Obsessive Compulsive Disorder Clinic & Translational Psychiatry Lab, Neurobiology Research Center at National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
Aust N Z J Psychiatry. 2013 Oct;47(10):930-7. doi: 10.1177/0004867413491153. Epub 2013 Jun 4.
Reward-processing deficits have been demonstrated in obsessive-compulsive disorder (OCD) and this has been linked to ventral striatal abnormalities. However, volumetric abnormalities of the nucleus accumbens (NAcc), a key structure in the reward pathway, have not been examined in OCD. We report on the volumetric abnormalities of NAcc and its correlation with illness severity in drug-naïve, adult patients with OCD.
In this cross-sectional study of case-control design, the magnetic resonance imaging (MRI) 1.5-T (1-mm) volume of NAcc was measured using 3D Slicer software in drug-naïve OCD patients (n = 44) and age, sex and handedness-matched healthy controls (HCs) (n = 36) using a valid and reliable method. OCD symptoms were assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Symptom checklist and severity and the Clinical Global Impression-Severity (CGI-S) scale.
There was no significant difference in NAcc volumes on either side between OCD patients and HCs (F = 3.45, p = 0.07). However, there was significant negative correlation between the right NAcc volume and Y-BOCS compulsion score (r = -0.48, p = 0.001).
Study observations suggest involvement of the NAcc in the pathogenesis of OCD, indicating potential reward-processing deficits. Correlation between the right NAcc volume deficit and severity of compulsions offers further support for this region as a candidate for deep brain stimulation treatment in OCD.
在强迫症（OCD）中已经证明了奖励处理缺陷，这与腹侧纹状体异常有关。然而，在强迫症中尚未检查到伏隔核（NAcc）的体积异常，NAcc 是奖励途径的关键结构。我们报告了在未经药物治疗的成年 OCD 患者中 NAcc 的体积异常及其与疾病严重程度的相关性。
在这项病例对照设计的横断面研究中，使用 3D Slicer 软件测量了未经药物治疗的 OCD 患者（n = 44）和年龄、性别和惯用手匹配的健康对照者（HCs）（n = 36）的 NAcc 的 1.5-T（1 毫米）体积磁共振成像（MRI），使用有效且可靠的方法。使用耶鲁-布朗强迫症量表（Y-BOCS）症状清单和严重程度和临床总体印象-严重程度（CGI-S）量表评估 OCD 症状。
OCD 患者和 HCs 之间的 NAcc 体积在任何一侧均无显着差异（F = 3.45，p = 0.07）。然而，右侧 NAcc 体积与 Y-BOCS 强迫得分之间存在显着负相关（r = -0.48，p = 0.001）。
研究观察表明 NAcc 参与 OCD 的发病机制，表明潜在的奖励处理缺陷。右侧 NAcc 体积缺陷与强迫严重程度之间的相关性进一步支持该区域作为 OCD 深部脑刺激治疗的候选区域。
