Characteristic Alteration of Subcortical Nuclei Shape in Medication-Free Patients with Obsessive-Compulsive Disorder

Abstract

Background: Subcortical nuclei are important components in the pathology model of obsessive-compulsive disorder (OCD); however, subregions of these structures subserve different functions that may distinctively contribute to OCD symptoms. A subregional-level profile of structural abnormalities of the basal ganglia in OCD is needed for a further understanding of the disorder. Methods: A total of 83 medication-free, non-comorbid OCD patients and 93 age- and sex-matched healthy controls were recruited, and high-resolution T1-weighted MR images were obtained for all participants. The volume and shape of the subcortical nuclei (including the nucleus accumbens, amygdala, caudate, pallidum, putamen and thalamus) were quantified and compared with an automated parcellation approach and vertex-wise shape analysis using FSL-FIRST software. Sex differences in these measurements were also explored with an exploratory subgroup analysis. Results: Volumetric analysis showed no significant differences between patients and healthy control subjects. Relative to healthy control subjects, the OCD patients showed an expansion of the lateral amygdala (right hemisphere) and right pallidum. These deformities were associated with illness duration and symptom severity of OCD. Exploratory subgroup analysis by sex revealed amygdala deformity in male patients and caudate deformity in female patients. Conclusions: The lateral amygdala may contribute to OCD pathology by its role in fear conditioning, and deformity in the subregion of the pallidum suggests a disrupted punishment/reinforcement learning pathway. Our study not only provides deeper insight into how these structures contribute to OCD symptoms by revealing these subregional-level deformities but also suggests that gender effects may be important in OCD studies. Funding Statement: This study was supported by the National Natural Science Foundation (Grant Nos. 81671669 and 81171488) and Youth Technology Grant of Sichuan Province (No. 2017JQ0001). Declaration of Interests: The authors declare that they have no conflicts of interest. Ethics Approval Statement: This study was approved by the Research Ethics Committee of West China Hospital, Sichuan University, and fully informed written consent was obtained from each participant.