Abstract
Objective: Patients with hypochondriasis hold unexplainable beliefs and a fear of having a lethal disease, with poor compliances and treatment response to psychotropic drugs. Although several studies have demonstrated that patients with hypochondriasis demonstrate abnormalities in brain structure and function, gray matter volume (GMV) and functional connectivity (FC) in hypochondriasis still remain unclear.Methods: The present study collected T1-weighted and resting-state functional magnetic resonance images from 21 hypochondriasis patients and 22 well-matched healthy controls (HCs). We first analyzed the difference in the GMV between the two groups. We then used the regions showing a difference in GMV between two groups as seeds to perform functional connectivity (FC) analysis. Finally, a support vector machine (SVM) was applied to the imaging data to distinguish hypochondriasis patients from HCs.Results: Compared with the HCs, the hypochondriasis group showed decreased GMV in the left precuneus, and increased GMV in the left medial frontal gyrus. FC analyses revealed decreased FC between the left medial frontal gyrus and cuneus, and between the left precuneus and cuneus. A combination of both GMV and FC in the left precuneus, medial frontal gyrus, and cuneus was able to discriminate the hypochondriasis patients from HCs with a sensitivity of 0.98, specificity of 0.93, and accuracy of 0.95.Conclusion: Our study suggests that smaller left precuneus volumes and decreased FC between the left precuneus and cuneus seem to play an important role of hypochondriasis. Future studies are needed to confirm whether this finding is generalizable to patients with hypochondriasis.
Highlights
Hypochondriasis is a disabling and exhausting psychiatric disorder, which can be characterized by unexplainable beliefs and a fear of having a lethal disease
Patients with hypochondriasis showed significantly decreased GM volume (GMV) in left precuneus and increased GMV in the left medial frontal gyrus compared to healthy patients (Table 2, Figure 1)
No significant correlation was observed between changes in GMV and HAMD score (MedFG: ρ = −0.177, p = 0.442; Precuneus: ρ = −0.09, p = 0.70), in functional connectivity (FC) and HAMD score (Ceunus_MedFG: ρ = 0.254, p = 0.266; Ceunus_Precuneus: ρ = 0.310, p = 0.172), in GMV and Hamilton’ anxiety scale (HAMA) score (MedFG: ρ = −0.265, p = 0.246; Precuneus: ρ = −349, p = 0.121), and in FC and HAMA score (Ceunus_MedFG: ρ = 0.014, p = 0.953; Ceunus_Precuneus: ρ = 0.420, p = 0.058)
Summary
Hypochondriasis is a disabling and exhausting psychiatric disorder, which can be characterized by unexplainable beliefs and a fear of having a lethal disease. Recent surveys revealed a growing proportion of individuals affected by hypochondriasis ranging from 3.4% in the Australian population (Sunderland et al, 2013) to a surprising 20% of outpatients in medical clinics in London (Tyrer et al, 2011). These patients may spend excessive time and money seeking repeated medical examinations and diagnosis from medical specialists. Hypochondriasis was moved from the category of somatoform disorders in the International Classification of Disease (ICD)-10 to those of Obsessive–Compulsive and Related Disorders in ICD-11 (Stein et al, 2016; van den Heuvel et al, 2014). We report our study based on a group of patients with hypochondriasis recruited locally, which hopefully may provide novel perspectives for the neuroimaging findings related to pathogenic mechanisms of hypochondriasis
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
