Am J Psychiatry. 2018 May 1;175(5):453-462. doi: 10.1176/appi.ajp.2017.17050485. Epub 2017 Dec 15.
Boedhoe PSW1, Schmaal L1, Abe Y1, Alonso P1, Ameis SH1, Anticevic A1, Arnold PD1, Batistuzzo MC1, Benedetti F1, Beucke JC1, Bollettini I1, Bose A1, Brem S1, Calvo A1, Calvo R1, Cheng Y1, Cho KIK1, Ciullo V1, Dallaspezia S1, Denys D1, Feusner JD1, Fitzgerald KD1, Fouche JP1, Fridgeirsson EA1, Gruner P1, Hanna GL1, Hibar DP1, Hoexter MQ1, Hu H1, Huyser C1, Jahanshad N1, James A1, Kathmann N1, Kaufmann C1, Koch K1, Kwon JS1, Lazaro L1, Lochner C1, Marsh R1, Martínez-Zalacaín I1, Mataix-Cols D1, Menchón JM1, Minuzzi L1, Morer A1, Nakamae T1, Nakao T1, Narayanaswamy JC1, Nishida S1, Nurmi E1, O'Neill J1, Piacentini J1, Piras F1, Piras F1, Reddy YCJ1, Reess TJ1, Sakai Y1, Sato JR1, Simpson HB1, Soreni N1, Soriano-Mas C1, Spalletta G1, Stevens MC1, Szeszko PR1, Tolin DF1, van Wingen GA1, Venkatasubramanian G1, Walitza S1, Wang Z1, Yun JY1; ENIGMA-OCD WorkingGroup1, Thompson PM1, Stein DJ1, van den Heuvel OA1; ENIGMA OCD Working Group.
Brain imaging studies of structural abnormalities in OCD have yielded inconsistent results, partly because of limited statistical power, clinical heterogeneity, and methodological differences. The authors conducted meta- and mega-analyses comprising the largest study of cortical morphometry in OCD ever undertaken.
T1-weighted MRI scans of 1,905 OCD patients and 1,760 healthy controls from 27 sites worldwide were processed locally using FreeSurfer to assess cortical thickness and surface area. Effect sizes for differences between patients and controls, and associations with clinical characteristics, were calculated using linear regression models controlling for age, sex, site, and intracranial volume.
In adult OCD patients versus controls, we found a significantly lower surface area for the transverse temporal cortex and a thinner inferior parietal cortex. Medicated adult OCD patients also showed thinner cortices throughout the brain. In pediatric OCD patients compared with controls, we found significantly thinner inferior and superior parietal cortices, but none of the regions analyzed showed significant differences in surface area. However, medicated pediatric OCD patients had lower surface area in frontal regions. Cohen's d effect sizes varied from -0.10 to -0.33.
The parietal cortex was consistently implicated in both adults and children with OCD. More widespread cortical thickness abnormalities were found in medicated adult OCD patients, and more pronounced surface area deficits (mainly in frontal regions) were found in medicated pediatric OCD patients. These cortical measures represent distinct morphological features and may be differentially affected during different stages of development and illness, and possibly moderated by disease profile and medication.
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