Multicenter voxel-based morphometry mega-analysis of structural brain scans in obsessive-compulsive disorder.
OBJECTIVE
Results from structural neuroimaging studies of obsessive-compulsive disorder (OCD) have been only partially consistent. The authors sought to assess regional gray and white matter volume differences between large samples of OCD patients and healthy comparison subjects and their relation with demographic and clinical variables.


METHODS
A multicenter voxel-based morphometry mega-analysis was performed on 1.5-T structural T1-weighted MRI scans derived from the International OCD Brain Imaging Consortium. Regional gray and white matter brain volumes were compared between 412 adult OCD patients and 368 healthy subjects.


RESULTS
Relative to healthy comparison subjects, OCD patients had significantly smaller volumes of frontal gray and white matter bilaterally, including the dorsomedial prefrontal cortex, the anterior cingulate cortex, and the inferior frontal gyrus extending to the anterior insula. Patients also showed greater cerebellar gray matter volume bilaterally compared with healthy subjects. Group differences in frontal gray and white matter volume were significant after correction for multiple comparisons. Additionally, group-by-age interactions were observed in the putamen, insula, and orbitofrontal cortex (indicating relative preservation of volume in patients compared with healthy subjects with increasing age) and in the temporal cortex bilaterally (indicating a relative loss of volume in patients compared with healthy subjects with increasing age).


CONCLUSIONS
These findings partially support the prevailing fronto-striatal models of OCD and offer additional insights into the neuroanatomy of the disorder that were not apparent from previous smaller studies. The group-by-age interaction effects in orbitofrontal-striatal and (para)limbic brain regions may be the result of altered neuroplasticity associated with chronic compulsive behaviors, anxiety, or compensatory processes related to cognitive dysfunction.
Stella J
SJ
de Wit
Pino
P
Alonso
Lizanne
L
Schweren
David
D
Mataix-Cols
Christine
C
Lochner
José M
JM
Menchón
Dan J
DJ
Stein
Jean-Paul
JP
Fouche
Carles
C
Soriano-Mas
Joao R
JR
Sato
Marcelo Q
MQ
Hoexter
Damiaan
D
Denys
Takashi
T
Nakamae
Seiji
S
Nishida
Jun Soo
JS
Kwon
Joon Hwan
JH
Jang
Geraldo F
GF
Busatto
Narcís
N
Cardoner
Danielle C
DC
Cath
Kenji
K
Fukui
Wi Hoon
WH
Jung
Sung Nyun
SN
Kim
Euripides C
EC
Miguel
Jin
J
Narumoto
Mary L
ML
Phillips
Jesus
J
Pujol
Peter L
PL
Remijnse
Yuki
Y
Sakai
Na Young
NY
Shin
Kei
K
Yamada
Dick J
DJ
Veltman
Odile A
OA
van den Heuvel
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001284:Atrophy / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D036421:Nerve Fibers, Unmyelinated / Q000473:pathology; D059906:Neuroimaging; D009771:Obsessive-Compulsive Disorder / Q000473:pathology*