A diffusion tensor imaging study of white matter in obsessive–compulsive disorder

Our objective was to test for differences between subjects with obsessive–compulsive disorder (OCD) and healthy controls with respect to white matter architecture within the cingulum bundle (CB) and anterior limb of the internal capsule (ALIC). We studied eight subjects with active OCD and 10 matched healthy controls using diffusion tensor magnetic resonance imaging (DT‐MRI) at 1.5 T (Tesla). Fractional anisotropy (FA) was evaluated in both CB and ALIC. Both voxelwise and region‐of‐interest methods of analysis were employed. Within both the left CB and the left ALIC, subjects with OCD exhibited significantly greater FA than healthy controls. In the right CB, subjects with OCD exhibited significantly decreased FA versus healthy control subjects. Additionally, the OCD group exhibited abnormal asymmetry (left > right) of FA in the CB. These results provide preliminary evidence for abnormal architecture within the CB and ALIC in OCD. FA differences in these areas are consistent with the presence of abnormal connections between the nodes linked by these tracts. This could explain why surgically severing these tracts is therapeutic. Additional studies are needed to replicate these findings and to clarify their pathological and clinical significance. Depression and Anxiety 22:440–446, 2007. Published 2006 Wiley‐Liss, Inc.

[1]  N. Alpert,et al.  A functional neuroimaging investigation of deep brain stimulation in patients with obsessive-compulsive disorder. , 2006, Journal of neurosurgery.

[2]  W. Goodman,et al.  The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. , 1989, Archives of general psychiatry.

[3]  B. Lippitz,et al.  Lesion topography and outcome after thermocapsulotomy or gamma knife capsulotomy for obsessive-compulsive disorder: relevance of the right hemisphere. , 1999, Neurosurgery.

[4]  S. Taylor,et al.  Deep brain stimulation for refractory obsessive-compulsive disorder , 2005, Biological Psychiatry.

[5]  B H Price,et al.  Volume reduction in the caudate nucleus following stereotactic placement of lesions in the anterior cingulate cortex in humans: a morphometric magnetic resonance imaging study. , 2000, Journal of neurosurgery.

[6]  J. Rapoport,et al.  Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder. , 1989, Archives of general psychiatry.

[7]  J. Mazziotta,et al.  Cerebral glucose metabolic rates in nondepressed patients with obsessive-compulsive disorder. , 1988, The American journal of psychiatry.

[8]  V S Caviness,et al.  Cerebral structural abnormalities in obsessive-compulsive disorder. A quantitative morphometric magnetic resonance imaging study. , 1996, Archives of general psychiatry.

[9]  P Pietrini,et al.  Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder. Revisualization during pharmacotherapy. , 1992, Archives of general psychiatry.

[10]  S. Rauch,et al.  Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. , 2000, The Psychiatric clinics of North America.

[11]  W. Goodman,et al.  The Yale-Brown Obsessive Compulsive Scale. II. Validity. , 1989, Archives of general psychiatry.

[12]  T. L. Davis,et al.  Morphometry of in vivo human white matter association pathways with diffusion‐weighted magnetic resonance imaging , 1997, Annals of neurology.

[13]  E. Smeraldi,et al.  Increased right caudate nucleus size in obsessive-compulsive disorder: Detection with magnetic resonance imaging , 1992, Psychiatry Research: Neuroimaging.

[14]  Michael Brady,et al.  Improved Optimization for the Robust and Accurate Linear Registration and Motion Correction of Brain Images , 2002, NeuroImage.

[15]  S. Rauch,et al.  Neurobiological models of obsessive-compulsive disorder. , 1993, Psychosomatics.

[16]  Deepak N. Pandya,et al.  Quantitative DT-MRI Investigations of the Human Cingulum Bundle , 2002, CNS Spectrums.

[17]  M E Phelps,et al.  Systematic changes in cerebral glucose metabolic rate after successful behavior modification treatment of obsessive-compulsive disorder. , 1996, Archives of general psychiatry.

[18]  P. Matthews,et al.  Normalized Accurate Measurement of Longitudinal Brain Change , 2001, Journal of computer assisted tomography.

[19]  Manzar Ashtari,et al.  White matter abnormalities in obsessive-compulsive disorder: a diffusion tensor imaging study. , 2005, Archives of general psychiatry.

[20]  A. Dale,et al.  Age-related alterations in white matter microstructure measured by diffusion tensor imaging , 2005, Neurobiology of Aging.

[21]  P. Basser,et al.  Estimation of the effective self-diffusion tensor from the NMR spin echo. , 1994, Journal of magnetic resonance. Series B.

[22]  R. C. Oldfield.  The assessment and analysis of handedness: the Edinburgh inventory. , 1971, Neuropsychologia.

[23]  Stephen M. Smith,et al.  Accurate, Robust, and Automated Longitudinal and Cross-Sectional Brain Change Analysis , 2002, NeuroImage.

[24]  S. Rauch,et al.  Prospective long-term follow-up of 44 patients who received cingulotomy for treatment-refractory obsessive-compulsive disorder. , 2002, The American journal of psychiatry.

[25]  F Fazio,et al.  [18F]FDG PET Study in Obsessive–Compulsive Disorder , 1995, British Journal of Psychiatry.

[26]  Kris van Kuyck,et al.  Electrical stimulation of the anterior limbs of the internal capsules in patients with severe obsessive-compulsive disorder: anecdotal reports. , 2003, Neurosurgery clinics of North America.

[27]  J. R. Baker,et al.  Functional magnetic resonance imaging of symptom provocation in obsessive-compulsive disorder. , 1996, Archives of general psychiatry.

[28]  P. Basser,et al.  Toward a quantitative assessment of diffusion anisotropy , 1996, Magnetic resonance in medicine.

[29]  M Ashtari,et al.  Reduced caudate nucleus volume in obsessive-compulsive disorder. , 1995, Archives of general psychiatry.

[30]  D. Murphy,et al.  Local cerebral glucose metabolic rates in obsessive-compulsive disorder. Patients treated with clomipramine. , 1990, Archives of general psychiatry.

[31]  S. Rauch.  Neuroimaging and neurocircuitry models pertaining to the neurosurgical treatment of psychiatric disorders. , 2003, Neurosurgery clinics of North America.

[32]  J. Kennedy,et al.  Myelin oligodendrocyte glycoprotein (MOG) gene is associated with obsessive‐compulsive disorder , 2004, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[33]  N. Alpert,et al.  Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using oxygen 15-labeled carbon dioxide and positron emission tomography. , 1994, Archives of general psychiatry.

[34]  J. Gybels,et al.  Electrical stimulation in anterior limbs of internal capsules in patients with obsessive-compulsive disorder , 1999, The Lancet.

[35]  M. Torrens.  Co-Planar Stereotaxic Atlas of the Human Brain—3-Dimensional Proportional System: An Approach to Cerebral Imaging, J. Talairach, P. Tournoux. Georg Thieme Verlag, New York (1988), 122 pp., 130 figs. DM 268 , 1990 .

[36]  P F Renshaw,et al.  Retrocallosal white matter abnormalities in patients with obsessive-compulsive disorder. , 1994, Archives of general psychiatry.

[37]  C D Frith,et al.  Functional Anatomy of Obsessive–Compulsive Phenomena , 1994, British Journal of Psychiatry.

[38]  T. Nordahl,et al.  Cerebral glucose metabolic rates in obsessive compulsive disorder. , 1989, Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology.

[39]  Stephen M. Smith,et al.  A global optimisation method for robust affine registration of brain images , 2001, Medical Image Anal..

[40]  J. Mazziotta,et al.  Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder. , 1992, Archives of general psychiatry.

[41]  P. Yakovlev,et al.  Limbic nuclei of thalamus and connections of limbic cortex. III. Corticocortical connections of the anterior cingulate gyrus, the cingulum, and the subcallosal bundle in monkey. , 1961, Archives of neurology.

[42]  G D Pearlson,et al.  Elevated medial-frontal cerebral blood flow in obsessive-compulsive patients: a SPECT study. , 1991, The American journal of psychiatry.