Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta- and Mega-Analysis
Authors: Premika S.W. Boedhoe, Lianne Schmaal, Yoshinari Abe, Stephanie H. Ameis, Paul D. Arnold, Marcelo C. Batistuzzo, Francesco Benedetti, Jan C. Beucke, Irene Bollettini, Anushree Bose, Silvia Brem, Anna Calvo, Yuqi Cheng, Kang Ik K. Cho, Sara Dallaspezia, Damiaan Denys, Kate D. Fitzgerald, Jean-Paul Fouche, Mònica Giménez, Patricia Gruner, Gregory L. Hanna, Derrek P. Hibar, Marcelo Q. Hoexter, Hao Hu, Chaim Huyser, Keisuke Ikari, Neda Jahanshad, Norbert Kathmann, Christian Kaufmann, Kathrin Koch, Jun Soo Kwon, Luisa Lazaro, Yanni Liu, Christine Lochner, Rachel Marsh, Ignacio Martínez-Zalacaín, David Mataix-Cols, José M. Menchón, Luciano Minuzzi, Takashi Nakamae, Tomohiro Nakao, Janardhanan C. Narayanaswamy, Fabrizio Piras, Federica Piras, Christopher Pittenger, Y.C. Janardhan Reddy, Joao R. Sato, H. Blair Simpson, Noam Soreni, Carles Soriano-Mas, Gianfranco Spalletta, Michael C. Stevens, Philip R. Szeszko, David F. Tolin, Ganesan Venkatasubramanian, Susanne Walitza, Zhen Wang, Guido A. van Wingen, Jian Xu, Xiufeng Xu, Je-Yeon Yun, Qing Zhao, Paul M. Thompson, Dan J. Stein, Odile A. van den Heuvel, Yoshinari Abe, Pino Alonso, Stephanie H. Ameis, Paul D. Arnold, Nuria Bargalló, Marcelo C. Batistuzzo, Francesco Benedetti, Jan C. Beucke, Premika S.W. Boedhoe, Irene Bollettini, Anushree Bose, Silvia Brem, Geraldo F. Busatto, Anna Calvo, Rosa Calvo, Danielle C. Cath, Yuqi Cheng, Kang Ik K. Cho, Sara Dallaspezia, Froukje E. de Vries, Stella J. de Wit, Damiaan Denys, Yu Fang, Kate D. Fitzgerald, Martine Fontaine, Jean-Paul Fouche, Mònica Giménez, Patricia Gruner, Gregory L. Hanna, Derrek P. Hibar, Marcelo Q. Hoexter, Hao Hu, Chaim Huyser, Keisuke Ikari, Neda Jahanshad, Norbert Kathmann, Christian Kaufmann, Sabin Khadka, Kathrin Koch, Jun Soo Kwon, Luisa Lazaro, Yanni Liu, Christine Lochner, Rachel Marsh, Ignacio Martínez-Zalacaín, David Mataix-Cols, José M. Menchón, Euripedes C. Miguel, Luciano Minuzzii, Astrid Morer, Takashi Nakamae, Tomohiro Nakao, Janardhanan C. Narayanaswamy, Fabrizio Piras, Federica Piras, Christopher Pittenger, Y.C. Janardhan Reddy, Joao R. Sato, H. Blair Simpson, Lianne Schmaal, Noam Soreni, Carles Soriano-Mas, Gianfranco Spalletta, Dan J. Stein, Michael C. Stevens, Philip R. Szeszko, Paul M. Thompson, David F. Tolin, Dick J. Veltman, Ganesan Venkatasubramanian, Odile A. van den Heuvel, Ysbrand D. van der Werf, Guido A. van Wingen, Susanne Walitza, Zhen Wang, Jian Xu, Xiufeng Xu, Je-Yeon Yun, Qing Zhao
Journal: American Journal of Psychiatry (2016)

Objective: Structural brain imaging studies in obsessive-compulsive disorder (OCD) have produced inconsistent findings. This may be partially due to limited statistical power from relatively small samples and clinical heterogeneity related to variation in illness profile and developmental stage. To address these limitations, the authors conducted meta- and mega-analyses of data from OCD sites worldwide. Method: T1 images from 1,830 OCD patients and 1,759 control subjects were analyzed, using coordinated and standardized processing, to identify subcortical brain volumes that differ between OCD patients and healthy subjects. The authors performed a meta-analysis on the mean of the left and right hemisphere measures of each subcortical structure, and they performed a mega-analysis by pooling these volumetric measurements from each site. The authors additionally examined potential modulating effects of clinical characteristics on morphological differences in OCD patients. Results: The meta-analysis indicated that adult patients had significantly smaller hippocampal volumes (Cohen’s d=−0.13; % difference=−2.80) and larger pallidum volumes (d=0.16; % difference=3.16) compared with adult controls. Both effects were stronger in medicated patients compared with controls (d=−0.29, % difference=−4.18, and d=0.29, % difference=4.38, respectively). Unmedicated pediatric patients had significantly larger thalamic volumes (d=0.38, % difference=3.08) compared with pediatric controls. None of these findings were mediated by sample characteristics, such as mean age or scanning field strength. The mega-analysis yielded similar results. Conclusions: The results indicate different patterns of subcortical abnormalities in pediatric and adult OCD patients. The pallidum and hippocampus seem to be of importance in adult OCD, whereas the thalamus seems to be key in pediatric OCD. These findings highlight the potential importance of neurodevelopmental alterations in OCD and suggest that further research on neuroplasticity in OCD may be useful.