White matter abnormalities in obsessive-compulsive disorder: a diffusion tensor imaging study.
BACKGROUND
Several neurobiological models of obsessive-compulsive disorder (OCD) posit a primary role for dysfunction of the anterior cingulate gyrus. Both functional and structural neuroimaging studies have implicated anterior cingulate gray matter abnormalities in the pathophysiology of OCD, but there has been little investigation of the anterior cingulate white matter in this disorder.


OBJECTIVE
To test the hypothesis that patients with OCD have abnormal white matter microstructure in the anterior cingulate gyrus compared with healthy volunteers as inferred from diffusion tensor imaging. Additional analyses examined group differences in white matter integrity across the entire brain.


METHODS
Fifteen patients with a DSM-IV diagnosis of OCD and 15 healthy volunteers matched for age, sex, and handedness underwent diffusion tensor imaging and structural magnetic resonance imaging examinations. Fractional anisotropy (FA), a robust intravoxel measure of water self-diffusion, was compared between groups on a voxel-by-voxel basis in the anterior cingulate white matter after standardization in Talairach space.


METHODS
Clinical ratings of symptom severity (ie, Yale-Brown Obsessive-Compulsive Scale) and FA.


RESULTS
Compared with healthy volunteers, patients demonstrated significantly lower FA bilaterally in 3 areas of the anterior cingulate gyrus white matter. Additional analyses conducted across the rest of the brain white matter revealed lower FA bilaterally in the parietal region (supramarginal gyri), right posterior cingulate gyrus, and left occipital lobe (lingual gyrus). No areas of significantly higher FA were observed in patients compared with healthy volunteers. Lower FA in the parietal region correlated significantly with higher Yale-Brown Obsessive-Compulsive Scale scores.


CONCLUSIONS
These preliminary findings provide evidence of an abnormality that involves the anterior cingulate white matter in the pathogenesis of OCD and are consistent with neurobiological models that posit a defect in connectivity in the anterior cingulate basal ganglia-thalamocortical circuit. White matter abnormalities in other brain regions may also be implicated in the neurobiology of OCD.
Department of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY 11004, USA. szeszko@lij.edu
Philip R
PR
Szeszko
Babak A
BA
Ardekani
Manzar
M
Ashtari
Anil K
AK
Malhotra
Delbert G
DG
Robinson
Robert M
RM
Bilder
Kelvin O
KO
Lim
D000328:Adult; D016880:Anisotropy; D001921:Brain / Q000378:metabolism* / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D005260:Female; D007839:Functional Laterality; D006179:Gyrus Cinguli / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D008959:Models, Neurological; D009434:Neural Pathways / Q000378:metabolism / Q000503:physiopathology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D009778:Occipital Lobe / Q000378:metabolism / Q000503:physiopathology; D011569:Psychiatric Status Rating Scales; D014867:Water / Q000378:metabolism
D014867:Water