Impairment in the goal-directed corticostriatal learning system as a biomarker for obsessive-compulsive disorder.

BACKGROUND: Compulsive behaviors in obsessive-compulsive disorder (OCD) have been related to impairment within the associative cortical-striatal system connecting the caudate and prefrontal cortex that underlies consciously-controlled goal-directed learning and behavior. However, little is known whether this impairment may serve as a biomarker for vulnerability to OCD. METHODS: Using resting-state functional magnetic resonance imaging (fMRI), we employed Granger causality analysis (GCA) to measure effective connectivity (EC) in previously validated striatal sub-regions, including the caudate, putamen, and the nucleus accumbens, in 35 OCD patients, 35 unaffected first-degree relatives and 35 matched healthy controls. RESULTS: Both OCD patients and their first-degree relatives showed greater EC than controls between the left caudate and the orbital frontal cortex (OFC). Both OCD patients and their first-degree relatives showed lower EC than controls between the left caudate and lateral prefrontal cortex. These results are consistent with findings from task-related fMRI studies which found impairment in the goal-directed system in OCD patients. CONCLUSIONS: The same changes in EC were present in both OCD patients and their unaffected first-degree relatives suggest that impairment in the goal-directed learning system may be a biomarker for OCD.

Non breathing-related sleep fragmentation and imaging markers in patients with atherosclerotic cerebral small vessel disease (CSVD): a cross-sectional case-control study.

BACKGROUND: Sleep fragmentation was shown to be positively associated with cognitive impairment in patients with cerebral small vessel disease (CSVD); however, the underlying mechanisms are not well characterized. In this study, we sought to clarify this issue by investigating the relationship between non breathing-related sleep fragmentation and brain imaging markers in patients with CSVD. METHODS: Eighty-four CSVD patients and 24 age- and sex-matched healthy controls were prospectively recruited. All subjects underwent 3.0 T superconducting magnetic resonance imaging and overnight polysomnography. Polysomnography parameters including sleep onset latency (SOL), total sleep time (TST); sleep efficiency (SE), wake after sleep onset (WASO), percentage of each sleep stage (N1, N2, N3 and rapid eye movement [REM]), arousal index (ArI), periodic limb movement in sleep index (PLSMI), and periodic limb movement related arousal index (PLMAI) were compared between CSVD patients and healthy controls. The relationship between arousal index and CSVD markers was explored in the CSVD group. RESULTS: On polysomnography, CSVD patients showed significantly higher ArI, WASO, PLSMI, and PLMAI, and lower sleep efficiency and N- 3 ratio compared to healthy controls (p < 0.05). On ordinal logistic regression, higher ArI showed a positive association with the severity of periventricular white matter hyperintensity (odds ratio [OR] 1.121, 95% confidence interval [CI] 0.138-2.185) and perivascular space (OR 2.108, 95% CI 1.032-4.017) in CSVD patients, after adjusting for potential confounding variables. CONCLUSIONS: These preliminary results indicate that non breathing-related sleep fragmentation is common and related to the pathological markers of CSVD patients. Future prospective research is required to determine the causal relationship between sleep parameters and CSVD pathology.

The association of GABRB2 SNPs with cognitive function in schizophrenia.

Cognitive impairment is one of the core symptoms of schizophrenia. Multiple domains of cognition are affected in patients with schizophrenia, which has a major effect on the functional outcome. Recent studies indicate that SNPs in the gamma-aminobutyric acid type A receptor beta 2 subunit (GABRB2) gene are associated with the risk of schizophrenia, however, the effect of these SNPs on cognitive function in patients with schizophrenia has not been explored. In this study, we first performed a case-control analysis of three SNPs (rs187269 allele A vs. G, rs252944 allele C vs. G, and rs194072 allele A vs. G) in 100 patients and 90 controls, then conducted a meta-analysis and found the SNP rs194072 was associated with schizophrenia (OR = 0.86, P = 0.0119), and survived after Bonferroni correction. The haplotype analysis suggested that the haplotype ACA, comprising the three SNPs (rs187269, rs252944 and rs194072) was also significantly associated with schizophrenia (P = 0.049).Then, we performed an association analysis of three SNPs (rs187269, rs252944 and rs194072) in GABRB2 gene with cognitive performance in patients with first episode schizophrenia. We found that the allele G of rs187269 in the GABRB2 gene was significantly associated with better cognitive flexibility (P = 0.005), a major aspect of executive function, in patients with first episode schizophrenia. The haplotype ACA was significantly associated with cognitive flexibility in patients with schizophrenia (P = 0.023). Our study showed that SNPs in GABRB2 may have a significant effect on cognitive function in patients with schizophrenia, suggesting that modulating GABRB2 may have therapeutic potential to improve cognitive function of patients with schizophrenia.

Effects of low-dose olanzapine on duloxetine-related nausea and vomiting for the treatment of major depressive disorder.

OBJECTIVE: This study aims to investigate the effects of low-dose olanzapine on preventing occurrence and controlling the severity of nausea and vomiting related to duloxetine in treating major depressive disorder. METHODS: Two hundred sixty-eight subjects with major depressive disorder were divided into control and trial groups. The control group had 165 subjects and was treated with duloxetine only, whereas the trial group had 103 subjects and received duloxetine combined with low-dose olanzapine. After the treatment for 2 weeks, both groups were evaluated for occurrence and severity of adverse effects on digestive tract using the Treatment Emergent Symptom Scale. RESULTS: The trial group, scored at 13, showed significantly less occurrence and severity of nausea and vomiting than the control group, scored at 38 (P < 0.05). The occurrence of nausea and vomiting in the trial group is significantly lower compared with that in the control group, and the occurrence decreases as the dose of olanzapine increases (P < 0.05). The antiemetic effect of olanzapine is valid to all subjects who received it. CONCLUSIONS: Duloxetine combined with low-dose olanzapine can effectively reduce the occurrence and severity of duloxetine-related nausea and vomiting. With the increase of olanzapine dose, the antiemetic effect becomes stronger. Olanzapine is a safe and efficient drug for the prevention of duloxetine-related nausea and vomiting.

Validity of the Chinese version of the brief index of sexual functioning for women with a new scoring algorithm and comparison of normative and recurrently depressed Han Chinese population.

INTRODUCTION: The Brief Index of Sexual Functioning for Women (BISF-W) is proved to be a useful instrument to assess female sexual function, but the validation information of its Chinese version is still unavailable. It has not been used to assess female sexual function among Han Chinese women with recurrent depression. AIM: This study aims to validate the Chinese version of BISF-W (C-BISF-W) with a new scoring algorithm and evaluate the impact of recurrent depression on sexual function among Han Chinese women. METHODS: Three groups of subjects, 63 unmedicated patients with recurrent depression, 50 medicated remitted patients with recurrent depression, and 92 healthy controls were enrolled in this study. Sexual function was assessed with C-BISF-W. A new scoring algorithm was developed to provide an overall composite score (G) and seven dimension scores: desire (D1), arousal (D2), frequency of sexual activity (D3), orgasm (D4), sexual interaction (D5), relationship dissatisfaction (D6), and problems affecting sexual function (D7). MAIN OUTCOME MEASURES: Psychometric analyses were conducted. RESULTS: Four factors whose Eigenvalues were higher than 1 were extracted, explaining 61.426% of the total variance. Compared with healthy age-matched control, unmedicated cases scored significantly lower in G, D1, D2, D3, D4 and D5, whereas these were higher in D6 and D7. No significant difference was found in the scores of G, D1, D2, D3, D4, and D5 between remitted cases and control, but the former scored higher in D6 and D7 than the latter. In comparison with unmedicated cases, medicated remitted cases got a higher score in G, D1, D2, and D5. For the healthy control, sexual function (G) was negatively correlated with age. CONCLUSIONS: With the new scoring algorithm, C-BISF-W is proved to be a validated instrument to assess female sexual function. The impact of recurrent depression on female sexual function is negatively profound and extensive.

Two new terpenoid benzoates with antitumor activity from the roots of Ferula dissecta.

Two new sesquiterpene benzoates, syreiteate A (1) and syreiteate B (2), were isolated from the roots of Ferula dissecta (Ledeb.) Ledeb. Their structures were elucidated by extensive spectroscopic methods including 1D ((1)H and (13)C) NMR, 2D (HSQC, HMBC, DQF-COSY, and NOESY) NMR, and ESI-TOF-MS. Their configurations were determined on the basis of the analysis of the coupling constants, NOESY correlations, and circular dichroism spectrum. Compounds 1 and 2 showed potent growth inhibitory activity against cervical cancer HeLa cell line with the IC50 values of 13.2 and 19.3 µM, respectively.

Factors associated with the high susceptibility to depression of women during the perimenopause.

OBJECTIVE: This study investigated the factors associated with the high susceptibility of perimenopausal women to depression. METHODS: A total of 66 perimenopausal women participated in this study. The Zung self-rating depression scale (SDS) was used to evaluate the intensity of depressive symptoms. The modified Kupperman index (KI) was used to assess common perimenopausal symptoms. Psychosocial factors were assessed via the Eysenck Personality Questionnaire, attitudes toward menopause checklist, and metacognition questionnaire (MCQ). Levels of serum estradiol, testosterone, and progesterone were determined. RESULTS: There were statistically significant associations between SDS standard score and the KI scale score (ß = .361, p = .001), years of education (ß = -.309, p = .005), and F3 cognitive self-consciousness score of MCQ (ß = -.234, p = .032; adjusted R2  = .264, F = 8.759, p < .001). CONCLUSIONS: High susceptibility to depression of perimenopausal women may be related to lower educational level, more severe perimenopausal symptoms, and altered metacognition.

The Gene Polymorphism of VMAT2 Is Associated with Risk of Schizophrenia in Male Han Chinese.

OBJECTIVE: To investigate the association between gene polymorphism of vesicular monoamine transporter type 2(VMAT2) and schizophrenia in Han Chinese population. METHODS: 430 patients with schizophrenia and 470 age-sex matched controls were recruited from four mental health centers. All patients were diagnosed by two psychiatrists based on the Structured Clinical Interview for DSM Disorders (SCID). The ligase detection reactions (LDR) method was used to assess the polymorphism of the two SNPs (rs363371 and rs363324) of VMAT2. RESULTS: No associations of two SNPs with schizophrenia was found. When we stratified males and females for the analysis, we found that that in the recessive model of rs363371, there was an obvious significant association between rs363371 and schizophrenia in males (OR=0.564, 95% CI=0.357-0.892, p=0.014) but not females. For the association between rs363324 and schizophrenia, no association was found in either males or females. No association was found when stratifying early-onset schizophrenia and late-onset schizophrenia. CONCLUSION: Our findings indicate that both rs363371 and rs363324 were not associated with schizophrenia, while it seemed that the AA genotype of rs363371 plays a protective effect in male Chinese in developing schizophrenia.

Effects of Trazodone on Sleep Quality and Cognitive Function in Arteriosclerotic Cerebral Small Vessel Disease Comorbid With Chronic Insomnia.

BACKGROUND: Chronic insomnia is common in patients with arteriosclerotic cerebral small vessel disease (CSVD) and aggravates the cognitive impairment caused by CSVD. Low-dose trazodone is effective in treating insomnia, but it is unclear whether it can also improve cognitive function in CSVD patients. This study was performed to explore the effects of trazodone on sleep quality and cognitive function in CSVD comorbid with chronic insomnia. METHODS: This was a randomized, double-blind, placebo-controlled pilot study. Forty patients suffering from arteriosclerotic CSVD and insomnia were recruited from an outpatient clinic. Participants were randomized individually to receive either trazodone (study group) or a placebo (control group) for 4 weeks. The primary outcome was the cognitive score on the Montreal Cognitive Assessment scale (MoCA). Secondary outcomes included sleep parameters measured with polysomnography (PSG) and the Pittsburgh Sleep Quality Index. RESULTS: Trazodone caused significantly better improvements in concentration and recall abilities, measured with MoCA, as well as in PSG parameters such as sleep efficiency, N3 sleep ratio, and sleep continuity than the placebo, with no significant differences in the occurrence of side effects. The improvement of sleep quality was correlated with increased concentration and recall abilities. CONCLUSIONS: A low dose of trazodone seems acceptable and effective in reducing insomnia severity and improving concentration and recall abilities in this pilot study. The improvement of cognition could be achieved by alleviation of insomnia severity. Considering the high incidence of insomnia in CSVD patients, the results of this preliminary study support the use of low-dose trazodone to deal with insomnia and cognitive impairment in CSVD.

Abnormal Anhedonia as a Potential Endophenotype in Obsessive-Compulsive Disorder.

BACKGROUND: Obsessive-compulsive disorder (OCD) is often accompanied by cognitive, particularly executive function, impairments. Recently, anhedonia has emerged as an apparently important symptom of OCD reflecting altered emotion regulation. These two aspects are often comorbid in OCD. However, little is known about whether anhedonia may be a trait marker for OCD. METHODS: To verify the role of executive function and evaluate the role of anhedonia in OCD and its relationship with OCD symptoms, we recruited 60 OCD patients, 30 unaffected first-degree relatives (FDRs), and 60 healthy controls (HCs). Participants completed psychometric testing to assess depression, anxiety, and anhedonia symptoms, as well as two cognitive tests to assess executive function, namely the Wisconsin Card Sorting Test (WCST) and the Stroop Color-Word Test (SCWT). RESULTS: Compared to HCs, OCD patients and FDRs had significantly lower anticipatory and consummatory pleasure scores. The severity of anticipatory anhedonia correlated positively with obsessive-compulsive symptoms (r = 0.253, p = 0.009), even after controlling for depression and anxiety symptoms. Compared to HCs, OCD patients and FDRs made more errors and achieved fewer categories in the WCST. For all three SWCT components, OCD patients and FDRs took more time to name colors than HCs, but the three groups had similar numbers of errors. CONCLUSION: This family-based study showed dampened pleasure together with cognitive dysfunction in OCD patients. The similar consummatory pleasure findings between OCD and FDR groups suggest anhedonia may be considered as a candidate OCD endophenotype.

Social brain dysfunctionality in individuals with autism spectrum disorder and their first-degree relatives: An activation likelihood estimation meta-analysis.

The social brain hypothesis is regarded as a powerful theory to understand social cognition. Individuals with autism spectrum disorder (ASD) have specific deficits in social and communicative behavior, but the exact relationship between these deficits and abnormalities in the social brain remains unclear. The high heritability of this disorder makes it important to focus on the first-degree relatives of those affected. Research focusing on genetically at-risk (yet healthy) relatives of patients with ASD is critical to the study of neuroimaging endophenotypes. We conducted a voxel-wise activation likelihood estimation (ALE) meta-analysis of 9 functional neuroimaging studies published during the period from 2006 to 2018. These studies included 200 individuals with ASD, 216 unaffected family members (UF), and 235 typical development controls (TD). The voxel-wise significance threshold was p < 0.01 (uncorrected p = 0.001).The ALE meta-analyses showed hyperactivation in the inferior frontal gyrus (IFG) and superior temporal gyrus (STG) among individuals with ASD and UF, compared with TD individuals. Group comparisons showed greater likelihood of hyperactivation in the amygdala for ASD, compared with UF and TD.

Anterior Cingulate Cortex Glutamate Levels Are Related to Response to Initial Antipsychotic Treatment in Drug-Naive First-Episode Schizophrenia Patients.

The glutamatergic system has previously been shown to be involved in the pathophysiology of schizophrenia and the mechanisms of action of antipsychotic treatment. The present study aimed to investigate the relationship between the levels of glutamate (Glu) or Glu/total creatine (Glu/Cr+PCr) in the anterior cingulate cortex (ACC) and psychiatric symptoms as well as the response to antipsychotic treatment. We performed proton magnetic resonance spectroscopy (1H-MRS) to measure Glu and Glu/Cr+PCr in the ACC of 35 drug-naïve first-episode schizophrenia (FES) patients and 40 well-matched healthy controls (HCs). After scanning, we treated the patients with risperidone for eight weeks. Remission status was based on the Positive and Negative Syndrome Scale (PANSS) scores at week 8. At baseline, there were no significant differences in the levels of Glu or Glu/Cr+PCr in the ACC between drug-naïve FES patients and HCs. Lower baseline levels of Glu/Cr+PCr but not Glu in the ACC were associated with more severe negative symptoms of schizophrenia. Compared to the remission group (RM), the non-remission group (NRM) had lower baseline ACC Glu levels (P < 0.05). Our results suggest that ACC Glu levels may be related to the severity of symptoms in the early stages of schizophrenia and therefore may be a marker with which to evaluate the treatment effect of antipsychotics in schizophrenia patients.

Modeling essential connections in obsessive-compulsive disorder patients using functional MRI.

OBJECT: Obsessive-compulsive disorder (OCD) is a mental disease in which people experience uncontrollable and repetitive thoughts or behaviors. Clinical diagnosis of OCD is achieved by using neuropsychological assessment metrics, which are often subjectively affected by psychologists and patients. In this study, we propose a classification model for OCD diagnosis using functional MR images. METHODS: Using functional connectivity (FC) matrices calculated from brain region of interest (ROI) pairs, a novel Riemann Kernel principal component analysis (PCA) model is employed for feature extraction, which preserves the topological information in the FC matrices. Hierarchical features are then fed into an ensemble classifier based on the XGBoost algorithm. Finally, decisive features extracted during classification are used to investigate the brain FC variations between patients with OCD and healthy controls. RESULTS: The proposed algorithm yielded a classification accuracy of 91.8%. Additionally, the well-known cortico-striatal-thalamic-cortical (CSTC) circuit and cerebellum were found as highly related regions with OCD. To further analyze the cerebellar-related function in OCD, we demarcated cerebellum into three subregions according to their anatomical and functional property. Using these three functional cerebellum regions as seeds for brain connectivity computation, statistical results showed that patients with OCD have decreased posterior cerebellar connections. CONCLUSIONS: This study provides a new and efficient method to characterize patients with OCD using resting-state functional MRI. We also provide a new perspective to analyze disease-related features. Despite of CSTC circuit, our model-driven feature analysis reported cerebellum as an OCD-related region. This paper may provide novel insight to the understanding of genetic etiology of OCD.

Imbalance in obesity and mental health among "little emperors" in China.

INTRODUCTION: Previous research has indicated that only children (i.e., those living with no siblings) have higher odds of obesity during childhood and young adulthood, compared with those living with siblings. However, little is known about whether the developing difference in overweight/obesity is accompanied by a difference in mental health (i.e., internalizing symptoms of depression and anxiety). METHODS: The subjects for this prospective study were a randomly generated cohort of 1348 high-school students in Guangzhou, China. Participants completed assessments of anthropometric indices, lipid profiles, family-based factors, lifestyle, and internalization of symptoms (including those of depression and anxiety). RESULTS: Compared to their peers with siblings, only children (adjusted odds ratio [aOR] = 1.68, 95% confidence interval [CI] [1.06, 2.65]) had significantly higher risk for obesity. However, only children with overweight/obesity had lower OR for depression at follow-up (aOR = 0.19, 95% CI [0.34, 0.86]), compared to individuals who were overweight/obese with siblings. This relationship was not significant for non-overweight individuals. No significant relationship between the number of siblings and anxiety at follow-up was observed, regardless of body mass index (BMI). CONCLUSIONS: Although being an only child was significantly associated with overweight and obesity among adolescents in China, participants with history of overweight/obesity are less likely to experience symptoms of depression associated with being an only child.

Generation of an integration-free iPSC line(SYSUi001-A) from a sporadic Alzheimer's disease patient.

Human iPSC line, iPSC-ADM01(SYSUi001-A), was generated from a 70-year-old male patient with sporadic Alzheimer's disease, using non-integrative reprogramming method. This cell line shows pluripotency both in vitro and in vivo, and has a normal karyotype.

Combined fluvoxamine and extended-release methylphenidate improved treatment response compared to fluvoxamine alone in patients with treatment-refractory obsessive-compulsive disorder: A randomized double-blind, placebo-controlled study.

More effective, tolerable interventions for treatment-refractory obsessive-compulsive disorder (OCD) are needed. Preliminary findings encourage optimism that methylphenidate augmentation may be of benefit in the treatment of OCD. To test modulator methylphenidate (MPH) of extended-release formulations (MPH-ER) a safe and effective add-on therapy for refractory OCD, a pilot randomized, placebo-controlled, double-blind trial was conducted at an outpatient, single-center academic setting. Participants included 44 adults with serotonin reuptake inhibitor (SRI) treatment-refractory OCD and receiving a stable fluvoxamine pharmacotherapy with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores higher than 20. Data were analyzed in the intention-to-treat sample. All subjects were randomized into two parallel groups to receive fluvoxamine (250 mg daily) plus MPH-ER (36 mg daily) or fluvoxamine (250 mg daily) plus identical placebo tablets under double-blind conditions and followed for 8 weeks. Forty-four patients (29 [66%] men), with a mean (SD) age of 24.7 (6) years participated; with a mean (SD) duration of episode 5.7 (3) were randomized and forty-one finished the trial. In the intention-to-treat analysis, the improvement in the Y-BOCS total score and Y-BOCS obsession subscale score was more prominent in the fluvoxamine and MPH-ER group compared with those receiving placebo (P < .001). Additionally, cumulative response rates were higher in the MPH-ER vs placebo groups (59% vs 5%; P  < .001). MPH-ER was well tolerated; No subjects dropped out due to side effects. In summary, combined treatment with MPH-ER demonstrated an enhanced clinical rate of response compared to placebo. Further trials should examine MPH-ER efficacy in a larger sample.

An Effect of Chronic Stress on Prospective Memory via Alteration of Resting-State Hippocampal Subregion Functional Connectivity.

The alteration of hippocampal function by chronic stress impairs higher order cognitive functions such as prospective memory (PM). However, how chronic stress affects hippocampal subregions related to PM remains largely unknown. In this study, the altered functional network of hippocampal subregions related to PM in chronic stress was explored. College students (N = 21) completed PM tasks and resting-state functional magnetic resonance imaging scans one month prior to (baseline) and during the final examination week (chronic stress). Hippocampal subregions' seed-based functional connectivity (FC) and PM were compared between baseline and chronic stress. PM performance declined in chronic stress. The FC of the cornu ammonis 2, 3 and dentate gyrus (CA23DG) with the bilateral caudate and precuneus was increased in chronic stress, while the FC of the subicular complex (SUBC) with the left middle frontal gyrus, the left inferior parietal gyrus and the right supramarginal gyrus was decreased. There was a negative correlation between PM performance and the FC of hippocampal subregions. We found chronic stress impairs PM by decreasing the FC of SUBC and increasing the FC of CA23DG. These findings suggest functional changes in hippocampal subregion networks as a mechanism underlying the impairment of PM in chronic stress.

COMT, 5-HTR2A, and SLC6A4 mRNA Expressions in First-Episode Antipsychotic-Naïve Schizophrenia and Association With Treatment Outcomes.

Background: Dopaminergic and serotonergic systems play crucial roles in the pathophysiology of schizophrenia and modulate response to antipsychotic treatment. However, previous studies of dopaminergic and serotonergic genes expression are sparse, and their results have been inconsistent. In this longitudinal study, we aim to investigate the expressions of Catechol-O-methyltransferase (COMT), serotonin 2A receptor (5-HTR2A), and serotonin transporter gene (SLC6A4) mRNA in first-episode antipsychotic-naïve schizophrenia and to test if these mRNA expressions are associated with cognitive deficits and treatment outcomes or not. Method: We measured COMT, 5-HTR2A, and SLC6A4 mRNA expressions in 45 drug-naive first-episode schizophrenia patients and 38 health controls at baseline, and repeated mRNA measurements in all patients at the 8-week follow up. Furthermore, we also assessed antipsychotic response and cognitive improvement after 8 weeks of risperidone monotherapy. Results: Patients were divided into responders (N = 20) and non-responders groups (N = 25) according to the Remission criteria of the Schizophrenia Working Group. Both patient groups have significantly higher COMT mRNA expression and lower SLC6A4 mRNA expression when compared with healthy controls. Interestingly, responder patients have significantly higher levels of COMT and 5-HTR2A mRNA expressions than non-responder patients at baseline. However, antipsychotic treatment has no significant effect on the expressions of COMT, 5-HTR2A, and SLC6A4 mRNA over 8-week follow up. Conclusion: Our findings suggest that dysregulated COMT and SLC6A4 mRNA expressions may implicate in the pathophysiology of schizophrenia, and that COMT and 5-HTR2A mRNA may be potential biomarkers to predict antipsychotic response.

Alterations of white matter fractional anisotropy in unmedicated obsessive-compulsive disorder.

BACKGROUND: Abnormalities in white matter (WM) have previously been reported in patients with obsessive-compulsive disorder (OCD). However, there was some inconsistency in the results obtained for altered regions of WM. The aim of this study was to investigate fractional anisotropy (FA) in the WM of the whole brain in patients with OCD by using diffusion tensor imaging (DTI). METHODS: In total, 28 unmedicated patients with OCD and 28 healthy volunteers underwent DTI scan. A voxel-based analysis was used to compare FA values in WM of the two groups at a voxel threshold of P<0.005 with an extent threshold of k>72 voxels (P<0.05; Alphasim correction). Subsequently, correlation analysis was conducted in order to find the correlation between the mean FA values in significantly altered brain regions and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores of the OCD patients. RESULTS: Compared with healthy volunteers, the OCD patients had lower FA value in the left lingual gyrus, right midbrain, and right precuneus. There were no regions with significantly higher FA values in OCD patients compared with healthy volunteers. The mean FA values in the above regions (left lingual, r=0.019, P=0.923; right midbrain, r=-0.208, P=0.289; and right precuneus, r=-0.273, P=0.161) had no significant correlation with the Y-BOCS scores of the OCD patients. CONCLUSION: The findings of this study suggest that alterations in WM of the left lingual gyrus, right midbrain, and right precuneus are associated with the pathophysiology mechanism of OCD, and these microstructural alterations do not correlate with symptom severity of OCD.