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. 2025 Sep 24.
doi: 10.1111/pcn.13895. Online ahead of print.

Neurometabolic dysregulation within the cortico-striatal-thalamo-cortical circuits in obsessive-compulsive disorder: A 1H-MRS meta-analysis

Fei Zhu  1   2 , Qiao Wen  1   2   3 , Senhao Liu  1   2 , Ziyang Gao  1   2 , Bo Tao  1   2 , Na Hu  1   2 , Qiannan Zhao  1   2 , Wei Yu  1   2 , Yuan Xiao  1   2   4 , Su Lui  1   2
Affiliations

Neurometabolic dysregulation within the cortico-striatal-thalamo-cortical circuits in obsessive-compulsive disorder: A 1H-MRS meta-analysis

Fei Zhu et al. Psychiatry Clin Neurosci. .

Abstract

Aim: Changes in neurometabolites are believed to have a significant impact on the underlying mechanisms of obsessive-compulsive disorder (OCD). However, current findings regarding the neurometabolite levels of OCD patients remain inconsistent. To address this issue, we conducted a comprehensive meta-analysis of proton magnetic resonance spectroscopy studies to investigate the differences in neurometabolite levels in OCD patients relative to healthy controls (HCs).

Methods: A systematic search of PubMed, Web of Science, and Embase included 55 original studies that compared the levels of eight in vivo neurometabolites in OCD patients (n = 1270) and HCs (n = 1186). Hedge's g with random effects model was employed to calculate the effect sizes for the between-group differences in neurometabolite levels. Meta-regression and subgroup analyses were conducted to examine confounding effects.

Results: Compared to HCs, OCD patients exhibited decreased N-acetylaspartate compounds (NAA) in the striatum, as well as elevated choline-containing compounds (Cho) levels in the thalamus. The symptom severity of OCD patients showed positive associations with Cho in the striatum. Subgroup analyses showed that decreased striatal NAA in OCD patients remained evident in both the medicated and 1.5T subgroups. Additionally, significantly increased thalamic Cho in OCD patients was also observed in the unmedicated, adult, 3.0T, and non-comorbid subgroups.

Conclusion: This study reveals neurometabolic dysregulation within the cortico-striatal-thalamo-cortical circuits in OCD, offering integrated insights into its underlying neurobiological mechanisms.

Keywords: cortico‐striato‐thalamo‐cortical circuits; magnetic resonance spectroscopy; neurochemical dysregulation; neurometabolite; obsessive‐compulsive disorder.

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