Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 467
Filtrar
1.
Psychiatry Res Neuroimaging ; 344: 111884, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39236485

RESUMEN

Obsessive-compulsive disorder (OCD) is characterized by structural alteration within white matter tissues of cortico-striato-thalamo-cortical, temporal and occipital circuits. However, the presence of microstructural changes in the white matter tracts of unaffected first-degree relatives of patients with OCD as a vulnerability marker remains unclear. Therefore, here, diffusion-tensor magnetic resonance imaging (DTI) data were obtained from 29 first-degree relatives of patients with OCD and 59 healthy controls. We investigated the group differences in FA using whole-brain analysis (DTI analysis). For additional regions of interest (ROI) analysis, we focused on the posterior thalamic radiation and sagittal stratum, shown in recent meta-analysis of patients with OCD. In both whole-brain and ROI analyses, using a strict statistical threshold (family-wise error rate [FWE] corrected p<.05 for whole-brain analyses, and p<.0125 (0.05/4) with Bonferroni correction for ROI analyses), we found no significant group differences in FA. Subtle reductions were observed in the anterior corona radiata, forceps minor, cingulum bundle, and corpus callosum only when a lenient statistical was applied (FWE corrected p<.20). These findings suggest that alterations in the white matter microstructure of first-degree relatives, as potential vulnerability markers for OCD, are likely subtle.


Asunto(s)
Imagen de Difusión Tensora , Familia , Trastorno Obsesivo Compulsivo , Sustancia Blanca , Humanos , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología , Trastorno Obsesivo Compulsivo/genética , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/patología , Masculino , Adulto , Femenino , Imagen de Difusión Tensora/métodos , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Persona de Mediana Edad , Adulto Joven
2.
Behav Brain Res ; 475: 115199, 2024 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-39182621

RESUMEN

Obsessive-compulsive disorder (OCD) is a mental affliction characterized by compulsive behaviors often manifested in intrusive thoughts and repetitive actions. The quinpirole model has been used with rats to replicate compulsive behaviors and study the neurophysiological processes associated with this pathology. Several changes in the dendritic spines of the medial prefrontal cortex (mPFC) and dorsolateral striatum (DLS) have been related to the occurrence of compulsive behaviors. Dendritic spines regulate excitatory synaptic contacts, and their morphology is associated with various brain pathologies. The present study was designed to correlate the occurrence of compulsive behaviors (generated by administering the drug quinpirole) with the morphology of the different types of dendritic spines in the mPFC and DLS. A total of 18 male rats were used. Half were assigned to the experimental group, the other half to the control group. The former received injections of quinpirole, while the latter rats were injected with physiological saline solution, for 10 days in both cases. After the experimental treatment, the quinpirole rats exhibited all the parameters indicative of compulsive behavior and a significant correlation with the density of stubby and wide neckless spines in both the mPFC and DLS. Dendritic spines from both mPFC and DLS neurons showed plastic changes correlatively with the expression of compulsive behavior induced by quinpirole. Further studies are suggested to evaluate the involvement of glutamatergic neurotransmission in the neurobiology of OCD.


Asunto(s)
Conducta Compulsiva , Cuerpo Estriado , Espinas Dendríticas , Plasticidad Neuronal , Corteza Prefrontal , Quinpirol , Animales , Masculino , Espinas Dendríticas/patología , Corteza Prefrontal/patología , Corteza Prefrontal/efectos de los fármacos , Conducta Compulsiva/fisiopatología , Conducta Compulsiva/patología , Cuerpo Estriado/patología , Cuerpo Estriado/efectos de los fármacos , Quinpirol/farmacología , Ratas , Plasticidad Neuronal/fisiología , Plasticidad Neuronal/efectos de los fármacos , Trastorno Obsesivo Compulsivo/patología , Trastorno Obsesivo Compulsivo/fisiopatología , Modelos Animales de Enfermedad , Agonistas de Dopamina/farmacología , Ratas Wistar
3.
J Psychiatr Res ; 177: 338-345, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39068778

RESUMEN

The putamen has been proposed to play a critical role in the development of obsessive-compulsive disorder (OCD). The primary objective of this study was to examine the resting-state regional activity and functional connectivity patterns of the putamen in individuals diagnosed with OCD. To achieve this, we employed resting-state functional magnetic resonance imaging (rs-fMRI) to collect data from a sample of 45 OCD patients and 53 healthy control participants. We aimed to use the regional amplitude of low-frequency fluctuation (ALFF) analysis to generate the ROI masks of the putamen and then conduct the whole brain functional connectivity of the putamen in individuals with OCD. Compared to controls, the OCD group demonstrated decreased ALFF in bilateral putamen. The right putamen also displayed decreased FC with the left putamen extending to the inferior frontal gyrus (IFG), bilateral precuneus extending to calcarine, the right middle occipital cortex extending to the right middle temporal cortex, and the left middle occipital gyrus. The decreased connectivity between the right putamen and the left IFG was negatively correlated with Yale-Brown Obsessive Compulsive scale (Y-BOCS) Obsession Scores. This study aimed to reveal the putamen changes in resting-state activity and connectivity in OCD patients, highlighting the significance of aberrant ALFF/FC of the putamen is a key characteristic of OCD.


Asunto(s)
Imagen por Resonancia Magnética , Vías Nerviosas , Trastorno Obsesivo Compulsivo , Putamen , Humanos , Trastorno Obsesivo Compulsivo/fisiopatología , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología , Putamen/diagnóstico por imagen , Putamen/fisiopatología , Masculino , Femenino , Adulto , Adulto Joven , Vías Nerviosas/diagnóstico por imagen , Vías Nerviosas/fisiopatología , Mapeo Encefálico , Descanso , Procesamiento de Imagen Asistido por Computador
4.
J Psychiatr Res ; 177: 39-45, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38971055

RESUMEN

Obsessive-Compulsive Disorder (OCD) is characterized by intrusive thoughts and repetitive behaviors, with associated brain abnormalities in various regions. This study explores the correlation between neural biomarkers and the response to transcranial Direct Current Stimulation (tDCS) in OCD patients. Using structural MRI data from two tDCS trials involving 55 OCD patients and 28 controls, cortical thickness, and gray matter morphometry was analyzed. Findings revealed thicker precentral and paracentral areas in OCD patients, compared to control (p < 0.001). Correlations between cortical thickness and treatment response indicated a significant association between a thinner precentral area and reduced Yale-Brown Obsessive Compulsive Scale (YBOCS) scores (p = 0.02). While results highlight the complexity of treatment response predictors, this study sheds light on potential neural markers for tDCS response in OCD patients. Further investigations with larger datasets are warranted to better understand the underpinnings of these biomarkers and their implications for personalized treatment approaches.


Asunto(s)
Imagen por Resonancia Magnética , Trastorno Obsesivo Compulsivo , Estimulación Transcraneal de Corriente Directa , Humanos , Trastorno Obsesivo Compulsivo/terapia , Trastorno Obsesivo Compulsivo/fisiopatología , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología , Femenino , Adulto , Masculino , Adulto Joven , Escalas de Valoración Psiquiátrica , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/patología , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Encéfalo/fisiopatología , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/fisiopatología , Corteza Cerebral/patología , Persona de Mediana Edad
5.
Psychiatry Res Neuroimaging ; 342: 111842, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38875766

RESUMEN

Obsessive-compulsive disorder (OCD) affects 2-3% of people worldwide. Although antidepressants are the standard pharmachological treatment of OCD, their effect on the brain of individuals with OCD has not yet been fully clarified. We conducted a systematic search on PubMed, Scopus, Embase, and Web of Science to explore the effects of antidepressants on neuroimaging findings in OCD. Thirteen neuroimaging investigations were included. After antidepressant treatment, structural magnetic resonance imaging studies suggested thalamic, amygdala, and pituitary volume changes in patients. In addition, the use of antidepressants was associated with alterations in diffusion tensor imaging metrics in the left striatum, the right midbrain, and the posterior thalamic radiation in the right parietal lobe. Finally, functional magnetic resonance imaging highlighted possible changes in the ventral striatum, frontal, and prefrontal cortex. The small number of included studies and sample sizes, short durations of follow-up, different antidepressants, variable regions of interest, and heterogeneous samples limit the robustness of the findings of the present review. In conclusion, our review suggests that antidepressant treatment is associated with brain changes in individuals with OCD, and these results may help to deepen our knowledge of the pathophysiology of OCD and the brain mechanisms underlying the effects of antidepressants.


Asunto(s)
Antidepresivos , Encéfalo , Neuroimagen , Trastorno Obsesivo Compulsivo , Humanos , Trastorno Obsesivo Compulsivo/tratamiento farmacológico , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/fisiopatología , Trastorno Obsesivo Compulsivo/patología , Antidepresivos/uso terapéutico , Antidepresivos/farmacología , Neuroimagen/métodos , Encéfalo/diagnóstico por imagen , Encéfalo/efectos de los fármacos , Encéfalo/patología , Encéfalo/fisiopatología , Imagen por Resonancia Magnética
6.
Artículo en Inglés | MEDLINE | ID: mdl-38901756

RESUMEN

BACKGROUND: Abnormal structure and function of gray matter (GM) have been discovered in the cortico-striatal-thalamic-cortical (CSTC) circuit in obsessive-compulsive disorder (OCD). The GM structure and function may be influenced by the structure and function of the white matter (WM). Therefore, it is crucial to explore the characteristics of WM in OCD. METHODS: Diffusion tensor imaging and resting-state functional magnetic resonance imaging data of 52 patients with OCD and 39 healthy controls (HCs) were collected. The tract-based spatial statistics, amplitude of low-frequency fluctuations (ALFF), and structural-functional coupling approaches were utilized to explore the WM structure and function. Furthermore, the relationship between the abnormal WM structure and function and clinical symptoms of OCD was investigated using Pearson's correlation. Support vector machine was performed to evaluate whether patients with OCD could be identified with the changed WM structure and function. RESULTS: Compared to HCs, the lower fractional anisotropy (FA) values of four clusters including the superior corona radiata, anterior corona radiata, right superior longitudinal fasciculus, corpus callosum, left posterior corona radiata, fornix, and the right anterior limb of internal capsule, reduced ALFF/FA ratio in the left anterior thalamic radiation (ATR), and the decreased functional connectivity between the left ATR and the left dorsal lateral prefrontal cortex within CSTC circuit at rest were observed in OCD. The decreased ALFF/FA ratio in the left ATR negatively correlated with Yale-Brown Obsessive-Compulsive Scale obsessive thinking scores and Hamilton Anxiety Rating Scale scores in OCD. Furthermore, the features that combined the abnormal WM structure and function performed best in distinguishing OCD from HCs with the appropriate accuracy (0.80), sensitivity (0.82), as well as specificity (0.80). CONCLUSION: Current research discovered changed WM structure and function in OCD. Furthermore, abnormal WM structural-functional coupling may lead to aberrant GM connectivity within the CSTC circuit at rest in OCD. TRIAL REGISTRATION: Study on the mechanism of brain network in obsessive-compulsive disorder with multi-model magnetic resonance imaging (ChiCTR-COC-17013301).


Asunto(s)
Imagen de Difusión Tensora , Imagen por Resonancia Magnética , Trastorno Obsesivo Compulsivo , Sustancia Blanca , Humanos , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/fisiopatología , Trastorno Obsesivo Compulsivo/patología , Masculino , Femenino , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/patología , Adulto , Adulto Joven , Máquina de Vectores de Soporte , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Encéfalo/fisiopatología
7.
Artículo en Inglés | MEDLINE | ID: mdl-38705507

RESUMEN

BACKGROUND: Skin-picking disorder (SPD) is conceptualized as an obsessive-compulsive and related disorder (OCRD). Patients with SPD excessively manipulate their skin, which leads to skin lesions, psychological distress, and functional impairment. The neuroanatomical facets of this disorder are still poorly understood. METHODS: A total of 220 participants (123 patients with a primary diagnosis of SPD and 97 healthy controls; mean age = 30 years, 80% female) were recruited for a voxel-based morphometry (VBM) study. VBM data were compared between patients and controls, and between three SPD subgroups, each characterized by a distinct age of symptom onset (before puberty, during puberty, adulthood). RESULTS: Relative to the healthy comparison group, patients with SPD had significantly less grey matter volume (GMV) in regions of interest (ROIs: insula, orbitofrontal cortex, pallidum, cerebellum, supramarginal gyrus) and in the frontal pole and occipital regions (whole-brain findings). Early onset of symptoms (before puberty) was associated with elevated levels of focused skin-picking, in addition to less GMV in specific ROIs (insula, orbitofrontal cortex) as well as in paracingulate/ superior temporal regions (whole-brain findings). CONCLUSIONS: SPD-related reductions in GMV were identified in brain regions involved in interoception, emotion regulation, and motor control. This partially aligns with findings for OCD. The detection of different age-of-onset groups based on clinical as well as morphometric data points to the heterogeneity of the disorder and warrants further investigation.


Asunto(s)
Encéfalo , Sustancia Gris , Imagen por Resonancia Magnética , Neuroimagen , Trastorno Obsesivo Compulsivo , Humanos , Femenino , Masculino , Adulto , Imagen por Resonancia Magnética/métodos , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología , Neuroimagen/métodos , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/patología , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Piel/diagnóstico por imagen , Piel/patología , Adulto Joven
8.
J Affect Disord ; 350: 887-894, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38272366

RESUMEN

BACKGROUND: Ablative surgery using bilateral anterior capsulotomy (BAC) is an option for treatment resistant depression (TRD) and obsessive-compulsive disorder (TROCD). The location and extent of the lesion within anterior limb of the internal capsule (ALIC) remains uncertain. Accumulating evidence has suggested that the lesion should be located ventrally while limiting the dorsal extent. Our center is now targeting specific fiber tracts within the lower half of the ALIC. METHOD: Presurgical diffusion tensor Magnetic Resonance Imaging (MRI) was used to identify individual fibre tracts within the ventral aspect of the ALIC in the last two patients who underwent BAC at our center. One patient had TRD and the other had both TROCD and TRD. Radiofrequency-induced thermal lesions were created in the identified targets with lesion volumes between 20 and 229 mm3 (average 95 mm3). FINDINGS: Both patients were responders with neither experiencing significant side effects including compromised executive functions. LIMITATIONS: The generalizability of our findings is limited because the outcome is based on two subjects. CONCLUSION: This work suggests that BAC can be individually tailored and more limited to the ventral aspect of the ALIC and is effective and safe for TRD and TROCD. Accumulating data also suggests that to be clinically effective the length of the capsulotomy should be about 10mm. BAC's use may increase with the growing utilization and mastery of magnetic resonance guided focused ultrasound.


Asunto(s)
Trastorno Depresivo Resistente al Tratamiento , Trastorno Obsesivo Compulsivo , Humanos , Depresión , Trastorno Depresivo Resistente al Tratamiento/diagnóstico por imagen , Trastorno Depresivo Resistente al Tratamiento/cirugía , Trastorno Depresivo Resistente al Tratamiento/patología , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/cirugía , Trastorno Obsesivo Compulsivo/patología , Función Ejecutiva , Imagen por Resonancia Magnética , Cápsula Interna/diagnóstico por imagen , Cápsula Interna/cirugía , Cápsula Interna/patología , Resultado del Tratamiento
9.
Mol Psychiatry ; 29(4): 1033-1045, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38228890

RESUMEN

Previous diffusion MRI studies have reported mixed findings on white matter microstructure alterations in obsessive-compulsive disorder (OCD), likely due to variation in demographic and clinical characteristics, scanning methods, and underpowered samples. The OCD global study was created across five international sites to overcome these challenges by harmonizing data collection to identify consistent brain signatures of OCD that are reproducible and generalizable. Single-shell diffusion measures (e.g., fractional anisotropy), multi-shell Neurite Orientation Dispersion and Density Imaging (NODDI) and fixel-based measures, were extracted from skeletonized white matter tracts in 260 medication-free adults with OCD and 252 healthy controls. We additionally performed structural connectome analysis. We compared cases with controls and cases with early (<18) versus late (18+) OCD onset using mixed-model and Bayesian multilevel analysis. Compared with healthy controls, adult OCD individuals showed higher fiber density in the sagittal stratum (B[SE] = 0.10[0.05], P = 0.04) and credible evidence for higher fiber density in several other tracts. When comparing early (n = 145) and late-onset (n = 114) cases, converging evidence showed lower integrity of the posterior thalamic radiation -particularly radial diffusivity (B[SE] = 0.28[0.12], P = 0.03)-and lower global efficiency of the structural connectome (B[SE] = 15.3[6.6], P = 0.03) in late-onset cases. Post-hoc analyses indicated divergent direction of effects of the two OCD groups compared to healthy controls. Age of OCD onset differentially affects the integrity of thalamo-parietal/occipital tracts and the efficiency of the structural brain network. These results lend further support for the role of the thalamus and its afferent fibers and visual attentional processes in the pathophysiology of OCD.


Asunto(s)
Edad de Inicio , Encéfalo , Conectoma , Imagen de Difusión Tensora , Trastorno Obsesivo Compulsivo , Sustancia Blanca , Humanos , Trastorno Obsesivo Compulsivo/patología , Sustancia Blanca/patología , Adulto , Masculino , Femenino , Conectoma/métodos , Imagen de Difusión Tensora/métodos , Encéfalo/patología , Persona de Mediana Edad , Imagen de Difusión por Resonancia Magnética/métodos , Adulto Joven , Anisotropía , Teorema de Bayes , Estudios de Casos y Controles , Adolescente
10.
J Hand Surg Am ; 49(2): 150-159, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37865912

RESUMEN

Osteochondritis dissecans (OCD) of the capitellum occurs relatively infrequently but can be found in young overhead-throwing athletes, most commonly in baseball players and gymnasts. Although non-operative management can effectively treat stable lesions, unstable lesions can lead to debilitating symptoms of the elbow and diminished quality of life without surgical intervention. This article reviews methods of treating OCD of the capitellum categorized by stability, size, and patient characteristics, and seeks to familiarize the reader with the appropriate selection of osteochondral allograft versus autograft in treating large, unstable lesions. We complement this review with 3 case examples, each using either an osteochondral autograft or allograft, and discuss the decision-making methodology used in each case.


Asunto(s)
Articulación del Codo , Trastorno Obsesivo Compulsivo , Osteocondritis Disecante , Humanos , Osteocondritis Disecante/cirugía , Autoinjertos/patología , Calidad de Vida , Resultado del Tratamiento , Articulación del Codo/cirugía , Articulación del Codo/patología , Aloinjertos/patología , Trastorno Obsesivo Compulsivo/patología
11.
BMC Psychiatry ; 23(1): 289, 2023 04 25.
Artículo en Inglés | MEDLINE | ID: mdl-37098479

RESUMEN

BACKGROUND: Previous studies discovered the presence of abnormal structures and functions in the brain regions of patients with obsessive-compulsive disorder (OCD). Nevertheless, whether structural changes in brain regions are coupled with alterations in dynamic functional connectivity (dFC) at rest in medicine-free patients with OCD remains vague. METHODS: Three-dimensional T1-weighed magnetic resonance imaging (MRI) and resting-state functional MRI were performed on 50 medicine-free OCD and 50 healthy controls (HCs). Firstly, the differences in gray matter volume (GMV) between OCD and HCs were compared. Then, brain regions with aberrant GMV were used as seeds for dFC analysis. The relationship of altered GMV and dFC with clinical parameters in OCD was explored using partial correlation analysis. Finally, support vector machine was applied to examine whether altered multimodal imaging data might be adopted to distinguish OCD from HCs. RESULTS: Our findings indicated that GMV in the left superior temporal gyrus (STG) and right supplementary motor area (SMA) was reduced in OCD, and the dFC between the left STG and the left cerebellum Crus I and left thalamus, and between the right SMA and right dorsolateral prefrontal cortex (DLPFC) and left precuneus was decreased at rest in OCD. The brain regions both with altered GMV and dFC values could discriminate OCD from HCs with the accuracy of 0.85, sensitivity of 0.90 and specificity of 0.80. CONCLUSION: The decreased gray matter structure coupling with dynamic function in the left STG and right SMA at rest may be crucial in the pathophysiology of OCD. TRIAL REGISTRATION: Study on the mechanism of brain network in obsessive-compulsive disorder with multi-model magnetic resonance imaging (registration date: 08/11/2017; registration number: ChiCTR-COC-17,013,301).


Asunto(s)
Sustancia Gris , Trastorno Obsesivo Compulsivo , Humanos , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/patología , Corteza Cerebral/patología , Encéfalo , Lóbulo Parietal , Imagen por Resonancia Magnética , Trastorno Obsesivo Compulsivo/patología
12.
Psychiatry Res Neuroimaging ; 332: 111644, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37087810

RESUMEN

Many studies have shown that limbic system abnormalities are seen in obsessive-compulsive disorder (OCD), but the neurobiological changes in OCD are still unclear. Moreover, olfactory bulb volume (OBV) and its association with symptom severity have not been yet investigated in patients with OCD. This is the first study on OBV and olfactory sulcus depth (OSD) values in OCD patients, to the best of our knowledge. Between January 2018 and March 2022, 25 patients with OCD and 26 healthy controls with brain magnetic resonance imaging (MRI) were included. Detailed disease history of OCD patients was taken, and Yale-Brown obsessive-compulsive scale (YBOCS) was applied. The mean age of the patient group was 33.40±9.58, the mean age of the control group was 32.84±8.01. LOBV, ROBV, TOBV, and LOSD in the patient group were significantly lower than in the control group (p=.013, p=.005, p=.001, p=.015, respectively). ROBV and TOBV were negatively correlated with YBOCS total and subscale scores. A negative correlation was found between ROBV and TOBV and disease duration (r=-0.749 and r=-0.640, respectively). The negative correlation of ROBV and TOBV values with disease duration and disease severity can be used to monitor the neurodegenerative process of OCD disease.


Asunto(s)
Trastorno Obsesivo Compulsivo , Bulbo Olfatorio , Humanos , Bulbo Olfatorio/diagnóstico por imagen , Bulbo Olfatorio/patología , Encéfalo/patología , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología , Sistema Límbico/patología , Corteza Prefrontal/patología
13.
Transl Psychiatry ; 12(1): 328, 2022 08 10.
Artículo en Inglés | MEDLINE | ID: mdl-35948535

RESUMEN

Obsessive-compulsive symptoms (OCS) are common in school-aged children and predict the development of obsessive compulsive disorder (OCD). White-matter abnormalities have been described in OCD, but the white matter correlates of OCS in the developing brain are unclear. Some correlates of OCS (or a diagnosis of OCD) may reflect correlates of a transdiagnostic or even general psychopathology factor. We examined these questions in a large sample of typically developing youth (N = 1208), using a hierarchical analysis of fixel-based white matter measures in relation to OCS and general psychopathology. General psychopathology was associated with abnormalities in the posterior corpus callosum and forceps major in an age-dependent manner, suggesting altered maturation (specifically, hypermaturation in younger subjects). A unidimensional measure of OCS did not associate with any white-matter abnormalities, but analysis of separate OCS dimensions (derived from factor analysis within this sample) revealed the 'Bad Thoughts' dimension to associate with white-matter abnormalities in dorsal parietal white-matter and descending corticospinal tracts, and the 'Symmetry' dimension to associate with abnormalities in the anterior corpus callosum. Repetition/checking and Symmetry OCS were additionally associated with posterior abnormalities overlapping with the correlates of general psychopathology. Contamination symptoms had no white-matter correlates. Secondary analysis of fractional anisotropy (FA) revealed distinct white-matter abnormalities, suggesting that fixel-based and FA analyses identify distinct features of white matter relevant to psychopathology. These findings suggest that OCS dimensions correlate with dissociable abnormalities in white matter, implicating separable networks. Future studies should examine these white-matter signatures in a longitudinal framework.


Asunto(s)
Trastorno Obsesivo Compulsivo , Sustancia Blanca , Adolescente , Anisotropía , Niño , Humanos , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología , Sustancia Blanca/diagnóstico por imagen , Sustancia Blanca/patología
14.
Brain Imaging Behav ; 16(5): 1946-1953, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35867324

RESUMEN

Little is known about the underlying neurobiological mechanisms in patients with obsessive-compulsive disorder (OCD). We aimed to examine cortical thickness and surface area in individuals with OCD and their unaffected siblings, comparing them to healthy controls. 30 patients with OCD, 21 unaffected siblings (SIB) and 30 controls underwent structural magnetic resonance imaging. Structural images were analyzed using the FreeSurfer software package (version 6.0). Compared to healthy controls, both OCD and SIB groups showed significantly lower cortical thickness in the right anterior insula. Surface areas of the superior frontal gyrus, paracentral gyrus and precuneus of the right hemisphere were also reduced in OCD patients compared to controls. There were no significant differences in cortical thickness and surface area between the OCD and SIB groups. We did not detect any significant differences in subcortical volumes between groups. Lower cortical thickness in the right anterior insula in both OCD patients and unaffected siblings may represent a potential structural endophenotype for OCD.


Asunto(s)
Imagen por Resonancia Magnética , Trastorno Obsesivo Compulsivo , Humanos , Imagen por Resonancia Magnética/métodos , Hermanos , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/patología , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología , Lóbulo Parietal/patología
15.
Int J Radiat Oncol Biol Phys ; 113(5): 960-966, 2022 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-35595157

RESUMEN

PURPOSE: Effective treatment options for refractory depression are needed. Recent advancements permit both precise ablative radiation and functional neurologic connectome analysis using standard magnetic resonance imaging. We combined these innovations to perform stereotactic radiosurgical capsulotomy for the treatment of medically refractory major depressive disorder and study connectome response using a novel tractography-based approach. METHODS AND MATERIALS: Patients with medically refractory depression were enrolled on a prospective pilot single-arm observational trial from 2020 to 2021 at a single academic tertiary referral center. Bilateral ablation of the anterior limb of the internal capsule was accomplished by mask-based linear accelerator stereotactic radiosurgery. Beck's Depression Inventory measured efficacy. Montreal Cognitive Assessment evaluated cognition. RESULTS: Three patients were enrolled. Depression burden was improved by 88% at 12-month follow-up and by 55% at 18-month follow-up for patient 1 and 2, respectively. Patient 1 discontinued ketamine therapy, and patient 2 discontinued electroconvulsive therapy. Patient 3 reported global improvement in symptoms and function at 3 months. All 3 patients had reduction or resolution of suicidal ideation. No patient experienced cognitive decline or neurologic toxicity, and Montreal Cognitive Assessment score, as well as subjective patient-reported evaluations of concentration and attention, were superior after treatment. Tractography confirmed intended disruption of the cortico-striatal-thalamo-cortical loop with structural reorganization in the connectome. Connectome change was consistent between patients. Observed increases in caudate and putamen connectivity and decreases in thalamic connectivity may explain improved concentration, attention, and depression. The diversity and magnitude of connectome change may correlate with degree of clinical response. CONCLUSIONS: In 3 patients with refractory depression, radiosurgical capsulotomy significantly reduced the burden of depression. Functional connectome reorganization offers neurobiological evidence to support further investigations of the role of radiosurgery in depression.


Asunto(s)
Trastorno Depresivo Mayor , Trastorno Depresivo Resistente al Tratamiento , Trastorno Obsesivo Compulsivo , Radiocirugia , Trastorno Depresivo Mayor/diagnóstico por imagen , Trastorno Depresivo Mayor/cirugía , Trastorno Depresivo Resistente al Tratamiento/diagnóstico por imagen , Trastorno Depresivo Resistente al Tratamiento/cirugía , Imagen de Difusión Tensora , Humanos , Imagen por Resonancia Magnética , Trastorno Obsesivo Compulsivo/patología , Trastorno Obsesivo Compulsivo/psicología , Trastorno Obsesivo Compulsivo/cirugía , Estudios Prospectivos , Radiocirugia/métodos
16.
Hum Brain Mapp ; 43(1): 23-36, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-32154629

RESUMEN

Neuroimaging has played an important part in advancing our understanding of the neurobiology of obsessive-compulsive disorder (OCD). At the same time, neuroimaging studies of OCD have had notable limitations, including reliance on relatively small samples. International collaborative efforts to increase statistical power by combining samples from across sites have been bolstered by the ENIGMA consortium; this provides specific technical expertise for conducting multi-site analyses, as well as access to a collaborative community of neuroimaging scientists. In this article, we outline the background to, development of, and initial findings from ENIGMA's OCD working group, which currently consists of 47 samples from 34 institutes in 15 countries on 5 continents, with a total sample of 2,323 OCD patients and 2,325 healthy controls. Initial work has focused on studies of cortical thickness and subcortical volumes, structural connectivity, and brain lateralization in children, adolescents and adults with OCD, also including the study on the commonalities and distinctions across different neurodevelopment disorders. Additional work is ongoing, employing machine learning techniques. Findings to date have contributed to the development of neurobiological models of OCD, have provided an important model of global scientific collaboration, and have had a number of clinical implications. Importantly, our work has shed new light on questions about whether structural and functional alterations found in OCD reflect neurodevelopmental changes, effects of the disease process, or medication impacts. We conclude with a summary of ongoing work by ENIGMA-OCD, and a consideration of future directions for neuroimaging research on OCD within and beyond ENIGMA.


Asunto(s)
Neuroimagen , Trastorno Obsesivo Compulsivo , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/patología , Humanos , Aprendizaje Automático , Estudios Multicéntricos como Asunto , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología
17.
Ocul Immunol Inflamm ; 30(2): 428-432, 2022 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-32946294

RESUMEN

BACKGROUND: To evaluate choroidal vascularity index (CVI) and to investigate the association of CVI with neutrophil-to-lymphocyte ratio (NLR) as an indicator of inflammation in obsessive-compulsive disorder (OCD). MATERIAL AND METHODS: This prospective study included newly diagnosed OCD patients and healthy controls. All patients underwent EDI-OCT imaging to assess the subfoveal choroidal thickness (sCT) and peripapillary CT (pCT). CVI was defined as the ratio of luminal area to stromal area after binarization on EDI-OCT images. RESULTS: A total of 39 patients with OCD and 25 controls were included. The sCT, pCT, and CVI values were significantly higher in the OCD vs. control group (p˂0.05 for all). The NLR values were significantly higher in the OCD vs. control group (p = .007). A significant positive correlation was noted between CVI and NLR (p = .039). CONCLUSION: Our findings suggest that systemic inflammation may play a role in the pathogenesis of OCD.


Asunto(s)
Trastorno Obsesivo Compulsivo , Tomografía de Coherencia Óptica , Biomarcadores , Coroides/patología , Humanos , Inflamación/diagnóstico , Inflamación/patología , Trastorno Obsesivo Compulsivo/diagnóstico , Trastorno Obsesivo Compulsivo/patología , Estudios Prospectivos , Estudios Retrospectivos , Tomografía de Coherencia Óptica/métodos
18.
Hum Brain Mapp ; 43(1): 167-181, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-32420672

RESUMEN

Left-right asymmetry of the human brain is one of its cardinal features, and also a complex, multivariate trait. Decades of research have suggested that brain asymmetry may be altered in psychiatric disorders. However, findings have been inconsistent and often based on small sample sizes. There are also open questions surrounding which structures are asymmetrical on average in the healthy population, and how variability in brain asymmetry relates to basic biological variables such as age and sex. Over the last 4 years, the ENIGMA-Laterality Working Group has published six studies of gray matter morphological asymmetry based on total sample sizes from roughly 3,500 to 17,000 individuals, which were between one and two orders of magnitude larger than those published in previous decades. A population-level mapping of average asymmetry was achieved, including an intriguing fronto-occipital gradient of cortical thickness asymmetry in healthy brains. ENIGMA's multi-dataset approach also supported an empirical illustration of reproducibility of hemispheric differences across datasets. Effect sizes were estimated for gray matter asymmetry based on large, international, samples in relation to age, sex, handedness, and brain volume, as well as for three psychiatric disorders: autism spectrum disorder was associated with subtly reduced asymmetry of cortical thickness at regions spread widely over the cortex; pediatric obsessive-compulsive disorder was associated with altered subcortical asymmetry; major depressive disorder was not significantly associated with changes of asymmetry. Ongoing studies are examining brain asymmetry in other disorders. Moreover, a groundwork has been laid for possibly identifying shared genetic contributions to brain asymmetry and disorders.


Asunto(s)
Trastorno del Espectro Autista/patología , Corteza Cerebral/anatomía & histología , Trastorno Depresivo Mayor/patología , Sustancia Gris/anatomía & histología , Imagen por Resonancia Magnética , Neuroimagen , Trastorno Obsesivo Compulsivo/patología , Trastorno del Espectro Autista/diagnóstico por imagen , Corteza Cerebral/diagnóstico por imagen , Trastorno Depresivo Mayor/diagnóstico por imagen , Sustancia Gris/diagnóstico por imagen , Humanos , Estudios Multicéntricos como Asunto , Trastorno Obsesivo Compulsivo/diagnóstico por imagen
19.
J Am Acad Child Adolesc Psychiatry ; 61(2): 321-330, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34217835

RESUMEN

OBJECTIVE: Pediatric obsessive-compulsive disorder (OCD) and clinically relevant obsessive-compulsive symptoms in the general population are associated with increased thalamic volume. It is unknown whether this enlargement is explained by specific thalamic subregions. The relation between obsessive-compulsive symptoms and volume of thalamic subregions was investigated in a population-based sample of children. METHOD: Obsessive-compulsive symptoms were measured in children (9-12 years of age) from the Generation R Study using the Short Obsessive-Compulsive Disorder Screener (SOCS). Thalamic nuclei volumes were extracted from structural 3T magnetic resonance imaging scans using the ThalamicNuclei pipeline and regrouped into anterior, ventral, intralaminar/medial, lateral, and pulvinar subregions. Volumes were compared between children with symptoms above clinical cutoff (probable OCD cases, SOCS ≥ 6, n = 156) and matched children without symptoms (n = 156). Linear regression models were fitted to investigate the association between continuous SOCS score and subregional volume in the whole sample (N = 2500). RESULTS: Children with probable OCD had larger ventral nuclei compared with children without symptoms (d = 0.25, p = .025, false discovery rate adjusted p = .126). SOCS score showed a negative association with pulvinar volume when accounting for overall thalamic volume (ß = -0.057, p = .009, false discovery rate adjusted p = .09). However, these associations did not survive multiple testing correction. CONCLUSION: The results suggest that individual nuclei groups contribute in varying degrees to overall thalamic volume in children with probable OCD, although this did not survive multiple comparisons correction. Understanding the role of thalamic nuclei and their associated circuits in pediatric OCD could lead toward treatment strategies targeting these circuits.


Asunto(s)
Trastorno Obsesivo Compulsivo , Tálamo , Niño , Humanos , Imagen por Resonancia Magnética , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología , Tálamo/diagnóstico por imagen , Tálamo/patología
20.
Hum Brain Mapp ; 42(12): 3871-3886, 2021 08 15.
Artículo en Inglés | MEDLINE | ID: mdl-34105832

RESUMEN

The objective of the current study is to determine robust transdiagnostic brain structural markers for compulsivity by capitalizing on the increasing number of case-control studies examining gray matter volume (GMV) alterations in substance use disorders (SUD) and obsessive-compulsive disorder (OCD). Voxel-based meta-analysis within the individual disorders and conjunction analysis were employed to reveal common GMV alterations between SUDs and OCD. Meta-analytic coordinates and signed brain volumetric maps determining directed (reduced/increased) GMV alterations between the disorder groups and controls served as the primary outcome. The separate meta-analysis demonstrated that SUD and OCD patients exhibited widespread GMV reductions in frontocortical regions including prefrontal, cingulate, and insular. Conjunction analysis revealed that the left inferior frontal gyrus (IFG) consistently exhibited decreased GMV across all disorders. Functional characterization suggests that the IFG represents a core hub in the cognitive control network and exhibits bidirectional (Granger) causal interactions with the striatum. Only OCD showed increased GMV in the dorsal striatum with higher changes being associated with more severe OCD symptomatology. Together the findings demonstrate robustly decreased GMV across the disorders in the left IFG, suggesting a transdiagnostic brain structural marker. The functional characterization as a key hub in the cognitive control network and casual interactions with the striatum suggest that deficits in inhibitory control mechanisms may promote compulsivity and loss of control that characterize both disorders.


Asunto(s)
Corteza Cerebral , Cuerpo Estriado , Función Ejecutiva , Sustancia Gris , Red Nerviosa , Trastorno Obsesivo Compulsivo , Trastornos Relacionados con Sustancias , Corteza Cerebral/diagnóstico por imagen , Corteza Cerebral/patología , Corteza Cerebral/fisiopatología , Cuerpo Estriado/diagnóstico por imagen , Cuerpo Estriado/patología , Cuerpo Estriado/fisiopatología , Función Ejecutiva/fisiología , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/patología , Sustancia Gris/fisiopatología , Humanos , Red Nerviosa/diagnóstico por imagen , Red Nerviosa/patología , Red Nerviosa/fisiopatología , Trastorno Obsesivo Compulsivo/diagnóstico por imagen , Trastorno Obsesivo Compulsivo/patología , Trastorno Obsesivo Compulsivo/fisiopatología , Trastornos Relacionados con Sustancias/diagnóstico por imagen , Trastornos Relacionados con Sustancias/patología , Trastornos Relacionados con Sustancias/fisiopatología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...