Reduced brain white matter integrity in trichotillomania: a diffusion tensor imaging study.
BACKGROUND
Trichotillomania is an Axis I disorder characterized by repetitive, pathological hair pulling.


OBJECTIVE
To assess the integrity of white matter tracts in subjects with the disorder.


METHODS
Between-group comparison using permutation cluster analysis, with stringent correction for multiple comparisons.


METHODS
Academic psychiatry department.


METHODS
Eighteen volunteers meeting DSM-IV criteria for trichotillomania and 19 healthy control subjects.


METHODS
Fractional anisotropy (measured using diffusion tensor imaging), trichotillomania disease severity (Massachusetts General Hospital Hairpulling Scale score), and dysphoria (Montgomery-Asberg Depression Rating Scale score).


RESULTS
Subjects with trichotillomania exhibited significantly reduced fractional anisotropy in anterior cingulate, presupplementary motor area, and temporal cortices. Fractional anisotropy did not correlate significantly with trichotillomania disease severity or depressive mood scores.


CONCLUSIONS
These data implicate disorganization of white matter tracts involved in motor habit generation and suppression, along with affective regulation, in the pathophysiology of trichotillomania.
Chamberlain
Samuel R
SR
Department of Psychiatry and Medical Research Council, Wellcome Trust Behavioural and Clinical Neurosciences Institute, University of Cambridge, England. srchamb@gmail.com
Hampshire
Adam
A
Menzies
Lara A
LA
Garyfallidis
Eleftherios
E
Grant
Jon E
JE
Odlaug
Brian L
BL
Craig
Kevin
K
Fineberg
Naomi
N
Sahakian
Barbara J
BJ
D000328:Adult; D016880:Anisotropy; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D016000:Cluster Analysis; D003866:Depressive Disorder / Q000473:pathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D056324:Diffusion Tensor Imaging / Q000706:statistics & numerical data*; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology; D006801:Humans; D008297:Male; D009044:Motor Cortex / Q000473:pathology; D009434:Neural Pathways / Q000473:pathology; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013702:Temporal Lobe / Q000473:pathology; D014256:Trichotillomania / Q000175:diagnosis / Q000473:pathology*