强迫症患者海马体和杏仁核亚区体积与用药状态的关系
Hippocampal and amygdala subfield volumes in obsessive-compulsive disorder by medication status.
作者信息
Ntwatwa Ziphozihle, Lochner Christine, Roos Annerine, Sevenoaks Tatum, van Honk Jack, Batistuzzo Marcelo C, Choi Sunah, Hoexter Marcelo Q, Kim Minah, Kwon Jun Soo, Mataix-Cols David, Menchón José M, Miguel Euripedes C, Nakamae Takashi, Soriano-Mas Carles, Veltman Dick J, Groenewold Nynke A, van den Heuvel Odile A, Stein Dan J, Ipser Jonathan
机构信息
From the Department of Psychiatry & Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Ntwatwa, Roos, Sevenoaks, van Honk, Groenewold, Stein, Ipser); the SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa (Lochner); the Department of Psychology, Utrecht University, Utrecht, The Netherlands (van Honk); the Department of Psychiatry and Department of Anatomy & Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands (Veltman, van den Heuvel); the Compulsivity Impulsivity and Attention program, Amsterdam Neuroscience, Amsterdam, The Netherlands (Veltman, van den Heuvel); the Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Department of Clinical Sciences, Bellvitge Campus, Universitat de Barcelona-UB, CIBERSAM, Carlos III Health Institute, Madrid, Spain (Menchón); the Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, Universitat de Barcelona-UB, CIBERSAM, Carlos III Health Institute, Madrid, Spain ( Soriano-Mas); the Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Mataix-Cols); the Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden (Mataix-Cols); the Department of Clinical Sciences, Lund University, Lund, Sweden (Mataix-Cols); the Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine (Nakamae); the Institute of Human Behavioral Medicine Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea (Choi, Kim, Kwon); the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (Choi); the Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Batistuzzo, Hoexter, Miguel); the Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, SP, Brazil (Batistuzzo); the SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa (Stein)
From the Department of Psychiatry & Mental Health, Neuroscience Institute, University of Cape Town, Cape Town, South Africa (Ntwatwa, Roos, Sevenoaks, van Honk, Groenewold, Stein, Ipser); the SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa (Lochner); the Department of Psychology, Utrecht University, Utrecht, The Netherlands (van Honk); the Department of Psychiatry and Department of Anatomy & Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands (Veltman, van den Heuvel); the Compulsivity Impulsivity and Attention program, Amsterdam Neuroscience, Amsterdam, The Netherlands (Veltman, van den Heuvel); the Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Department of Clinical Sciences, Bellvitge Campus, Universitat de Barcelona-UB, CIBERSAM, Carlos III Health Institute, Madrid, Spain (Menchón); the Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, Department of Social Psychology and Quantitative Psychology, Institute of Neurosciences, Universitat de Barcelona-UB, CIBERSAM, Carlos III Health Institute, Madrid, Spain ( Soriano-Mas); the Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Mataix-Cols); the Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden (Mataix-Cols); the Department of Clinical Sciences, Lund University, Lund, Sweden (Mataix-Cols); the Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine (Nakamae); the Institute of Human Behavioral Medicine Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea (Choi, Kim, Kwon); the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (Choi); the Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil (Batistuzzo, Hoexter, Miguel); the Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, SP, Brazil (Batistuzzo); the SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa (Stein).
出版信息
J Psychiatry Neurosci. 2025 May 21;50(3):E170-E180. doi: 10.1503/jpn.230119. Print 2025 May-Jun.
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 -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 ( = 0.04, = -0.26) and molecular layer ( = 0.04, = -0.29), and larger volumes in the lateral ( = 0.049, = 0.23) and basal ( = 0.049, = 0.25) amygdala subfields, than healthy controls. Unmedicated people with OCD had significantly smaller volumes in the hippocampal cornu ammonis sector 1 ( = 0.02, = -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.
背景
尽管有研究表明海马体和杏仁核（HA）参与了强迫症（OCD）的神经生物学过程，但体积测量结果并不一致，而且针对HA异质解剖单位的体积测量研究较少，这些单位具有特定功能和细胞结构，在强迫症中尚未得到充分研究。我们试图通过对使用和未使用精神药物的人群进行单独分析，以及探讨亚区体积与强迫症症状严重程度之间的关联，来探索脑容量异质性的潜在来源。
方法
我们对强迫症脑成像联盟中患有强迫症的人和健康对照者的加权图像进行分割，使用Free-Surfer 6.0生成12个海马亚区和9个杏仁核亚区。我们使用混合效应模型评估亚区体积的组间差异，该模型针对年龄、年龄的二次效应、性别、部位和整个HA体积进行了调整。我们还进行了亚组分析，以检查亚区体积与共病焦虑和抑郁、药物状态以及症状严重程度之间的关系。我们使用错误发现率（FDR）对所有分析进行多重比较校正。
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亚区体积上没有显著差异。然而，使用药物的强迫症患者海马齿状回（ = 0.04， = -0.26）和分子层（ = 0.04， = -0.29）的体积明显较小，而外侧（ = 0.049， = 0.23）和基底（ = 0.049， = 0.25）杏仁核亚区的体积明显较大，与健康对照者相比。未使用药物的强迫症患者海马角回1区（ = 0.02， = -0.28）的体积明显小于对照组。我们未检测到任何亚区体积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，这限制了我们分析结果的解释。
结论
强迫症患者与健康对照者之间HA亚区的差异取决于药物状态，这与先前关于强迫症其他脑容量改变的研究结果一致。这强调了在强迫症神经影像学研究中考虑精神药物的重要性。
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