Meta-Analysis

. 2018 May 1;175(5):453-462.

doi: 10.1176/appi.ajp.2017.17050485. Epub 2017 Dec 15.

Cortical Abnormalities Associated With Pediatric and Adult Obsessive-Compulsive Disorder: Findings From the ENIGMA Obsessive-Compulsive Disorder Working Group

Premika S W Boedhoe¹, Lianne Schmaal¹, Yoshinari Abe¹, Pino Alonso¹, Stephanie H Ameis¹, Alan Anticevic¹, Paul D Arnold¹, Marcelo C Batistuzzo¹, Francesco Benedetti¹, Jan C Beucke¹, Irene Bollettini¹, Anushree Bose¹, Silvia Brem¹, Anna Calvo¹, Rosa Calvo¹, Yuqi Cheng¹, Kang Ik K Cho¹, Valentina Ciullo¹, Sara Dallaspezia¹, Damiaan Denys¹, Jamie D Feusner¹, Kate D Fitzgerald¹, Jean-Paul Fouche¹, Egill A Fridgeirsson¹, Patricia Gruner¹, Gregory L Hanna¹, Derrek P Hibar¹, Marcelo Q Hoexter¹, Hao Hu¹, Chaim Huyser¹, Neda Jahanshad¹, Anthony James¹, Norbert Kathmann¹, Christian Kaufmann¹, Kathrin Koch¹, Jun Soo Kwon¹, Luisa Lazaro¹, Christine Lochner¹, Rachel Marsh¹, Ignacio Martínez-Zalacaín¹, David Mataix-Cols¹, José M Menchón¹, Luciano Minuzzi¹, Astrid Morer¹, Takashi Nakamae¹, Tomohiro Nakao¹, Janardhanan C Narayanaswamy¹, Seiji Nishida¹, Erika Nurmi¹, Joseph O'Neill¹, John Piacentini¹, Fabrizio Piras¹, Federica Piras¹, Y C Janardhan Reddy¹, Tim J Reess¹, Yuki Sakai¹, Joao R Sato¹, H Blair Simpson¹, Noam Soreni¹, Carles Soriano-Mas¹, Gianfranco Spalletta¹, Michael C Stevens¹, Philip R Szeszko¹, David F Tolin¹, Guido A van Wingen¹, Ganesan Venkatasubramanian¹, Susanne Walitza¹, Zhen Wang¹, Je-Yeon Yun¹; ENIGMA-OCD Working Group¹; Paul M Thompson¹, Dan J Stein¹, Odile A van den Heuvel¹; ENIGMA OCD Working Group

Collaborators, Affiliations

Collaborators

Premika S W Boedhoe, Lianne Schmaal, Yoshinari Abe, Pino Alonso, Stephanie H Ameis, Alan Anticevic, Paul D Arnold, Nuria Bargalló, Marcelo C Batistuzzo, Francesco Benedetti, Jan C Beucke, Irene Bollettini, Anushree Bose, Daniel Brandeis, Silvia Brem, Elizabeth Buimer, Geraldo F Busatto, Anna Calvo, Rosa Calvo, Yuqi Cheng, Kang Ik K Cho, Valentina Ciullo, Sara Dallaspezia, Froukje E de Vries, Stella J de Wit, Damiaan Denys, Renate Drechsler, Andrea Falini, Yu Fang, Jamie D Feusner, Martijn Figee, Kate D Fitzgerald, Martine Fontaine, Jean-Paul Fouche, Egill A Fridgeirsson, Patricia Gruner, Gregory L Hanna, Tobias U Hauser, Derrek P Hibar, Marcelo Q Hoexter, Hao Hu, Chaim Huyser, Mariangela Iorio, Neda Jahanshad, Anthony James, Norbert Kathmann, Christian Kaufmann, Sabin Khadka, Kathrin Koch, Jun Soo Kwon, Luisa Lazaro, Yanni Liu, Christine Lochner, Rachel Marsh, Ignacio Martínez-Zalacaín, David Mataix-Cols, James T McCracken, José M Menchón, Euripedes C Miguel, Luciano Minuzzi, Astrid Morer, Takashi Nakamae, Tomohiro Nakao, Janardhanan C Narayanaswamy, Jin Narumoto, Seiji Nishida, Erika Nurmi, Joseph O'Neill, Jose C Pariente, John Piacentini, Christopher Pittenger, Fabrizio Piras, Federica Piras, Sara Poletti, Y C Janardhan Reddy, Tim J Reess, Oana G Rus, Yuki Sakai, Joao R Sato, H Blair Simpson, Noam Soreni, Carles Soriano-Mas, Gianfranco Spalletta, Michael C Stevens, Philip R Szeszko, Jinsong Tang, David F Tolin, Ysbrand D van der Werf, Guido A van Wingen, Daniela Vecchio, Dick J Veltman, Ganesan Venkatasubramanian, Susanne Walitza, Zhen Wang, Anri Watanabe, Jian Xu, Xiufeng Xu, Kei Yamada, Je-Yeon Yun, Mojtaba Zarei, Qing Zhao, Paul M Thompson, Dan J Stein, Odile A van den Heuvel

Affiliation

¹ From the Department of Psychiatry and the Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam; Amsterdam Neuroscience, Amsterdam; Orygen, National Centre of Excellence in Youth Mental Health, Melbourne; the Centre for Youth Mental Health, University of Melbourne, Melbourne; the Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; the Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona; the Department of Clinical Sciences, University of Barcelona, Barcelona; the Margaret and Wallace McCain Centre for Child, Youth, and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto; the Centre for Brain and Mental Health, Hospital for Sick Children, Toronto; the Department of Psychiatry, Yale University School of Medicine, New Haven, Conn.; the Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute and Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada; the Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil; Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milan, Italy; the Department of Psychology, Humboldt-Universität zu Berlin, Berlin; the Obsessive-Compulsive Disorder (OCD) Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; the Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich; the Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona; the Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona; the Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China; the Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; the Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome; the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam; the Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam; the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; the Department of Psychiatry, University of Michigan, Ann Arbor; the Department of Psychiatry, University of Cape Town, Cape Town, South Africa; Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea; Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; the Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam; the Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam; the Department of Psychiatry, Oxford University, Oxford, U.K.; the Department of Neuroradiology and the TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München, Munich; the Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea; Institut d'Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Barcelona; the Department of Medicine, University of Barcelona, Barcelona; the SU/UCT MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa; the Department of Psychiatry, Columbia University Medical College, and New York State Psychiatric Institute, New York; the Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm; the Mood Disorders Clinic and the Anxiety Treatment and Research Center, St. Joseph's HealthCare, Hamilton, Ontario; the Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Centro Fermi-Enrico Fermi Historical Museum of Physics and Study and Research Center, Rome; ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan; the Center for Mathematics, Computing, and Cognition, Universidade Federal do ABC, Santo Andre, Brazil; the Center for OCD and Related Disorders, New York State Psychiatric Institute, New York; the Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona; the Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston; the Clinical Neuroscience and Development Laboratory, Olin Neuropsychiatry Research Center, Hartford, Conn.; the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York; the James J. Peters VA Medical Center, Bronx, N.Y.; the Institute of Living, Hartford Hospital, Hartford, Conn.; the Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; and the Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.

PMID: 29377733
PMCID: PMC7106947
DOI: 10.1176/appi.ajp.2017.17050485

Meta-Analysis

Cortical Abnormalities Associated With Pediatric and Adult Obsessive-Compulsive Disorder: Findings From the ENIGMA Obsessive-Compulsive Disorder Working Group

Premika S W Boedhoe et al. Am J Psychiatry. 2018.

. 2018 May 1;175(5):453-462.

doi: 10.1176/appi.ajp.2017.17050485. Epub 2017 Dec 15.

Authors

Collaborators

Premika S W Boedhoe, Lianne Schmaal, Yoshinari Abe, Pino Alonso, Stephanie H Ameis, Alan Anticevic, Paul D Arnold, Nuria Bargalló, Marcelo C Batistuzzo, Francesco Benedetti, Jan C Beucke, Irene Bollettini, Anushree Bose, Daniel Brandeis, Silvia Brem, Elizabeth Buimer, Geraldo F Busatto, Anna Calvo, Rosa Calvo, Yuqi Cheng, Kang Ik K Cho, Valentina Ciullo, Sara Dallaspezia, Froukje E de Vries, Stella J de Wit, Damiaan Denys, Renate Drechsler, Andrea Falini, Yu Fang, Jamie D Feusner, Martijn Figee, Kate D Fitzgerald, Martine Fontaine, Jean-Paul Fouche, Egill A Fridgeirsson, Patricia Gruner, Gregory L Hanna, Tobias U Hauser, Derrek P Hibar, Marcelo Q Hoexter, Hao Hu, Chaim Huyser, Mariangela Iorio, Neda Jahanshad, Anthony James, Norbert Kathmann, Christian Kaufmann, Sabin Khadka, Kathrin Koch, Jun Soo Kwon, Luisa Lazaro, Yanni Liu, Christine Lochner, Rachel Marsh, Ignacio Martínez-Zalacaín, David Mataix-Cols, James T McCracken, José M Menchón, Euripedes C Miguel, Luciano Minuzzi, Astrid Morer, Takashi Nakamae, Tomohiro Nakao, Janardhanan C Narayanaswamy, Jin Narumoto, Seiji Nishida, Erika Nurmi, Joseph O'Neill, Jose C Pariente, John Piacentini, Christopher Pittenger, Fabrizio Piras, Federica Piras, Sara Poletti, Y C Janardhan Reddy, Tim J Reess, Oana G Rus, Yuki Sakai, Joao R Sato, H Blair Simpson, Noam Soreni, Carles Soriano-Mas, Gianfranco Spalletta, Michael C Stevens, Philip R Szeszko, Jinsong Tang, David F Tolin, Ysbrand D van der Werf, Guido A van Wingen, Daniela Vecchio, Dick J Veltman, Ganesan Venkatasubramanian, Susanne Walitza, Zhen Wang, Anri Watanabe, Jian Xu, Xiufeng Xu, Kei Yamada, Je-Yeon Yun, Mojtaba Zarei, Qing Zhao, Paul M Thompson, Dan J Stein, Odile A van den Heuvel

Affiliation

¹ From the Department of Psychiatry and the Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam; Amsterdam Neuroscience, Amsterdam; Orygen, National Centre of Excellence in Youth Mental Health, Melbourne; the Centre for Youth Mental Health, University of Melbourne, Melbourne; the Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; the Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Centro de Investigación Biomèdica en Red de Salud Mental (CIBERSAM), Barcelona; the Department of Clinical Sciences, University of Barcelona, Barcelona; the Margaret and Wallace McCain Centre for Child, Youth, and Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto; the Centre for Brain and Mental Health, Hospital for Sick Children, Toronto; the Department of Psychiatry, Yale University School of Medicine, New Haven, Conn.; the Mathison Centre for Mental Health Research and Education, Hotchkiss Brain Institute and Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Canada; the Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil; Psychiatry and Clinical Psychobiology, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milan, Italy; the Department of Psychology, Humboldt-Universität zu Berlin, Berlin; the Obsessive-Compulsive Disorder (OCD) Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; the Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich; the Magnetic Resonance Image Core Facility, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona; the Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona; the Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China; the Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; the Laboratory of Neuropsychiatry, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome; the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam; the Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam; the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; the Department of Psychiatry, University of Michigan, Ann Arbor; the Department of Psychiatry, University of Cape Town, Cape Town, South Africa; Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea; Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; the Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam; the Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam; the Department of Psychiatry, Oxford University, Oxford, U.K.; the Department of Neuroradiology and the TUM-Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technische Universität München, Munich; the Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea; Institut d'Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Barcelona; the Department of Medicine, University of Barcelona, Barcelona; the SU/UCT MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa; the Department of Psychiatry, Columbia University Medical College, and New York State Psychiatric Institute, New York; the Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Stockholm; the Mood Disorders Clinic and the Anxiety Treatment and Research Center, St. Joseph's HealthCare, Hamilton, Ontario; the Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Centro Fermi-Enrico Fermi Historical Museum of Physics and Study and Research Center, Rome; ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan; the Center for Mathematics, Computing, and Cognition, Universidade Federal do ABC, Santo Andre, Brazil; the Center for OCD and Related Disorders, New York State Psychiatric Institute, New York; the Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona; the Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston; the Clinical Neuroscience and Development Laboratory, Olin Neuropsychiatry Research Center, Hartford, Conn.; the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York; the James J. Peters VA Medical Center, Bronx, N.Y.; the Institute of Living, Hartford Hospital, Hartford, Conn.; the Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; and the Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.

PMID: 29377733
PMCID: PMC7106947
DOI: 10.1176/appi.ajp.2017.17050485

Abstract

Objective: Brain imaging studies of structural abnormalities in OCD have yielded inconsistent results, partly because of limited statistical power, clinical heterogeneity, and methodological differences. The authors conducted meta- and mega-analyses comprising the largest study of cortical morphometry in OCD ever undertaken.

Method: T₁-weighted MRI scans of 1,905 OCD patients and 1,760 healthy controls from 27 sites worldwide were processed locally using FreeSurfer to assess cortical thickness and surface area. Effect sizes for differences between patients and controls, and associations with clinical characteristics, were calculated using linear regression models controlling for age, sex, site, and intracranial volume.

Results: In adult OCD patients versus controls, we found a significantly lower surface area for the transverse temporal cortex and a thinner inferior parietal cortex. Medicated adult OCD patients also showed thinner cortices throughout the brain. In pediatric OCD patients compared with controls, we found significantly thinner inferior and superior parietal cortices, but none of the regions analyzed showed significant differences in surface area. However, medicated pediatric OCD patients had lower surface area in frontal regions. Cohen's d effect sizes varied from -0.10 to -0.33.

Conclusions: The parietal cortex was consistently implicated in both adults and children with OCD. More widespread cortical thickness abnormalities were found in medicated adult OCD patients, and more pronounced surface area deficits (mainly in frontal regions) were found in medicated pediatric OCD patients. These cortical measures represent distinct morphological features and may be differentially affected during different stages of development and illness, and possibly moderated by disease profile and medication.

Keywords: Cortical Thickness; FreeSurfer; MRI; Obsessive-Compulsive Disorder; Surface Area.

PubMed Disclaimer

Figures

**Figure 1:**
Mega-analysis effect sizes for regions that showed a significant (q<0.05) difference in cortical thickness between adult OCD patients and healthy controls. Negative effect sizes d (red) indicate cortical thinning in OCD compared to controls

**Figure 2:**
Mega-analysis effect sizes for regions that showed a significant (q<0.05) difference in cortical thickness between pediatric OCD patients and healthy controls. Negative effect sizes d (red) indicate cortical thinning in OCD compared to controls

**Figure 3:**
Mega-analysis effect sizes for regions that showed a significant (q<0.05) difference in cortical thickness between adult medicated OCD patients and healthy controls. Negative effect sizes d (red) indicate cortical thinning in OCD compared to controls.

**Figure 4:**
Mega-analysis effect sizes for regions that showed a significant (q<0.05) difference in cortical surface area between pediatric medicated OCD patients and healthy controls. Negative effect sizes d (red) indicate reduced cortical surface area in OCD compared to controls.

See this image and copyright information in PMC

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Cortical Abnormalities Associated With Pediatric and Adult Obsessive-Compulsive Disorder: Findings From the ENIGMA Obsessive-Compulsive Disorder Working Group

Collaborators

Affiliation

Cortical Abnormalities Associated With Pediatric and Adult Obsessive-Compulsive Disorder: Findings From the ENIGMA Obsessive-Compulsive Disorder Working Group

Authors

Collaborators

Affiliation

Abstract

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

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Medical

Miscellaneous