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Cellular and Extracellular White Matter Abnormalities in Obsessive-Compulsive Disorder: A Diffusion Magnetic Resonance Imaging Study

2021; Elsevier BV; Volume: 6; Issue: 10 Linguagem: Inglês

10.1016/j.bpsc.2021.04.001

2451-9030

Maria Paula Maziero, Johanna Seitz‐Holland, Kang Ik K. Cho, Joshua E. Goldenberg, Tais Tanamatis, Juliana Belo Diniz, Carolina Cappi, Maria Alice de Mathis, Maria Concepción García Otaduy, Maria da Graça Morais Martin, Renata de Melo Felipe da Silva, Roseli Gedanke Shavitt, Marcelo C. Batistuzzo, Antônio Carlos Lopes, Eurípedes C. Miguel, Ofer Pasternak, Marcelo Q. Hoexter,

Botulinum Toxin and Related Neurological Disorders

While previous studies have implicated white matter (WM) as a core pathology of obsessive-compulsive disorder (OCD), the underlying neurobiological processes remain elusive. This study used free-water (FW) imaging derived from diffusion magnetic resonance imaging to identify cellular and extracellular WM abnormalities in patients with OCD compared with control subjects. Next, we investigated the association between diffusion measures and clinical variables in patients. We collected diffusion-weighted magnetic resonance imaging and clinical data from 83 patients with OCD (56 women/27 men, age 37.7 ± 10.6 years) and 52 control subjects (27 women/25 men, age 32.8 ± 11.5 years). Fractional anisotropy (FA), FA of cellular tissue, and extracellular FW maps were extracted and compared between patients and control subjects using tract-based spatial statistics and voxelwise comparison in FSL Randomise. Next, we correlated these WM measures with clinical variables (age of onset and symptom severity) and compared them between patients with and without comorbidities and patients with and without psychiatric medication. Patients with OCD demonstrated lower FA (43.4% of the WM skeleton), lower FA of cellular tissue (31% of the WM skeleton), and higher FW (22.5% of the WM skeleton) compared with control subjects. We did not observe significant correlations between diffusion measures and clinical variables. Comorbidities and medication status did not influence diffusion measures. Our findings of widespread FA, FA of cellular tissue, and FW abnormalities suggest that OCD is associated with microstructural cellular and extracellular abnormalities beyond the corticostriatothalamocortical circuits. Future multimodal longitudinal studies are needed to understand better the influence of essential clinical variables across the illness trajectory.