Ziphozihle Ntwatwa, Christine Lochner, Annerine Roos, Tatum Sevenoaks, Jack van Honk, Marcelo C Batistuzzo, Sunah Choi, Marcelo Q Hoexter, Minah Kim, Jun Soo Kwon, David Mataix-Cols, José M Menchón, Euripedes C Miguel, Takashi Nakamae, Carles Soriano-Mas, Dick J Veltman, Nynke A Groenewold, Odile A van den Heuvel, Dan J Stein, Jonathan Ipser
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We sought to explore potential sources of heterogeneity in brain volumes by performing a separate analysis for people with and without psychotropic medication use, as well as the association of subfield volumes with OCD symptom severity.</p><p><strong>Methods: </strong>We segmented <i>T</i> <sub>1</sub>-weighted images from people with OCD and healthy controls in the OCD Brain Imaging Consortium to produce 12 hippocampal subfields and 9 amygdala subfields using Free-Surfer 6.0. We assessed between-group differences in subfield volume using a mixed-effects model adjusted for age and quadratic effects of age, sex, site, and whole HA volume. We also performed subgroup analyses to examine subfield volume in relation to comorbid anxiety and depression, medication status, and symptom severity. We corrected all analyses for multiple comparisons using the false discovery rate (FDR).</p><p><strong>Results: </strong>We included images from 381 people with OCD and 338 healthy controls. These groups did not significantly differ in HA subfield volumes. However, medicated people with OCD had significantly smaller volumes in the hippocampal dentate gyrus (<i>p</i> <sub>FDR</sub> = 0.04, <i>d</i> = -0.26) and molecular layer (<i>p</i> <sub>FDR</sub> = 0.04, <i>d</i> = -0.29), and larger volumes in the lateral (<i>p</i> <sub>FDR</sub> = 0.049, <i>d</i> = 0.23) and basal (<i>p</i> <sub>FDR</sub> = 0.049, <i>d</i> = 0.25) amygdala subfields, than healthy controls. Unmedicated people with OCD had significantly smaller volumes in the hippocampal cornu ammonis sector 1 (<i>p</i> <sub>FDR</sub> = 0.02, <i>d</i> = -0.28) than controls. We did not detect associations between any subfield volume and OCD severity.</p><p><strong>Limitations: </strong>We used cross-sectional data, which limits the interpretation of our analysis.</p><p><strong>Conclusion: </strong>Differences in HA subfields between people with OCD and healthy controls are dependent on medication status, in line with previous work on other brain volumetric alterations in OCD. 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引用次数: 0
摘要
背景：虽然已经提出海马和杏仁核（HA）参与强迫症（OCD）的神经生物学，但体积研究结果并不一致，而且在强迫症中HA的异质解剖单位及其特定功能和细胞结构的体积研究很少。我们通过对使用和不使用精神药物的人进行单独分析，以及子区容量与强迫症症状严重程度的关联，试图探索脑容量异质性的潜在来源。方法：使用Free-Surfer 6.0软件对强迫症脑成像联盟中强迫症患者和健康对照者的t1加权图像进行分割，得到12个海马区和9个杏仁核区。我们使用混合效应模型对年龄和年龄、性别、地点和整个HA体积的二次效应进行了调整，评估了组间子区体积的差异。我们还进行了亚组分析，以检查子野容量与共病焦虑和抑郁、药物状况和症状严重程度的关系。我们使用错误发现率（FDR）修正了所有的多重比较分析。结果：我们纳入了381名强迫症患者和338名健康对照者的图像。这些组在HA子区数量上没有显著差异。然而，服用药物的强迫症患者海马齿状回（p FDR = 0.04, d = -0.26）和分子层（p FDR = 0.04, d = -0.29）的体积明显小于健康对照组，而外侧（p FDR = 0.049, d = 0.23）和基底（p FDR = 0.049, d = 0.25）杏仁核亚区体积明显大于健康对照组。未接受药物治疗的强迫症患者海马角氨区体积明显小于对照组（p FDR = 0.02, d = -0.28）。我们没有检测到任何子区容量与强迫症严重程度之间的关联。局限性：我们使用的是横断面数据，这限制了我们分析的解释。结论：强迫症患者与健康对照组之间HA子区差异依赖于药物状态，这与之前关于强迫症患者其他脑容量改变的研究一致。这强调了在强迫症的神经影像学研究中考虑精神药物的重要性。
Hippocampal and amygdala subfield volumes in obsessive-compulsive disorder by medication status.
Background: Although it has been suggested that the hippocampus and amygdala (HA) are involved in the neurobiology of obsessive-compulsive disorder (OCD), volumetric findings have been inconsistent, and little work has been undertaken on the volumetry of the heterogeneous anatomic units of HA, with their specific functions and cytoarchitecture, in OCD. We sought to explore potential sources of heterogeneity in brain volumes by performing a separate analysis for people with and without psychotropic medication use, as well as the association of subfield volumes with OCD symptom severity.
Methods: We segmented T1-weighted images from people with OCD and healthy controls in the OCD Brain Imaging Consortium to produce 12 hippocampal subfields and 9 amygdala subfields using Free-Surfer 6.0. We assessed between-group differences in subfield volume using a mixed-effects model adjusted for age and quadratic effects of age, sex, site, and whole HA volume. We also performed subgroup analyses to examine subfield volume in relation to comorbid anxiety and depression, medication status, and symptom severity. We corrected all analyses for multiple comparisons using the false discovery rate (FDR).
Results: We included images from 381 people with OCD and 338 healthy controls. These groups did not significantly differ in HA subfield volumes. However, medicated people with OCD had significantly smaller volumes in the hippocampal dentate gyrus (pFDR = 0.04, d = -0.26) and molecular layer (pFDR = 0.04, d = -0.29), and larger volumes in the lateral (pFDR = 0.049, d = 0.23) and basal (pFDR = 0.049, d = 0.25) amygdala subfields, than healthy controls. Unmedicated people with OCD had significantly smaller volumes in the hippocampal cornu ammonis sector 1 (pFDR = 0.02, d = -0.28) than controls. We did not detect associations between any subfield volume and OCD severity.
Limitations: We used cross-sectional data, which limits the interpretation of our analysis.
Conclusion: Differences in HA subfields between people with OCD and healthy controls are dependent on medication status, in line with previous work on other brain volumetric alterations in OCD. This emphasizes the importance of considering psychotropic medication in neuroimaging studies of OCD.
期刊介绍：
The Journal of Psychiatry & Neuroscience publishes papers at the intersection of psychiatry and neuroscience that advance our understanding of the neural mechanisms involved in the etiology and treatment of psychiatric disorders. This includes studies on patients with psychiatric disorders, healthy humans, and experimental animals as well as studies in vitro. Original research articles, including clinical trials with a mechanistic component, and review papers will be considered.
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