强迫症的发病年龄对白质微观结构有不同影响。

Age of onset of obsessive-compulsive disorder differentially affects white matter microstructure.

作者信息

Vriend Chris, de Joode Niels T, Pouwels Petra J W, Liu Feng, Otaduy Maria C G, Pastorello Bruno, Robertson Frances C, Ipser Jonathan, Lee Seonjoo, Hezel Dianne M, van Meter Page E, Batistuzzo Marcelo C, Hoexter Marcelo Q, Sheshachala Karthik, Narayanaswamy Janardhanan C, Venkatasubramanian Ganesan, Lochner Christine, Miguel Euripedes C, Reddy Y C Janardhan, Shavitt Roseli G, Stein Dan J, Wall Melanie, Simpson Helen Blair, van den Heuvel Odile A

机构信息

Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, and Department of Anatomy and Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands.

Compulsivity, Impulsivity and Attention, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands.

出版信息

Mol Psychiatry. 2024 Apr;29(4):1033-1045. doi: 10.1038/s41380-023-02390-8. Epub 2024 Jan 16.

Abstract

Previous diffusion MRI studies have reported mixed findings on white matter microstructure alterations in obsessive-compulsive disorder (OCD), likely due to variation in demographic and clinical characteristics, scanning methods, and underpowered samples. The OCD global study was created across five international sites to overcome these challenges by harmonizing data collection to identify consistent brain signatures of OCD that are reproducible and generalizable. Single-shell diffusion measures (e.g., fractional anisotropy), multi-shell Neurite Orientation Dispersion and Density Imaging (NODDI) and fixel-based measures, were extracted from skeletonized white matter tracts in 260 medication-free adults with OCD and 252 healthy controls. We additionally performed structural connectome analysis. We compared cases with controls and cases with early (<18) versus late (18+) OCD onset using mixed-model and Bayesian multilevel analysis. Compared with healthy controls, adult OCD individuals showed higher fiber density in the sagittal stratum (B[SE] = 0.10[0.05], P = 0.04) and credible evidence for higher fiber density in several other tracts. When comparing early (n = 145) and late-onset (n = 114) cases, converging evidence showed lower integrity of the posterior thalamic radiation -particularly radial diffusivity (B[SE] = 0.28[0.12], P = 0.03)-and lower global efficiency of the structural connectome (B[SE] = 15.3[6.6], P = 0.03) in late-onset cases. Post-hoc analyses indicated divergent direction of effects of the two OCD groups compared to healthy controls. Age of OCD onset differentially affects the integrity of thalamo-parietal/occipital tracts and the efficiency of the structural brain network. These results lend further support for the role of the thalamus and its afferent fibers and visual attentional processes in the pathophysiology of OCD.

摘要

先前的扩散磁共振成像研究报告了强迫症(OCD)患者白质微观结构改变的混合结果,这可能是由于人口统计学和临床特征、扫描方法以及样本量不足等方面的差异所致。强迫症全球研究在五个国际站点开展,通过统一数据收集来克服这些挑战,以识别强迫症一致的、可重复且可推广的脑特征。从260名未服药的成年强迫症患者和252名健康对照者的骨骼化白质束中提取了单壳扩散测量值(如分数各向异性)、多壳神经突方向离散度和密度成像(NODDI)以及基于固定点的测量值。我们还进行了结构连接组分析。我们使用混合模型和贝叶斯多级分析,将病例与对照进行比较,并将早发性(<18岁)与晚发性(18岁及以上)强迫症患者的病例进行比较。与健康对照相比,成年强迫症患者在矢状层显示出更高的纤维密度(B[标准误]=0.10[0.05],P=0.04),并且在其他几条束中也有更高纤维密度的可信证据。在比较早发性(n=145)和晚发性(n=114)病例时,一致的证据表明,晚发性病例中丘脑后辐射的完整性较低,尤其是径向扩散率(B[标准误]=0.28[0.12],P=0.03),并且结构连接组的全局效率较低(B[标准误]=15.3[6.6],P=0.03)。事后分析表明,与健康对照相比,两个强迫症组的效应方向不同。强迫症发病年龄对丘脑-顶叶/枕叶束的完整性和脑结构网络的效率有不同影响。这些结果进一步支持了丘脑及其传入纤维和视觉注意过程在强迫症病理生理学中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f57/11176057/a1487a801c23/41380_2023_2390_Fig1_HTML.jpg

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