Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta- and Mega-Analysis.
Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta- and Mega-Analysis.
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DOI：
10.1176/appi.ajp.2016.16020201
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发表时间：
2017-01-01
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影响因子：
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通讯作者：
van den Heuvel OA
中科院分区：
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作者：
Boedhoe PS;Schmaal L;Abe Y;Ameis SH;Arnold PD;Batistuzzo MC;Benedetti F;Beucke JC;Bollettini I;Bose A;Brem S;Calvo A;Cheng Y;Cho KI;Dallaspezia S;Denys D;Fitzgerald KD;Fouche JP;Giménez M;Gruner P;Hanna GL;Hibar DP;Hoexter MQ;Hu H;Huyser C;Ikari K;Jahanshad N;Kathmann N;Kaufmann C;Koch K;Kwon JS;Lazaro L;Liu Y;Lochner C;Marsh R;Martínez-Zalacaín I;Mataix-Cols D;Menchón JM;Minuzzi L;Nakamae T;Nakao T;Narayanaswamy JC;Piras F;Piras F;Pittenger C;Reddy YC;Sato JR;Simpson HB;Soreni N;Soriano-Mas C;Spalletta G;Stevens MC;Szeszko PR;Tolin DF;Venkatasubramanian G;Walitza S;Wang Z;van Wingen GA;Xu J;Xu X;Yun JY;Zhao Q;ENIGMA OCD Working Group;Thompson PM;Stein DJ;van den Heuvel OA
强迫症（OCD）的结构脑成像研究产生了不一致的结果。这可能部分是由于相对较小样本的统计功效有限以及与疾病特征和发育阶段变化相关的临床异质性。为了解决这些局限性，我们对来自全球OCD网站的数据进行了荟萃分析和大型分析。使用协调和标准化处理，分析了来自1，830名强迫症患者和1，759名对照的T1图像，以确定强迫症患者和健康对照之间的皮层下脑体积差异。此外，我们还研究了强迫症患者的临床特征对形态学差异的潜在调节作用。荟萃分析表明，与成人对照组相比，成人患者的海马体积显著较小（Cohen's d =-0.13; p = 5.1x10 − 3，%差异-2.80），苍白球体积较大（d = 0.16; p = 1.6x10 − 3，%差异3.16）。与对照组相比，用药患者的两种效应均更强（分别为d =-0.29; p = 2.4x10 − 5，%差异-4.18和d = 0.29; p = 1.2x10 − 5，%差异4.38）。与儿童对照组相比，未用药儿童患者的丘脑体积较大（d = 0.38，p = 2.1x10 − 3）。这些发现均不受样本特征（如平均年龄或场强）的影响。总体而言，大规模分析得出了类似的结果。我们的研究表明，儿童与成人强迫症患者皮质下异常的不同模式。苍白球和海马似乎是成人强迫症的重要性，而丘脑似乎是儿童强迫症的关键。这突出了神经发育改变在强迫症中的潜在重要性，并表明进一步研究强迫症的神经可塑性可能是有用的。
Structural brain imaging studies in Obsessive-Compulsive Disorder (OCD) have produced inconsistent findings. This may be partially due to limited statistical power from relatively small samples and clinical heterogeneity related to variation in disease profile and developmental stage. To address these limitations, we conducted a meta- and mega-analysis of data from OCD sites worldwide. T1 images from 1,830 OCD patients and 1,759 controls were analyzed, using coordinated and standardized processing, to identify subcortical brain volumes that differ in OCD patients and healthy controls. We additionally examined potential modulating effects of clinical characteristics on morphological differences in OCD patients. The meta-analysis indicated that adult patients had significantly smaller hippocampal volumes (Cohen’s d=−0.13; p=5.1x10−3, % difference −2.80) and larger pallidum volumes (d=0.16; p=1.6x10−3, % difference 3.16) compared to adult controls. Both effects were stronger in medicated patients compared to controls (d=−0.29; p=2.4x10−5, % difference −4.18 and d=0.29; p=1.2x10−5, % difference 4.38, respectively). Unmedicated pediatric patients had larger thalamic volumes (d=0.38, p=2.1x10−3) compared to pediatric controls. None of these findings were mediated by sample characteristics such as mean age or field strength. Overall the mega-analysis yielded similar results. Our study indicates a different pattern of subcortical abnormalities in pediatric versus adult OCD patients. The pallidum and hippocampus seem to be of importance in adult OCD, whereas the thalamus seems to be key in pediatric OCD. This highlights the potential importance of neurodevelopmental alterations in OCD, and suggests that further research on neuroplasticity in OCD may be useful.