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Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta- and Mega-Analysis
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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: 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.
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“Consistent with this expanded orbitofrontal striatal model, a worldwide meta‐analysis of 1830 OCD patients and 1759 control subjects found smaller hippocampal volumes in patients (Boedhoe et al., 2017; such hippocampal volume might help explain visuospatial deficits in OCD discussed below).”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Boedhoe et al., 2017
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“The interference control and motor response inhibition are both dependent on cortico–striato–thalamo–cortical (CSTC) circuits [for review, see (3, 20)] intensively studied in OCD (21–24).”
From Functional connectivity changes in obsessive-compulsive disorder correspond to interference control and obsessions severity (2020) · cites this paper as [23]
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Self-citation
Metadata
- Authors
- Boedhoe, P. S. W., Schmaal, L., Abe, Y., Ameis, S. H., Arnold, P. D., Batistuzzo, M. C., Benedetti, F., Beucke, J. C., Bollettini, I., Bose, A., Brem, S., Calvo, A., Cheng, Y., Cho, K. I. K., Dallaspezia, S., Denys, D., Fitzgerald, K. D., Fouche, J.-P., Giménez, M., Gruner, P., Hanna, G. L., Hibar, D. P., Hoexter, M. Q., Hu, H., Huyser, C., Ikari, K., Jahanshad, N., Kathmann, N., Kaufmann, C., Koch, K., Kwon, J. S., Lazaro, L., Liu, Y., Lochner, C., Marsh, R., Martínez-Zalacaín, I., Mataix-Cols, D., Menchón, J. M., Minuzzi, L., Nakamae, T., Nakao, T., Narayanaswamy, J. C., Piras, F., Piras, F., Pittenger, C., Reddy, Y. C. J., Sato, J. R., Simpson, H. B., Soreni, N., Soriano-Mas, C., Spalletta, G., Stevens, M. C., Szeszko, P. R., Tolin, D. F., Venkatasubramanian, G., Walitza, S., Wang, Z., van Wingen, G. A., Xu, J., Xu, X., Yun, J.-Y., Zhao, Q., ENIGMA OCD Working Group, Thompson, P. M., Stein, D. J., van den Heuvel, O. A., The members of the ENIGMA OCD Working Group, Abe, Y., Alonso, P., Ameis, S. H., Arnold, P. D., Bargalló, N., Batistuzzo, M. C., Benedetti, F., Beucke, J. C., Boedhoe, P. S. W., Bollettini, I., Bose, A., Brem, S., Busatto, G. F., Calvo, A., Calvo, R., Cath, D. C., Cheng, Y., Cho, K. I. K., Dallaspezia, S., de Vries, F. E., de Wit, S. J., Denys, D., Fang, Y., Fitzgerald, K. D., Fontaine, M., Fouche, J.-P., Giménez, M., Gruner, P., Hanna, G. L., Hibar, D. P., Hoexter, M. Q., Hu, H., Huyser, C., Ikari, K., Jahanshad, N., Kathmann, N., Kaufmann, C., Khadka, S., Koch, K., Kwon, J. S., Lazaro, L., Liu, Y., Lochner, C., Marsh, R., Martínez-Zalacaín, I., Mataix-Cols, D., Menchón, J. M., Miguel, E. C., Minuzzii, L., Morer, A., Nakamae, T., Nakao, T., Narayanaswamy, J. C., Piras, F., Piras, F., Pittenger, C., Reddy, Y. C. J., Sato, J. R., Simpson, H. B., Schmaal, L., Soreni, N., Soriano-Mas, C., Spalletta, G., Stein, D. J., Stevens, M. C., Szeszko, P. R., Thompson, P. M., Tolin, D. F., Veltman, D. J., Venkatasubramanian, G., van den Heuvel, O. A., van der Werf, Y. D., van Wingen, G. A., Walitza, S., Wang, Z., Xu, J., Xu, X., Yun, J.-Y., & Zhao, Q.
- Affiliations
- Hospital for Sick Children (CA)
- St. Joseph’s Healthcare Hamilton (CA)
- Venue
- American Journal of Psychiatry
- Published
- 2017-01-01
- Volume
- 174
- Issue
- 1
- Pages
- 60-69
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC5344782
- OpenAlex
- W2517818012
- Cited by
- 335
- References
- 38
- Citations by year
- 2026: 28 · 2025: 20 · 2024: 24 · 2023: 29 · 2022: 37 · 2021: 41 · 2020: 55 · 2019: 50 · 2018: 25 · 2017: 25
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- KNAW Research Portal (The Royal Netherlands Academy of Arts and Sciences) (publishedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (acceptedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- KNAW research portal (Royal Academy of Art and Sciences (KNAW)) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, public-domain)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- National Science Foundation
- Bristol-Myers Squibb
- Eli Lilly and Company
- GlaxoSmithKline
- Yale University
- University of Southern California
- International OCD Foundation
- Hamilton Health Sciences
- Ontario Brain Institute
- Wellcome Trust (U54 EB020403, 064846)
- Canadian Network for Mood and Anxiety Treatments
- National Institute of Mental Health and Neurosciences
- Universidade Federal do ABC
- University of Cambridge
- Department of Biotechnology, Ministry of Science and Technology, India (BT/06/IYBA/2012., 500236/ Z/11/Z)
- Department of Science and Technology, Ministry of Science and Technology, India (IFA 12-LSBM 26, /PR13334/Med/30/259/2009, DST INSPIRE faculty grant -IFA12-LSBM-26, IFA-12)
- Deutsche Forschungsgemeinschaft (U54 EB020403, KO 3744/2-1)
- Ministry of Education, Culture, Sports, Science and Technology (26461753)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (130237, 320030)
- Koninklijke Nederlandse Akademie van Wetenschappen
- Universiteit van Amsterdam
- Bundesministerium für Bildung und Forschung (U54 EB020403)
- Seoul National University
- Ministero della Salute
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (917-15-318)
- Kunming Medical University
- Karolinska Institutet
- Ministerio de Ciencia e Innovación
- Shanghai Jiao Tong University
- Universidade de São Paulo
- Technische Universität München
- Universitat de Barcelona
- Hospital for Sick Children
- Humboldt-Universität zu Berlin
- Universität Zürich
- Centro de Investigación Biomédica en Red de Salud Mental
- University of Cape Town
- The Wellcome Trust DBT India Alliance (500236/Z/11/Z)
- Universitat Autònoma de Barcelona
- Servier
- H. Lundbeck A/S
- Hamilton Health Sciences Foundation
- National Institutes of Health (12-13, EB020403, UL1TR001863)
- Mathison Centre for Mental Health Research and Education
- Cumming School of Medicine, University of Calgary
- College of Medicine, Seoul National University
- Canadian Institutes of Health Research
- Medical Research Council (U54 EB020403)
- Japan Society for the Promotion of Science (26461753)
- Agència de Gestió d'Ajuts Universitaris i de Recerca (2014 SGR 1672)
- Instituto de Salud Carlos III (PI13/01958, PI14/00413, PI14/, PI13/00918, PI040829, CP10/00604)
- School of Medicine, Shanghai Jiao Tong University
- European Regional Development Fund (PI14/00413, PI13/01958)
- National Institute of Mental Health (R01MH101493, R21MH093889, R01MH085321)
- National Institute of Biomedical Imaging and Bioengineering (U54EB020403)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- obsessive-compulsive disorder, subcortical volume, hippocampus, globus pallidus, thalamus, pediatric OCD, neuroplasticity, antipsychotic effects, brain structure
- MeSH terms
- Adolescent, Adult, Child, Globus Pallidus, Hippocampus, Humans, Magnetic Resonance Imaging, Middle Aged, Obsessive-Compulsive Disorder, Organ Size, Thalamus, Young Adult, Neuroimaging
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