title: Disproportionate alterations in the anterior and posterior insular cortices in obsessive-compulsive disorder.
abstract: BACKGROUND
  Recent studies have reported that the insular cortex is involved in the pathophysiology of obsessive-compulsive disorder (OCD). However, specific morphometric abnormalities of the insular subregions remain unclear. In this study, we examined insular cortical volume to determine whether the volume of the anterior and posterior insular cortices of unmedicated OCD patients differed according to different symptom dimensions.
  
  
  RESULTS
  Using magnetic resonance imaging, we measured the gray matter volumes of the insular cortex and its subregions (anterior and posterior divisions) in 41 patients with OCD (31 drug-naïve and 10 non-medicated) and 53 healthy controls. Volumetric measures of the insular cortex were compared according to different OC symptoms. Enlarged anterior and reduced posterior insular cortices were observed in OCD patients. The insular volumetric alterations were more significant in OCD patients with predominant checking rather than cleaning symptoms when compared with healthy controls.
  
  
  CONCLUSIONS
  Our results suggest the presence of unbalanced anterior and posterior insular volumetric abnormalities in unmedicated OCD patients and emphasize the distinct role of the insular cortex in different OC symptoms. We propose that the insular morphometric alterations may influence the modulation of interoceptive processing, the insular functional role, in OCD patients with different symptoms.
authors.affiliation: Interdisciplinary Program in Neuroscience, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
authors.forename: Aram
authors.initials: A
authors.lastname: Song
authors.forename: Wi Hoon
authors.initials: WH
authors.lastname: Jung
authors.forename: Joon Hwan
authors.initials: JH
authors.lastname: Jang
authors.forename: Euitae
authors.initials: E
authors.lastname: Kim
authors.forename: Geumsook
authors.initials: G
authors.lastname: Shim
authors.forename: Hye Yoon
authors.initials: HY
authors.lastname: Park
authors.forename: Chi-Hoon
authors.initials: CH
authors.lastname: Choi
authors.forename: Jun Soo
authors.initials: JS
authors.lastname: Kwon
mesh_terms: D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D003710:Demography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000473:pathology / Q000503:physiopathology*; D009929:Organ Size; D055815:Young Adult