Structural neuroimaging biomarkers for obsessive-compulsive disorder in the ENIGMA-OCD consortium: medication matters
Authors: Bruin Willem B. , Taylor Luke , Thomas Rajat M. , Shock Jonathan P. , Zhutovsky Paul , Abe Yoshinari , Alonso Pino , Ameis Stephanie H. , Anticevic Alan , Arnold Paul D. , Assogna Francesca , Benedetti Francesco , Beucke Jan C. , Boedhoe Premika S. W. , Bollettini Irene , Bose Anushree , Brem Silvia , Brennan Brian P. , Buitelaar Jan K. , Calvo Rosa , Cheng Yuqi , Cho Kang Ik K. , Dallaspezia Sara , Denys Damiaan , Ely Benjamin A. , Feusner Jamie D. , Fitzgerald Kate D. , Fouche Jean-Paul , Fridgeirsson Egill A. , Gruner Patricia , Gürsel Deniz A. , Hauser Tobias U. , Hirano Yoshiyuki , Hoexter Marcelo Q. , Hu Hao , Huyser Chaim , Ivanov Iliyan , James Anthony , Jaspers-Fayer Fern , Kathmann Norbert , Kaufmann Christian , Koch Kathrin , Kuno Masaru , Kvale Gerd , Kwon Jun Soo , Liu Yanni , Lochner Christine , Lázaro Luisa , Marques Paulo , Marsh Rachel , Martínez-Zalacaín Ignacio , Mataix-Cols David , Menchón José M. , Minuzzi Luciano , Moreira Pedro S. , Morer Astrid , Morgado Pedro , Nakagawa Akiko , Nakamae Takashi , Nakao Tomohiro , Narayanaswamy Janardhanan C. , Nurmi Erika L. , O’Neill Joseph , Pariente Jose C. , Perriello Chris , Piacentini John , Piras Fabrizio , Piras Federica , Reddy Y. C. Janardhan , Rus-Oswald Oana G. , Sakai Yuki , Sato João R. , Schmaal Lianne , Shimizu Eiji , Simpson H. Blair , Soreni Noam , Soriano-Mas Carles , Spalletta Gianfranco , Stern Emily R. , Stevens Michael C. , Stewart S. Evelyn , Szeszko Philip R. , Tolin David F. , Venkatasubramanian Ganesan , Wang Zhen , Yun Je-Yeon , van Rooij Daan ,   ENIGMA-OCD Working Group, Banaj Nerisa , Bargalló Nuria , Batistuzzo Marcelo C. , Brandeis Daniel , Busatto Geraldo F. , Calvo Anna , Ciullo Valentina , Drechsler Renate , Esteves Madalena , Falini Andrea , Fang Yu , Figee Martijn , Fontaine Martine , Gueguen Margot , Hamatani Sayo , Hanna Gregory L. , Hansen Bjarne , Ikari Keisuke , Lázaro Luisa , Magalhães Ricardo , Masuda Yasutaka , Matsumoto Koji , Miguel Euripedes C. , Morer Astrid , Pittenger Christopher , Poletti Sara , Sakai Yuki , Sousa Nuno , Takahashi Jumpei , Thorsen Anders L. , Tsuchiyagaito Aki , Vecchio Daniela , Veltman Dick J. , Walitza Susanne , Watanabe Anri , Xu Xiufeng , Xu Jian , Yamada Kei , Yoshida Tokiko , Zarei Mojtaba , Zhao Qing , Zhou Cong , de Vries Froukje E. , de Wit Stella J. , van Rooij Daan , van Wingen Guido A. , van den Heuvel Odile A. , van der Werf Ysbrand D. , Thompson Paul M. , van den Heuvel Odile A. , Stein Dan J. , van Wingen Guido A. 
Published: October 2020

No diagnostic biomarkers are available for obsessive-compulsive disorder (OCD). Here, we aimed to identify magnetic resonance imaging (MRI) biomarkers for OCD, using 46 data sets with 2304 OCD patients and 2068 healthy controls from the ENIGMA consortium. We performed machine learning analysis of regional measures of cortical thickness, surface area and subcortical volume and tested classification performance using cross-validation. Classification performance for OCD vs. controls using the complete sample with different classifiers and cross-validation strategies was poor. When models were validated on data from other sites, model performance did not exceed chance-level. In contrast, fair classification performance was achieved when patients were grouped according to their medication status. These results indicate that medication use is associated with substantial differences in brain anatomy that are widely distributed, and indicate that clinical heterogeneity contributes to the poor performance of structural MRI as a disease marker.