title: The involvement of distinct neural systems in patients with obsessive-compulsive disorder with autogenous and reactive obsessions.
abstract: OBJECTIVE
  To investigate the regional metabolite abnormalities and changes after treatment in patients with OCD with autogenous and reactive obsessions.
  
  
  METHODS
  We assessed right anterior cingulate cortex (ACC) and amygdala-hippocampal region (Am + Hpp) N-acetyl-aspartate (NAA), choline (Cho) and creatine (Cr) concentrations and NAA/Cr and Cho/Cr ratios using single-voxel proton magnetic resonance spectroscopy in 15 patients with autogenous obsessions (OCD-A), 15 patients with reactive obsessions (OCD-R) and 15 healthy controls (HC). Measurements were repeated after 16 weeks of fluoxetine treatment.
  
  
  RESULTS
  Baseline ACC NAA/Cr ratios of both OCD groups were significantly lower than HC. OCD-A group had significantly lower baseline NAA/Cr ratios in the Am + Hpp than other groups. These differences were more likely to be explained by higher Cr levels in ACC. We found no significant differences and changes for Cho levels and Cho/Cr ratios between groups and within groups. Significant increase in NAA/Cr ratios of OCD-A group found in the Am + Hpp was more likely to be explained by increased NAA levels. No significant changes were found in ACC NAA/Cr ratios.
  
  
  CONCLUSIONS
  While disturbed energy metabolism in ACC might reflect a common pathology in patients with OCD regardless of symptom dimension, alterations in mesiotemporal lobe are more likely for autogenous obsessions.
authors.affiliation: Department of Psychiatry, Yuzuncu Yil University, Van, Turkey. lbesiroglu@gmail.com
authors.forename: L
authors.initials: L
authors.lastname: Besiroglu
authors.forename: M
authors.initials: M
authors.lastname: Sozen
authors.forename: O
authors.initials: O
authors.lastname: Ozbebit
authors.forename: S
authors.initials: S
authors.lastname: Avcu
authors.forename: Y
authors.initials: Y
authors.lastname: Selvi
authors.forename: A
authors.initials: A
authors.lastname: Bora
authors.forename: A
authors.initials: A
authors.lastname: Atli
authors.forename: O
authors.initials: O
authors.lastname: Unal
authors.forename: M D
authors.initials: MD
authors.lastname: Bulut
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D039721:Diagnostic and Statistical Manual of Mental Disorders; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage / Q000493:pharmacokinetics*; D006801:Humans; D008032:Limbic System / Q000187:drug effects / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009770:Obsessive Behavior / Q000188:drug therapy / Q000378:metabolism; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000378:metabolism* / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics; D016896:Treatment Outcome
chemical_list: D001224:Aspartic Acid; D002794:Choline; D003401:Creatine; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors; C000179:N-acetylaspartate