title: Reduced brain white matter integrity in trichotillomania: a diffusion tensor imaging study.
abstract: 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.
authors.affiliation: Department of Psychiatry and Medical Research Council, Wellcome Trust Behavioural and Clinical Neurosciences Institute, University of Cambridge, England. srchamb@gmail.com
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Chamberlain
authors.forename: Adam
authors.initials: A
authors.lastname: Hampshire
authors.forename: Lara A
authors.initials: LA
authors.lastname: Menzies
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Garyfallidis
authors.forename: Jon E
authors.initials: JE
authors.lastname: Grant
authors.forename: Brian L
authors.initials: BL
authors.lastname: Odlaug
authors.forename: Kevin
authors.initials: K
authors.lastname: Craig
authors.forename: Naomi
authors.initials: N
authors.lastname: Fineberg
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Sahakian
mesh_terms: 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*