Cortical Abnormalities Associated With Pediatric and Adult Obsessive-Compulsive Disorder: Findings From the ENIGMA Obsessive-Compulsive Disorder Working Group.,American Journal of Psychiatry

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Cortical Abnormalities Associated With Pediatric and Adult Obsessive-Compulsive Disorder: Findings From the ENIGMA Obsessive-Compulsive Disorder Working Group.
American Journal of Psychiatry ( IF 15.1 ) Pub Date : 2017-12-15 , DOI: 10.1176/appi.ajp.2017.17050485
Premika S W Boedhoe ₁ , Lianne Schmaal ₁ , Yoshinari Abe ₁ , Pino Alonso ₁ , Stephanie H Ameis ₁ , Alan Anticevic ₁ , Paul D Arnold ₁ , Marcelo C Batistuzzo ₁ , Francesco Benedetti ₁ , Jan C Beucke ₁ , Irene Bollettini ₁ , Anushree Bose ₁ , Silvia Brem ₁ , Anna Calvo ₁ , Rosa Calvo ₁ , Yuqi Cheng ₁ , Kang Ik K Cho ₁ , Valentina Ciullo ₁ , Sara Dallaspezia ₁ , Damiaan Denys ₁ , Jamie D Feusner ₁ , Kate D Fitzgerald ₁ , Jean-Paul Fouche ₁ , Egill A Fridgeirsson ₁ , Patricia Gruner ₁ , Gregory L Hanna ₁ , Derrek P Hibar ₁ , Marcelo Q Hoexter ₁ , Hao Hu ₁ , Chaim Huyser ₁ , Neda Jahanshad ₁ , Anthony James ₁ , Norbert Kathmann ₁ , Christian Kaufmann ₁ , Kathrin Koch ₁ , Jun Soo Kwon ₁ , Luisa Lazaro ₁ , Christine Lochner ₁ , Rachel Marsh ₁ , Ignacio Martínez-Zalacaín ₁ , David Mataix-Cols ₁ , José M Menchón ₁ , Luciano Minuzzi ₁ , Astrid Morer ₁ , Takashi Nakamae ₁ , Tomohiro Nakao ₁ , Janardhanan C Narayanaswamy ₁ , Seiji Nishida ₁ , Erika Nurmi ₁ , Joseph O'Neill ₁ , John Piacentini ₁ , Fabrizio Piras ₁ , Federica Piras ₁ , Y C Janardhan Reddy ₁ , Tim J Reess ₁ , Yuki Sakai ₁ , Joao R Sato ₁ , H Blair Simpson ₁ , Noam Soreni ₁ , Carles Soriano-Mas ₁ , Gianfranco Spalletta ₁ , Michael C Stevens ₁ , Philip R Szeszko ₁ , David F Tolin ₁ , Guido A van Wingen ₁ , Ganesan Venkatasubramanian ₁ , Susanne Walitza ₁ , Zhen Wang ₁ , Je-Yeon Yun ₁ , ₁ , Paul M Thompson ₁ , Dan J Stein ₁ , Odile A van den Heuvel ₁ ,

Affiliation

From the Department of Psychiatry and the Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam; Amsterdam Neuroscience, Amsterdam; Orygen, National Centre of Excellence in Youth Mental Health, Melbourne; the Centre for Youth Mental Health, University of Melbourne, Melbourne; the Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; the Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona; the Department of Clinical Sciences, University of Barcelona, Barcelona; the Margaret and Wallace McCain Centre for Child, Youth, and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto; the Centre for Brain and Mental Health, Hospital for Sick Children, Toronto; the Department of Psychiatry, Yale University School of Medicine, New Haven, Conn.; the Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute and Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada; the Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil; Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milan, Italy; the Department of Psychology, Humboldt-Universität zu Berlin, Berlin; the Obsessive-Compulsive Disorder (OCD) Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; the Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich; the Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona; the Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona; the Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China; the Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; the Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome; the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam; the Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam; the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; the Department of Psychiatry, University of Michigan, Ann Arbor; the Department of Psychiatry, University of Cape Town, Cape Town, South Africa; Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea; Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; the Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam; the Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam; the Department of Psychiatry, Oxford University, Oxford, U.K.; the Department of Neuroradiology and the TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München, Munich; the Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea; Institut d'Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Barcelona; the Department of Medicine, University of Barcelona, Barcelona; the SU/UCT MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa; the Department of Psychiatry, Columbia University Medical College, and New York State Psychiatric Institute, New York; the Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm; the Mood Disorders Clinic and the Anxiety Treatment and Research Center, St. Joseph's HealthCare, Hamilton, Ontario; the Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Centro Fermi-Enrico Fermi Historical Museum of Physics and Study and Research Center, Rome; ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan; the Center for Mathematics, Computing, and Cognition, Universidade Federal do ABC, Santo Andre, Brazil; the Center for OCD and Related Disorders, New York State Psychiatric Institute, New York; the Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona; the Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston; the Clinical Neuroscience and Development Laboratory, Olin Neuropsychiatry Research Center, Hartford, Conn.; the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York; the James J. Peters VA Medical Center, Bronx, N.Y.; the Institute of Living, Hartford Hospital, Hartford, Conn.; the Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; and the Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.

OBJECTIVE Brain imaging studies of structural abnormalities in OCD have yielded inconsistent results, partly because of limited statistical power, clinical heterogeneity, and methodological differences. The authors conducted meta- and mega-analyses comprising the largest study of cortical morphometry in OCD ever undertaken. METHOD T1-weighted MRI scans of 1,905 OCD patients and 1,760 healthy controls from 27 sites worldwide were processed locally using FreeSurfer to assess cortical thickness and surface area. Effect sizes for differences between patients and controls, and associations with clinical characteristics, were calculated using linear regression models controlling for age, sex, site, and intracranial volume. RESULTS In adult OCD patients versus controls, we found a significantly lower surface area for the transverse temporal cortex and a thinner inferior parietal cortex. Medicated adult OCD patients also showed thinner cortices throughout the brain. In pediatric OCD patients compared with controls, we found significantly thinner inferior and superior parietal cortices, but none of the regions analyzed showed significant differences in surface area. However, medicated pediatric OCD patients had lower surface area in frontal regions. Cohen's d effect sizes varied from -0.10 to -0.33. CONCLUSIONS The parietal cortex was consistently implicated in both adults and children with OCD. More widespread cortical thickness abnormalities were found in medicated adult OCD patients, and more pronounced surface area deficits (mainly in frontal regions) were found in medicated pediatric OCD patients. These cortical measures represent distinct morphological features and may be differentially affected during different stages of development and illness, and possibly moderated by disease profile and medication.

中文翻译：

小儿和成人强迫症相关的皮层异常：ENIGMA强迫症工作组的发现。

目的对强迫症患者结构异常的脑成像研究结果不一致，部分原因是统计能力有限，临床异质性和方法学差异。作者进行了荟萃分析和大规模分析，这是有史以来最大规模的OCD皮质形态测量研究。方法使用FreeSurfer在本地处理来自全球27个地点的1,905名OCD患者和1,760名健康对照的T1加权MRI扫描，以评估皮层厚度和表面积。使用控制年龄，性别，部位和颅内体积的线性回归模型，计算患者与对照组之间差异的效应大小以及与临床特征的相关性。结果在成人强迫症患者与对照组中，我们发现横向颞叶皮层的表面积明显较低，而顶下皮层较薄。接受药物治疗的成人强迫症患者的大脑皮层也较薄。在小儿强迫症患者中，与对照组相比，我们发现下皮质和上皮质明显更薄，但是所分析的区域均未显示出明显的表面积差异。但是，带药的小儿强迫症患者的额叶表面积较小。科恩的d大小从-0.10到-0.33不等。结论在成人和儿童强迫症中，顶叶皮层始终受到牵连。在成年服药的成年强迫症患者中发现了更广泛的皮质厚度异常，而在儿科强迫症患者中发现了更明显的表面积不足（主要在额叶区域）。

更新日期：2018-05-01

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