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. 2025 Aug;15(8):e70716.
doi: 10.1002/brb3.70716.

Metacognition and Its Relationship With Orbitofrontal Cortex and Thalamus Volumes in Patients With Obsessive-Compulsive Disorder

Murad Atmaca  1 , Sevler Yildiz  2 , Ismail Taskent  3 , Muhammed Fatih Tabara  1 , Mehmet Gurkan Gurok  1 , Sevda Korkmaz  1 , Osman Mermi  1 , Hanefi Yildirim  4
Affiliations

Metacognition and Its Relationship With Orbitofrontal Cortex and Thalamus Volumes in Patients With Obsessive-Compulsive Disorder

Murad Atmaca et al. Brain Behav. 2025 Aug.

Abstract

Purpose: The study aims to explore the relationship between orbitofrontal cortex (OFC) and thalamus volumes and metacognition in patients with obsessive-compulsive disorder (OCD). By analyzing structural MRI data and metacognitive measures, it investigates how brain volume variations correlate with dysfunctional beliefs and OCD symptoms.

Method: The study consisted of 20 patients with OCD and 20 healthy controls. Yale-Brown Obsession Compulsion Scale (Y-BOCS), Metacognition Questionnaire-30 (MCQ-30), Hamilton Depression Scale (HAM-D), and Hamilton Anxiety Scale (HAM-A) were administered to OCD patients and healthy controls. They then underwent structural MRI scans to measure the volume of the OFC and thalamus.

Finding: On both sides, OCD patients had smaller volumes of OFC than healthy control individuals, and their thalamic volumes were similar to those of the control participants. Furthermore, MCQ-30 scores showed a substantial negative correlation with left OFC volume.

Conclusion: In conclusion, we suggest that dysfunctional metacognitive beliefs might be related to the occurrence of OCD, and these beliefs might be associated with the left side of OFC neuroanatomically.

Keywords: metacognition | obsessive‐compulsive disorder (OCD) | orbitofrontal cortex (OFC) | thalamus.

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Figures

FIGURE 1
FIGURE 1
Representative MRI slice depicting the orbitofrontal cortex (OFC). This image illustrates the anatomical localization of the OFC on a T1‐weighted axial MRI slice from a study participant. The region of interest (ROI), segmented using the vol2Brain pipeline and visualized in ITK‐SNAP, is highlighted to demonstrate the boundaries used for volumetric analysis. This region was examined bilaterally to assess structural differences between patients with obsessive‐compulsive disorder (OCD) and healthy controls.
FIGURE 2
FIGURE 2
Representative MRI slice depicting the thalamus. This figure shows a T1‐weighted axial MRI slice highlighting the thalamus region, as segmented for volumetric analysis. The thalamus was delineated using the vol2Brain pipeline and rendered in ITK‐SNAP for visual confirmation. Bilateral thalamus volumes were compared between OCD patients and healthy controls to explore associations with metacognitive functioning.
FIGURE 3
FIGURE 3
Boxplots of orbitofrontal cortex (OFC) volumes in obsessive‐compulsive disorder (OCD) patients and healthy controls. Boxplots comparing the left and right OFC volumes (in cm3) between patients with OCD and healthy control participants. Central lines indicate medians; box edges represent interquartile ranges (IQR). OCD patients showed significantly lower bilateral OFC volumes.
FIGURE 4
FIGURE 4
Boxplots of thalamus volumes in OCD patients and healthy controls. Boxplots comparing the left and right thalamus volumes (in cm3) between patients with OCD and healthy control participants. Central lines indicate medians; box edges represent interquartile ranges (IQR). No statistically significant difference was found in the thalamus volumes of the groups.
See this image and copyright information in PMC

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