRI: 928; fMRI: 247) and control subjects. Multimodal meta-analysis compared groups across voxel-based morphometry and fMRI. RESULTS Both disorders shared reduced function and structure in the rostral and dorsomedial prefrontal cortex including the anterior cingulate. OCD patients had a disorder-specific increase in structure and function of left basal ganglia (BG) and insula relative to control subjects and ASD patients, who had reduced right BG and insula volumes versus OCD patients. In fMRI, ASD patients showed disorder-specific reduced left dorsolateral-prefrontal activation and reduced posterior cingulate deactivation, whereas OCD patients showed temporoparietal underactivation. CONCLUSIONS The multimodal comparative meta-analysis shows shared and disorder-specific abnormalities. Whereas the rostrodorsomedial prefrontal cortex was smaller in structure and function in both disorders, this was concomitant with increased structure and function in BG and insula in OCD patients, but a reduction in ASD patients, presumably reflecting a disorder-specific frontostriatoinsular dysregulation in OCD in the form of poor frontal control over overactive BG, and a frontostriatoinsular maldevelopment in ASD with reduced structure and function in this network. Disorder-differential mechanisms appear to drive overlapping phenotypes of inhibitory control abnormalities in patients with ASD and OCD.
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Affiliation(s)
- Christina O Carlisi
- Department of Child and Adolescent Psychiatry Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, United Kingdom
| | - Luke J Norman
- Department of Child and Adolescent Psychiatry Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, United Kingdom
| | - Steve S Lukito
- Department of Child and Adolescent Psychiatry Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, United Kingdom
| | - Joaquim Radua
- Department of Psychosis Studies, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, United Kingdom; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden; FIDMAG Germanes Hospitalàries, CIBERSAM, Barcelona, Spain
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, United Kingdom.
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9
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Tang W, Zhu Q, Gong X, Zhu C, Wang Y, Chen S. Cortico-striato-thalamo-cortical circuit abnormalities in obsessive-compulsive disorder: A voxel-based morphometric and fMRI study of the whole brain. Behav Brain Res 2016; 313:17-22. [PMID: 27388149 DOI: 10.1016/j.bbr.2016.07.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/27/2016] [Accepted: 07/02/2016] [Indexed: 10/21/2022]
Abstract
The primary aim of this study was to identify structural and functional abnormalities in the brains of obsessive-compulsive disorder (OCD) patients. Another aim was to assess the effect of serotonin selective reuptake inhibitors (SSRIs) on brain structure of OCD patients. All subjects underwent brain magnetic resonance imaging (MRI) and resting functional MRI (fMRI). High-resolution three-dimensional images were processed using the voxel-based morphometry (VBM) method. The final analysis included 18 OCD patients and 16 healthy controls. In the OCD patients there was a decrease in gray matter volume in the bilateral cingulate cortex and bilateral striatum. In some cortical structures including the cerebellar anterior lobe, left orbital frontal gyrus, right middle frontal gyrus, left middle temporal gyrus, precentral gyrus, and postcentral gyrus, there was an increase in gray matter volume. On fMRI the OCD patients had overactivation of the right cerebellum and right parietal lobe and reduced activation of the left cingulate gyrus, putamen, and caudate nucleus. Eleven OCD patients who improved during 12 weeks of drug treatment with sertraline hydrochloride had a significant increase in gray matter volume in several brain structures but no significant differences were found on resting fMRI. The results indicated a consistent trend between structural and functional images. Higher cortical structures showed increased gray matter volume and increased activation as did the cerebellum whereas subcortical structures showed decreased gray matter volume and decreased activation. And brain structure improvement consisted with symptom improvement after SSRIs treatment in OCD patients.
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Affiliation(s)
- Wenxin Tang
- Hangzhou Seventh People's Hospital, Hangzhou, China; Mental Health Center, Medical School of Zhejiang University, Hangzhou, China
| | - Qifeng Zhu
- Medical School of Zhejiang University, Hangzhou, China
| | - Xiangyang Gong
- Radiology Department, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Cheng Zhu
- Hangzhou Seventh People's Hospital, Hangzhou, China; Mental Health Center, Medical School of Zhejiang University, Hangzhou, China
| | - Yiquan Wang
- Hangzhou Seventh People's Hospital, Hangzhou, China; Mental Health Center, Medical School of Zhejiang University, Hangzhou, China
| | - Shulin Chen
- Department of Psychology, Zhejiang University, Hangzhou, China.
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10
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Abstract
BACKGROUND Previous morphology and diffusion-imaging studies have suggested that structural changes in white matter is an important part of the pathophysiology of obsessive-compulsive disorder (OCD). However, different methodological approaches and the heterogeneity of patient samples question the validity of the findings. Materials and methods In total, 30 patients were matched for age and sex with 30 healthy controls. All participants underwent T1-weighted magnetic resonance imaging, diffusion tensor imaging and T2 fluid-attenuated inversion recovery. Voxel-based morphometry and tract-based spatial statistics were used to compare white matter volumes and diffusion tensor imaging between groups. These data were analysed correcting for the effects of multiple comparisons, age, sex, severity and duration of illness as nuisance covariates. White matter hyperintensities were manually identified. RESULTS Increase in fractional anisotropy in cerebellum was the most prominent result. A decrease in fractional anisotrophy in patients comparable with previous studies was located in forceps minor. There were no differences in the white matter morphology or in the white matter hyperintensities between patients and healthy controls. CONCLUSION Decrease in fractional anisotrophy in forceps minor and increase in cerebellum were found, and they were not due to neither white matter hyperintensities nor morphology of the white matter. Cerebellar hyperconnectivity could be an important part of OCD pathophysiology.
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11
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Fan S, van den Heuvel OA, Cath DC, van der Werf YD, de Wit SJ, de Vries FE, Veltman DJ, Pouwels PJW. Mild White Matter Changes in Un-medicated Obsessive-Compulsive Disorder Patients and Their Unaffected Siblings. Front Neurosci 2016; 9:495. [PMID: 26793045 PMCID: PMC4707235 DOI: 10.3389/fnins.2015.00495] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 12/14/2015] [Indexed: 11/21/2022] Open
Abstract
Objective: Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disorder with moderate genetic influences and white matter abnormalities in frontal-striatal and limbic regions. Inconsistencies in reported white matter results from diffusion tensor imaging (DTI) studies can be explained, at least partly, by medication use and between-group differences in disease profile and stage. We used a family design aiming to establish whether white matter abnormalities, if present in un-medicated OCD patients, also exist in their unaffected siblings. Method: Forty-four OCD patients, un-medicated for at least the past 4 weeks, 15 of their unaffected siblings, and 37 healthy controls (HC) underwent DTI using a 3-Tesla MRI-scanner. Data analysis was done using tract-based spatial statistics (TBSS). Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) values were compared within seven skeletonised regions of interest (ROIs), i.e., corpus callosum, bilateral cingulum bundle, bilateral inferior longitudinal fasciculus/frontal-occipital fasciculus (ILF/FOF) and bilateral superior longitudinal fasciculus (SLF). Results: Un-medicated OCD patients, compared with HC, had significantly lower FA in the left cingulum bundle. FA was trend-significantly lower in all other ROIs, except for the corpus callosum. Significant three-group differences in FA (and in RD at trend-significant level) were observed in the left cingulum bundle, with the unaffected siblings representing an intermediate group between OCD patients and HC. Conclusions: OCD patients showed lower FA in the left cingulum bundle, partly driven by trend-significantly higher values in RD. Since the unaffected siblings were found to be an intermediate group between OCD patients and HC, this white matter alteration may be considered an endophenotype for OCD.
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Affiliation(s)
- Siyan Fan
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Department of Social and Behavioural Science, Utrecht UniversityUtrecht, Netherlands
| | - Odile A van den Heuvel
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands; The OCD Team, Haukeland University HospitalBergen, Norway
| | - Danielle C Cath
- Department of Social and Behavioural Science, Utrecht UniversityUtrecht, Netherlands; Academic Anxiety Center AltrechtUtrecht, Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands; Netherlands Institute for NeuroscienceAmsterdam, Netherlands
| | - Stella J de Wit
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands; The OCD Team, Haukeland University HospitalBergen, Norway
| | - Froukje E de Vries
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands
| | - Petra J W Pouwels
- Neuroscience Campus Amsterdam, VU/VU University Medical CenterAmsterdam, Netherlands; Department of Physics and Medical Technology, VU University Medical CenterAmsterdam, Netherlands
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12
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Piras F, Piras F, Chiapponi C, Girardi P, Caltagirone C, Spalletta G. Widespread structural brain changes in OCD: A systematic review of voxel-based morphometry studies. Cortex 2015; 62:89-108. [DOI: 10.1016/j.cortex.2013.01.016] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 10/16/2012] [Accepted: 01/07/2013] [Indexed: 10/27/2022]
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13
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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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14
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Radua J, Grau M, van den Heuvel OA, Thiebaut de Schotten M, Stein DJ, Canales-Rodríguez EJ, Catani M, Mataix-Cols D. Multimodal voxel-based meta-analysis of white matter abnormalities in obsessive-compulsive disorder. Neuropsychopharmacology 2014; 39:1547-57. [PMID: 24407265 PMCID: PMC4023155 DOI: 10.1038/npp.2014.5] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 12/30/2013] [Accepted: 01/02/2014] [Indexed: 11/09/2022]
Abstract
White matter (WM) abnormalities have long been suspected in obsessive-compulsive disorder (OCD) but the available evidence has been inconsistent. We conducted the first multimodal meta-analysis of WM volume (WMV) and fractional anisotropy (FA) studies in OCD. All voxel-wise studies comparing WMV or FA between patients with OCD and healthy controls in the PubMed, ScienceDirect, Google Scholar, Web of Knowledge and Scopus databases were retrieved. Manual searches were also conducted and authors were contacted soliciting additional data. Thirty-four data sets were identified, of which 22 met inclusion criteria (five of them unpublished; comprising 537 adult and pediatric patients with OCD and 575 matched healthy controls). Whenever possible, raw statistical parametric maps were also obtained from the authors. Peak and raw WMV and FA data were combined using novel multimodal meta-analytic methods implemented in effect-size signed differential mapping. Patients with OCD showed widespread WM abnormalities, but findings were particularly robust in the anterior midline tracts (crossing between anterior parts of cingulum bundle and body of corpus callosum), which showed both increased WMV and decreased FA, possibly suggesting an increase of fiber crossing in these regions. This finding was also observed when the analysis was limited to adult participants, and especially pronounced in samples with a higher proportion of medicated patients. Therefore, patients with OCD may have widespread WM abnormalities, particularly evident in anterior midline tracts, although these changes might be, at least in part, attributable to the effects of therapeutic drugs.
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Affiliation(s)
- Joaquim Radua
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK,Research Unit, FIDMAG Germanes Hospitalàries—CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain,Department of Psychosis Studies, Institute of Psychiatry, King's College London, PO 69, 16 De Crespigny Park, London SE5 8AF, UK, Tel: +44 (0) 207 848 0363, Fax: +44 (0) 207 848 0379, E-mail:
| | - Mar Grau
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK,Westminster and Kensington and Chelsea Early Intervention in Psychosis Team, Central North West London NHS Trust, London, UK
| | - Odile A van den Heuvel
- Department of Psychiatry and Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Michel Thiebaut de Schotten
- Natbrainlab—Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, UK,UMR_S 975—CNRS UMR 7225, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Dan J Stein
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Marco Catani
- Natbrainlab—Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - David Mataix-Cols
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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15
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Spalletta G, Piras F, Fagioli S, Caltagirone C, Piras F. Brain microstructural changes and cognitive correlates in patients with pure obsessive compulsive disorder. Brain Behav 2014; 4:261-77. [PMID: 24683518 PMCID: PMC3967541 DOI: 10.1002/brb3.212] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 12/12/2013] [Accepted: 12/15/2013] [Indexed: 02/06/2023] Open
Abstract
OBJECT The aim of this study was to investigate macrostructural and microstructural brain changes in patients with pure obsessive compulsive disorder (OCD) and to examine the relationship between brain structure and neuropsychological deficits. METHOD 20 patients with OCD underwent a comprehensive neuropsychological battery. A combined voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) analysis was used to capture gray matter (GM) and white matter changes in OCD patients as compared to pair-matched healthy volunteers. Multiple regression designs explored the relationship between cognition and neuroimaging parameters. RESULTS OCD patients had increased mean diffusivity (MD) in GM nodes of the orbitofronto-striatal loop (left dorsal anterior cingulate [Z = 3.67, P < 0.001] left insula [Z = 3.35 P < 0.001] left thalamus [Z = 3.59, P < 0.001] left parahippocampal gyrus [Z = 3.77 P < 0.001]) and in lateral frontal and posterior associative cortices (right frontal operculum [Z = 3.42 P < 0.001], right temporal lobe [Z = 3.79 P < 0.001] left parietal lobe [Z = 3.91 P < 0.001]). Decreased fractional anisotropy (FA) was detected in intrahemispheric (left superior longitudinal fasciculus [Z = 4.07 P < 0.001]) and interhemispheric (body of corpus callosum [CC, Z = 4.42 P < 0.001]) bundles. Concurrently, the semantic fluency score, a measure of executive control processes, significantly predicted OCD diagnosis (Odds Ratio = 1.37; 95% Confidence Intervals = 1.09-1.73; P = 0.0058), while variation in performance was correlated with increased MD in left temporal (Z = 4.25 P < 0.001) and bilateral parietal regions (left Z = 3.94, right Z = 4.19 P < 0.001), and decreased FA in the right posterior corona radiata (Z = 4.07 P < 0.001) and the left corticospinal tract (Z = 3.95 P < 0.001). CONCLUSIONS The reported deficit in executive processes and the underlying microstructural alterations may qualify as behavioral and biological markers of OCD.
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Affiliation(s)
- Gianfranco Spalletta
- Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation Via Ardeatina 306, 00179, Rome, Italy
| | - Fabrizio Piras
- Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation Via Ardeatina 306, 00179, Rome, Italy
| | - Sabrina Fagioli
- Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation Via Ardeatina 306, 00179, Rome, Italy
| | - Carlo Caltagirone
- Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation Via Ardeatina 306, 00179, Rome, Italy ; Department of Neuroscience, Tor Vergata University of Rome Rome, Italy
| | - Federica Piras
- Department of Clinical and Behavioral Neurology, Neuropsychiatry Laboratory, IRCCS Santa Lucia Foundation Via Ardeatina 306, 00179, Rome, Italy
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16
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Gurvich C, Maller JJ, Lithgow B, Haghgooie S, Kulkarni J. Vestibular insights into cognition and psychiatry. Brain Res 2013; 1537:244-59. [PMID: 24012768 DOI: 10.1016/j.brainres.2013.08.058] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 08/28/2013] [Accepted: 08/29/2013] [Indexed: 12/21/2022]
Abstract
The vestibular system has traditionally been thought of as a balance apparatus; however, accumulating research suggests an association between vestibular function and psychiatric and cognitive symptoms, even when balance is measurably unaffected. There are several brain regions that are implicated in both vestibular pathways and psychiatric disorders. The present review examines the anatomical associations between the vestibular system and various psychiatric disorders. Despite the lack of direct evidence for vestibular pathology in the key psychiatric disorders selected for this review, there is a substantial body of literature implicating the vestibular system in each of the selected psychiatric disorders. The second part of this review provides complimentary evidence showing the link between vestibular dysfunction and vestibular stimulation upon cognitive and psychiatric symptoms. In summary, emerging research suggests the vestibular system can be considered a potential window for exploring brain function beyond that of maintenance of balance, and into areas of cognitive, affective and psychiatric symptomology. Given the paucity of biological and diagnostic markers in psychiatry, novel avenues to explore brain function in psychiatric disorders are of particular interest and warrant further exploration.
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Affiliation(s)
- Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University Central Clinical School, Melbourne, VIC 3004, Australia.
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17
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Fan Q, Palaniyappan L, Tan L, Wang J, Wang X, Li C, Zhang T, Jiang K, Xiao Z, Liddle PF. Surface anatomical profile of the cerebral cortex in obsessive-compulsive disorder: a study of cortical thickness, folding and surface area. Psychol Med 2013; 43:1081-1091. [PMID: 22935427 DOI: 10.1017/s0033291712001845] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Studying the distribution of anatomical abnormalities over the entire cortical surface can help to identify key neural circuits implicated in generating symptoms of neuropsychiatric disorders. There is a significant inconsistency among studies investigating the neuroanatomy of obsessive-compulsive disorder (OCD) because of the confounding influence of co-morbid depression and medication use and the lack of unbiased estimation of whole-brain morphometric changes. It is also unknown whether the distinct surface anatomical properties of thickness, surface area and gyrification, which collectively contribute to grey matter volume (GMV), are independently affected in OCD. Method The cortical maps of thickness, gyrification and surface areal change were acquired from 23 unmedicated OCD patients and 20 healthy controls using an unbiased whole-brain surface-based morphometric (SBM) method to detect regional changes in OCD. Subcortical structures were not assessed in this study. RESULTS Patients showed a significant increase in the right inferior parietal cortical thickness. Significant increases in gyrification were also noted in the left insula, left middle frontal and left lateral occipital regions extending to the precuneus and right supramarginal gyrus in OCD. Areal contraction/expansion maps revealed no significant regional differences between the patients and controls. In patients, gyrification of the insula significantly predicted the symptom severity measured using Yale-Brown Obsessive-Compulsive Scale (YBOCS). CONCLUSIONS An alteration in the cortical surface anatomy is an important feature of OCD seen in unmedicated samples that relates to the severity of the illness. The results underscore the presence of a neurodevelopmental aberration underlying the pathophysiology of OCD.
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Affiliation(s)
- Q Fan
- Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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18
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Talati A, Pantazatos SP, Schneier FR, Weissman MM, Hirsch J. Gray matter abnormalities in social anxiety disorder: primary, replication, and specificity studies. Biol Psychiatry 2013; 73:75-84. [PMID: 22748614 PMCID: PMC3465490 DOI: 10.1016/j.biopsych.2012.05.022] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 05/23/2012] [Accepted: 05/24/2012] [Indexed: 12/28/2022]
Abstract
BACKGROUND Despite increasing evidence that neuroanatomical abnormalities underlie pathological anxiety, social anxiety disorder (SAD)-although among the most common of anxiety disorders-has received little attention. With magnetic resonance imaging, we: 1) examined gray matter (GM) differences between generalized SAD and healthy control groups; 2) retested the findings in an independent clinical sample; and 3) tested for specificity by contrasting the SAD group to a separate group of panic disorder (PD) subjects. METHODS The primary SAD group (n = 16) was required to meet DSM-IV criteria for SAD, with onset by age 30 years; control subjects (n = 20) had no lifetime history of anxiety. The replication sample included 17 generalized SAD and 17 control subjects. The PD comparison group (n = 16) was required to have no lifetime SAD. Images were acquired on a 1.5-Tesla GE Signa magnetic resonance imaging scanner with a three-dimensional T1-weighted spoiled gradient recalled pulse sequence. Morphological differences were determined with voxel-based morphometry, in SPM8. RESULTS After adjusting for age, gender, and total intracranial volume, SAD (as compared with control) subjects had greater GM in the left parahippocampal and middle occipital, and bilateral supramarginal and angular cortices, and left cerebellum; and lower GM in bilateral temporal poles and left lateral orbitofrontal cortex. Cerebellar, parahippocampal, and temporal pole differences were observed in both samples, survived whole brain corrections, and were not observed in the PD group, pointing to relative specificity to SAD. CONCLUSIONS These findings parallel the functional literature on SAD and suggest structural abnormalities underlying the functional disturbances.
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Affiliation(s)
- Ardesheer Talati
- Department of Psychiatry, Columbia University Medical Center, New York State PsychiatricInstitute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Spiro P. Pantazatos
- Department of Physiology and Cellular Biophysics, Columbia University Medical Center, New York, NY,Program for Imaging and Cognitive Sciences, Columbia University, New York, NY
| | - Franklin R. Schneier
- Department of Psychiatry, Columbia University Medical Center, New York, NY,Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, NY
| | - Myrna M Weissman
- Department of Psychiatry, Columbia University Medical Center, New York, NY,Department of Epidemiology, Columbia University Medical Center, New York, NY,Division of Epidemiology, New York State Psychiatric Institute, New York, NY
| | - Joy Hirsch
- Department of Psychology, Columbia University Medical Center, New York, NY,Department of Neuroscience, Columbia University Medical Center, New York, NY,Department of Radiology, Columbia University Medical Center, New York, NY,Program for Imaging and Cognitive Sciences, Columbia University, New York, NY
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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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