Transcranial sonography in obsessive-compulsive disorder.
There is convergent evidence that basal ganglia structures are involved in the pathogenesis of obsessive-compulsive disorder (OCD). It has been also assumed that OCD is caused by a central serotonergic dysfunction. Transcranial sonography (TCS) has become a reliable, sensitive and non-invasive diagnostic tool concerning the evaluation of extrapyramidal movement disorders. This study used TCS to examine the alterations in different parenchymal regions, especially concerning serotonergic brainstem raphe nuclei as well as basal ganglia in OCD. Thirty-one OCD patients were compared with 31 matched healthy controls. Echogenecities were investigated according to the examination protocol for extrapyramidal disorders using a Siemens Sonoline(®) Elegra system. Obsessive-compulsive disorder patients showed reduced echogenity of the serotonergic brainstem raphe nuclei (32.3%) compared with healthy controls (16.1%). In nine OCD-patients (31%), but only in 2 control subjects (6.2%), a hyperechogenicity of the caudate nucleus was found. Patients with OCD significantly more often reveal a hypoechogenic brainstem raphe possibly reflecting altered serotonergic neurons there and a hyperechogenicity of caudate nucleus indicating structural or molecular cell changes. Further research is warranted to examine, whether TCS is useful in order to classify OCD and its subtypes.
Dept. of Psychiatry, Ruhr University Bochum, LWL-Universitätsklinikum, Alexandrinenstr. 1, 44791 Bochum, Germany.
Paraskevi
P
Mavrogiorgou
Fabio
F
Nalato
Saskia
S
Meves
Stefanie
S
Luksnat
Christine
C
Norra
Ralf
R
Gold
Georg
G
Juckel
Christos
C
Krogias
D000328:Adult; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000494:pharmacology / Q000627:therapeutic use; D011903:Raphe Nuclei / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D018709:Statistics, Nonparametric; D017585:Ultrasonography, Doppler, Transcranial; D055815:Young Adult
D011619:Psychotropic Drugs
Basal ganglia; OCD; Raphe nuclei; TCS; Ultrasound