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Neural Correlates of Factor-Analyzed OCD Symptom Dimensions: A PET Study

Published online by Cambridge University Press:  07 November 2014

Abstract

Various schemes have been developed in attempts to define meaningful subtypes of obsessive-compulsive disorder (OCD). A factor analytic approach presumes that the symptom of the disorder can be described by several independent symptom dimensions. The purpose of this study was to explore the neural correlates of three symptom dimensions that were derived from previous factor analyses. Positron emission tomography was used to measure relative regional cerebral blood flow (rCBF) in 14 subjects with OCD while they engaged in a continuous performance task. Clinical indices, including factor scores, we ascertained via structured interviews plus administration of the Yale-Brown Obsessive-Compulsive Scale and checklist. The severity of Factor 1 (religious/aggressive/sexual obsessions and checking) was positively correlated with rCBF in striatum bilaterally. In addition, distinct trends were observed for the other two Factors. These findings provide initial support for a modular neurobiologic model of OCD, where dysfunction within separate component systems may principally mediate independent symptom factors. More important, this nove strategy may represent a powerful new approach to interpreting brain imaging studies of neuropsychiatric diseases.

Type
Feature Articles
Copyright
Copyright © Cambridge University Press 1998

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References

REFERENCES

1.Insel, TR. Toward a neuroanatomy of obsessive-compulsive disorder. Arch Gen Psychiatry. 1992;49:739744.CrossRefGoogle Scholar
2.Hoehn-Saric, R, Benkelfat, C. Structural and functional brain imaging in obsessive compulsive disorder. In: Hollander, E, Zohar, J, Marazziti, D, et al, eds. Current Insights in Obsessive Compulsive Disorder. New York, NY: John Wiley and Sons; 1995:183214.Google Scholar
3.Rauch, SL, Bates, JF, Grachev, ID. Obsessive compulsive disorder. Child Adolesc Psychiatr Clin Am. 1997;6:365381.CrossRefGoogle Scholar
4.Rauch, SL. Advances in neuroimaging research: how might they influence our diagnostic classification scheme? Harv Rev Psychiatry. 1996;4:159162.Google Scholar
5.Rachman, S, Hodgson, R. Obsessions and Compulsions. Englewood Cliffs, NJ: Prentice Hall; 1980.Google Scholar
6.Baer, L, Jenike, MA. Introduction. In: Jenike, MA, Baer, L, Minichiello, WE, eds. Obsessive Compulsive Disorders: Theory and Management. 2nd ed. Chicago, IL: Year Book Medical Publishing; 1990:39.Google Scholar
7.McDougle, CJ, Goodman, WK, Price, LH, et al.Neuroleptic addition in fluvoxamine refractory obsessive compulsive disorder. Am J Psychiatry. 1990;147:652654.Google ScholarPubMed
8.George, MS, Trimble, MR, Ring, HA, et al.Obsessions in obsessive-compulsive disorder with and without Gilles de la Tourette's syndrome. Am J Psychiatry. 1992;150:9397.Google Scholar
9.Holzer, JC, Goodman, WK, McDougle, CJ, et al.Obsessive compulsive disorder with and without a chronic tic disorder: a comparison of symptoms in 70 patients. Br J Psychiatry. 1994;164:469473.CrossRefGoogle ScholarPubMed
10.McDougle, CJ, Goodman, WK, Leckman, JF, et al.Haloperidol addition in fluvoxamine-refractory obsessive-compulsive disorder: a double-blind, placebo-controlled study in patients with and without tics. Arch Gen Psychiatry. 1994;51:302308.Google Scholar
11.Miguel, EC, Baer, L, Coffey, BJ, et al.Phenomenological differences appearing with repetitive behaviors in obsessive-compulsive disorder and Gilles de la Tourette's syndrome. Br J Psychiatry. 1997;170:140145.CrossRefGoogle ScholarPubMed
12.Baer, L. Factor analysis of symptom subtypes of obsessive compulsive disorder and their relation to personality and tic disorders. J Clin Psychiatry. 1994;55:1823.Google ScholarPubMed
13.Leckman, JF, Grice, DE, Boardman, J, et al.Symptoms of obsessive-compulsive disorder. Am J Psychiatry. 1997;154:911917.Google Scholar
14.Baer, L, Rauch, SL, Ballantine, HT, et al.Cingulotomy for intractable obsessive-compulsive disorder: prospective long-term follow-up of 18 patients. Arch Gen Psychiatry. 1995;52:384392.Google Scholar
15.Geschwind, N. The organization of language and the brain. Science. 1970;170:940944.Google Scholar
16.Goodman, WK, Price, LH, Rasmussen, SA, et al.The Yale-Brown Obsessive Compulsive Scale (Y-BOGS), part I: development, use, and reliability. Arch Gen Psychiatry. 1989;46:10061011.Google Scholar
17.Goodman, WK, Price, LH, Rasmussen, SA, et al.The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), part II: validity. Arch Gen Psychiatry. 1989;46:10121016.Google Scholar
18.Rauch, SL, Jenike, MA. Neural mechanisms of obsessive-compulsive disorder. Current Review of Mood and Anxiety Disorders. 1997;1:8494.Google Scholar
19.Rauch, SL, Savage, CR, Alpert, NM, et al.Probing striatal function in obsessive compulsive disorder: a PET study of implicit sequence learning. J Neuropsychiatry. 1997;9:568573.Google ScholarPubMed
20.Mansari, ME, Bouchard, C, Blier, P. Alteration of serotonin release in the guinea pig orbito-frontal cortex by selective serotonin reuptake inhibitors: relevance to treatment of obsessive-compulsive disorder. Neuropsychopharmacology. 1995;13:117127.CrossRefGoogle ScholarPubMed
21.Oldfield, RC. The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia. 1971;9:97113.CrossRefGoogle ScholarPubMed
22.Spitzer, RL, Williams, JBW, Gibbon, M, et al. Structured Clinical Interview for DSM-III-R (SCID). Washington, DC: American Psychiatric Press; 1990.Google Scholar
23.Nissen, MJ, Bullemer, P. Attentional requirements of learning: evidence from performance measures. Cognitive Psychology. 1987;19:132.CrossRefGoogle Scholar
24.Rauch, SL, Savage, CR, Brown, HD, et al.A PET investigation of implicit and explicit sequence learning. Hum Brain Mapping. 1995;3:271286.Google Scholar
25.Alpert, NM, Berdichevsky, D, Levin, Z, et al.Improved methods for image registration. Neuroimage. 1996;3:1018.Google Scholar
26.Talairach, J, Tournoux, P. Co-Planar Stereotaxic Atlas of the Human Brain. New York, NY: Thieme Medical Publishers Inc; 1988.Google Scholar
27.Alpert, NM, Berdichevsky, D, Weise, S, et al.Stereotactic transformation of PET scans by nonlinear least squares. In: Uemura, K, Lassen, NA, Jones, T, eds. Quantification of Brain Function: Tracer Kinetics and Image Analysis in Brain PET. Amsterdam, The Netherlands: Elsevier; 1993:459463.Google Scholar
28.Friston, KJ, Frith, CD, Liddle, PF, Frackowiak, RSJ. Comparing functional (PET) images: the assessment of significant change. J Cereb Blood Flow Metab. 1991;11:690699.CrossRefGoogle ScholarPubMed
29.Worsley, KJ, Evans, AC, Marrett, S, et al.A three dimensional statistical analysis for rCBF activation studies in human brain. J Cereb Blood Flow Metab. 1992;12:900918.CrossRefGoogle Scholar
30.Friston, KJ, Worsley, KJ, Frackowiak, RSJ, et al.Assessing the significance of focal activations using their spatial extent. Hum Brain Mapping. 1994;1:214220.Google Scholar
31.Friston, KJ, Holmes, AP, Worsley, KJ, et al.Statistical parametric maps in functional imaging: a general approach. Hum Brain Mapping. 1995;2:189210.CrossRefGoogle Scholar
32.Baxter, LR, Schwartz, JM, Guze, BH, et al.Neuroimaging in obsessive-compulsive disorder: seeking the mediating neuroanatomy. In: Jenike, MA, Baer, L, Minichiello, WE, eds. Obsessive Compulsive Disorder: Theory and Management. 2nd ed. Chicago, Ill: Year Book Medical Publishers; 1990:167188.Google Scholar
33.Rauch, SL, Jenike, MA, Alpert, NM, et al.Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using 15O-labeled CO2 and positron emission tomography. Arch Gen Psychiatry. 1994;51:6270.Google Scholar
34.Rauch, SL, Savage, CR, Alpert, NM, et al.A positron emission tomographic study of simple phobic symptom provocation. Arch Gen Psychiatry. 1995;52:2028.Google Scholar