Normal Caudate Nucleus in Obsessive-compulsive Disorder Assessed by Quantitative Neuroimaging

Elizabeth Aylward

143 citations0/0 files storedArchives of General Psychiatry

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Obsessive-Compulsive Spectrum Disorders Neural and Behavioral Psychology Studies Neurological disorders and treatments

Abstract

BACKGROUND: Prior neuroimaging studies have not consistently demonstrated a structural or functional abnormality of the caudate nucleus in patients with obsessive-compulsive disorder (OCD). However, there is theoretical support for some associated dysfunction of the caudate nucleus. METHODS: We examined volumes of the caudate nucleus and putamen with magnetic resonance imaging in 24 patients with adult-onset OCD and 21 control subjects, group-matched on age, race, education, and sex. Patients were relatively free from tics. To evaluate function (metabolism or blood flow) of the caudate nucleus, we performed a quantitative review, including a meta-analysis, of normalized data from functional neuroimaging studies that compared patients who had OCD with normal control subjects. RESULTS: All structural basal ganglia measures failed to exhibit differences between patients with OCD and matched normal control subjects. Patients did not demonstrate evidence of ventricular enlargement. Quantitative meta-analysis of the functional neuroimaging literature did not demonstrate a consistent abnormality of the caudate nucleus. CONCLUSIONS: We did not observe evidence of a structural abnormality of the caudate nucleus in patients with OCD. Prior reports of a structural aberration of the caudate nucleus were mixed. We also did not find strong support for relative caudate metabolic or perfusion dysfunction in the literature, although increased function in the frontal cerebral cortex was identified. The heterogeneous nature of this disorder may account for inconsistencies between studies. For example, ventricular enlargement or reduced caudate volume or blood flow might be evident in patients with soft neurological signs (eg, tics), while patients in the current study were relatively free from tics. Although theories of OCD suggest a dysfunction of the caudate nucleus, the structural and functional neuroimaging literature has not consistently verified this.

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References

1967Development of a Rating Scale for Primary Depressive Illness 1989The Yale-Brown Obsessive Compulsive Scale 1994The Yale-Brown Obsessive-Compulsive Scale: Measures of internal consistency 1992Caudate Glucose Metabolic Rate Changes With Both Drug and Behavior Therapy for Obsessive-Compulsive Disorder 1988Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised 1995A family study of obsessive-compulsive disorder 1994Regional Cerebral Blood Flow Measured During Symptom Provocation in Obsessive-Compulsive Disorder Using Oxygen 15—Labeled Carbon Dioxide and Positron Emission Tomography 1987Local Cerebral Glucose Metabolic Rates in Obsessive-Compulsive Disorder

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2000Review of Neuroimaging Studies of Child and Adolescent Psychiatric Disorders From the Past 10 Years 2005A manual and automated MRI study of anterior cingulate and orbito-frontal cortices, and caudate nucleus in obsessive-compulsive disorder: comparison with healthy controls and patients with schizophrenia 2012Localization of cerebral functional deficits in patients with obsessive–compulsive disorder: A resting-state fMRI study 2009Endophenotypes of obsessive–compulsive disorder: rationale, evidence and future potential

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