Regional Cerebral Blood Flow Abnormalities in Early-Onset Obsessive-Compulsive Disorder: An Exploratory SPECT Study

Busatto, Geraldo F.; Buchpiguel, Carlos Alberto; Zamignani, Denis Roberto; Garrido, Griselda E.J.; Glabus, Michael F.; Rosario, Maria Conceição do; Castro, Cláudio Campi de; Maia, A K; Rocha, Euclides Timóteo da; McGuire, Philip; Miguel, Eurí­pedes Constantino

doi:10.1097/00004583-200103000-00015

Cited by 103 publications

(52 citation statements)

References 40 publications

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“…At the same time, this finding could focus more attention on the GABA system and its potential contribution to corticostriatal dysfunction in OCD. The significant negative association that we found between age of OCD onset and MPFC GABA levels also warrants more study: although contrary to the idea that early onset of illness leads to greater abnormalities, it is consistent with other data, suggesting that the pathophysiology of early-and late-onset OCD differs (Busatto et al, 2001;Dickel et al, 2006Dickel et al, , 2007Huyser et al, 2009;Simpson et al, 2011). That DLPFC GABA levels did not differ between OCD and healthy controls suggests there may be some regional specificity to the MPFC finding.…”

Section: Discussionsupporting

confidence: 81%

Investigation of Cortical Glutamate–Glutamine and γ-Aminobutyric Acid in Obsessive–Compulsive Disorder by Proton Magnetic Resonance Spectroscopy

Simpson

Shungu

Bender

et al. 2012

Neuropsychopharmacol

124

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Glutamatergic abnormalities in corticostriatal brain circuits are thought to underlie obsessive-compulsive disorder (OCD). Whether these abnormalities exist in adults with OCD is not clear. We used proton magnetic resonance spectroscopy ( 1 H MRS) to test our hypothesis that unmedicated adults with OCD have reduced glutamate plus glutamine (Glx) levels in the medial prefrontal cortex (MPFC) compared with healthy controls. Levels of g-aminobutyric acid (GABA) were also explored. Twenty-four unmedicated adults with OCD and 22 matched healthy control subjects underwent 1 H MRS scans at 3.0 T. Resonances of both Glx and GABA were obtained using the standard J-editing technique and assessed as ratios relative to voxel tissue water (W) in the MPFC (the region of interest) and the dorsolateral prefrontal cortex (DLPFC) to explore the regional specificity of any finding. In the MPFC, Glx/W did not differ by diagnostic group (p ¼ 0.98) or sex (p ¼ 0.57). However, GABA/W was decreased in OCD (2.16 ± 0.46 Â 10 À3 ) compared with healthy controls (2.43 ± 0.45 Â 10 À3 , p ¼ 0.045); moreover, age of OCD onset was inversely correlated with MPFC GABA/W (r ¼ À0.50, p ¼ 0.015). MPFC GABA/W was higher in females than in males. In the DLPFC, there were no main effects of diagnosis or gender on Glx/W or GABA/W. These data indicate that unmedicated adults with OCD do not have Glx abnormalities in a MPFC voxel that includes the pregenual anterior cingulate cortex. However, they may have decreased MPFC GABA levels. How GABA abnormalities might contribute to corticostriatal dysfunction in OCD deserves further study.

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Section: Discussionsupporting

confidence: 81%

Investigation of Cortical Glutamate–Glutamine and γ-Aminobutyric Acid in Obsessive–Compulsive Disorder by Proton Magnetic Resonance Spectroscopy

Simpson

Shungu

Bender

et al. 2012

Neuropsychopharmacol

124

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“…Because reproductive hormones could have specific roles, at least in some specific subtypes such as post-partive onset OCD (Camarena et al, 2001), gender has been suggested as a predictive variable to treatment (Mundo et al, 1999) because brain mechanism in OCD may differ depending on the age at which symptoms are first expressed (Busatto et al, 2001).…”

Section: Subtypesmentioning

confidence: 99%

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Pallanti

Quercioli

2006

Progress in Neuro-Psychopharmacology and Biological Psychiatry

328

190

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While controlled trials with SRIs have demonstrated a selective efficacy in obsessive-compulsive disorder (OCD), up to 40 -60% of patients do not have a satisfactory outcome. Non-response to treatment in OCD is associated with serious social disability. There are a large number of nonresponsive patients, and they are difficult to cluster due to ambiguities in diagnostic criteria, possibility of subtypes and a high rate of comorbidity. Moreover, the findings of current studies of ''so-called'' non-responsive cases are currently non-generalizable because of the lack of an operational definition of non-response. The result has been that a cumulative body of data on a reasonably homogeneous sample of non-responders has not been developed. The aims of the research in this area are to clarify some of the obstacles in defining stages of response and levels of non-response and, through a comprehensive analysis, to propose a systematic nosology for this rather common condition. Better characterization of which patients respond and do not respond to various treatments will enable more accurate clustering of patients, and help facilitate multisite data collection for future research trials. The authors reviewed also the more recent therapeutic pharmacological and psychological lines for the treatment of refractoriness in OCD. D

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“…These brain regions are part of cortico-striato-thalamo-cortical circuits [Alexander et al, 1986], which may be overactive in OCD. Structural and functional brain studies in OCD report smaller OFC [Szeszko et al, 1999], smaller caudate (basal ganglia) [Robinson et al, 1995], increased OFC actitivity [Baxter et al, 1987] as well as [Insel and Winslow, 1992;Swedo et al, 1992] decreased left anterior cingulate by SPECT in OCD [Busatto et al, 2001]. Although these studies investigated the global phenotype of OCD, it is possible that there are different brain substrates for subtypes of OCD.…”

Section: Introductionmentioning

confidence: 99%

New onset obsessive-compulsive symptoms in children and adolescents with severe traumatic brain injury

et al. 2008

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Traumatic brain injury (TBI) constitutes a major source of psychiatric morbidity and disability. This study examines new onset of obsessions and compulsions (OCS) within 1 year of severe pediatric TBI. Eighty children and adolescents ages 6-18 years with severe TBI were interviewed by a child psychiatrist using the Diagnostic Interview for Children and Adolescents-Revised to diagnose OCS and comorbidities. A brain magnetic resonance imaging used a 1.5 T scanner 3 months after injury with a T1-weighted spoiled gradient-recalled-echo sequence to provide high spatial resolution and T1- and T2(*)-contrast sensitivity. Race, sex, socioeconomic status, psychosocial adversity, and injury severity were used to predict new onset OCS. Psychiatric comorbidities and brain lesion volumes in orbitofrontal, mesial prefrontal, temporal lobe, basal ganglia, and thalamus were examined in relation to new onset OCS. Twenty-one children (21/72, 29.2%) had OCS after TBI. Most common were worries about disease, cleanliness, and inappropriate actions as well as excessive cleaning, doing things a certain way and ordering. Anxiety disorders, mania, dysthymia, depressive symptoms, and posttraumatic stress disorder were significantly associated with new onset OCS. Injury severity was not associated with new onset OCS. Greater psychosocial adversity (P=0.009), and being female (P=0.005) were associated with OCS while mesial prefrontal and temporal lobe lesions were associated with new onset obsessions (P<0.05). OCS are common after severe pediatric TBI and are associated with greater comorbidities. New onset obsessions are associated with female sex, psychosocial adversity, and mesial prefrontal and temporal lesions.

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Regional Cerebral Blood Flow Abnormalities in Early-Onset Obsessive-Compulsive Disorder: An Exploratory SPECT Study

Cited by 103 publications

References 40 publications

Investigation of Cortical Glutamate–Glutamine and γ-Aminobutyric Acid in Obsessive–Compulsive Disorder by Proton Magnetic Resonance Spectroscopy

Investigation of Cortical Glutamate–Glutamine and γ-Aminobutyric Acid in Obsessive–Compulsive Disorder by Proton Magnetic Resonance Spectroscopy

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

New onset obsessive-compulsive symptoms in children and adolescents with severe traumatic brain injury

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