Editors' ChoiceObsessive-Compulsive Disorder

Connecting the Dots for Obsessive-Compulsive Disorder

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Science Translational Medicine  13 Jul 2011:
Vol. 3, Issue 91, pp. 91ec111
DOI: 10.1126/scitranslmed.3002852

Society is obsessed with social networking tools like Facebook and the increased connectivity they provide. It turns out that in the brain, increased connectivity may also be associated with obsession—in this case, obsessive-compulsive disorders (OCD).

Current diagnosis and monitoring of many psychiatric disorders largely rely on clinical criteria and structured clinical interviews, as listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, imaging—particularly magnetic resonance imaging (MRI)—is increasingly being investigated for the detection of structural and functional changes in the brain associated with many psychiatric conditions.

Li et al. used diffusion-tensor (DT) MRI to evaluate microstructural brain changes in 23 patients with moderate OCD and 23 healthy age-matched controls. DT MRI measures fractional anisotrophy (FA) at a particular location. FA contains information about directionality and coherence of neuronal fiber tracts; in essence, this can show connections between brain regions. Compared with control subjects, patients with OCD had significantly increased FA in certain areas of the brain, particularly involving specific white matter tracts. Importantly, some FA changes correlated with clinical symptoms of OCD.

Although the cellular mechanisms underlying increased FA in patients with OCD are unknown at this time, these changes could be related to increased myelination and neuronal remodeling. Other studies have also suggested that increased FA in OCD patients might reflect increased white matter connectivity. Indeed, increased information transmission in certain brain regions has also been the suspected culprit for other psychiatric disorders. DT imaging, which measures FA, may thus be potentially useful in diagnosing and monitoring disease progression in OCD.

These data suggest that increased connectivity in the brain may be a cause of OCD. Just as obsession with Facebook may be caused by increased social connectivity, pathological obsession may be caused by increased neural connectivity.

F. Li et al., Microstructural brain abnormalities in patients with obsessive-compulsive disorder: diffusion-tensor MR imaging study at 3.0 T. Radiology 260, 216–223 (2011). [Abstract]

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