Distinct subcortical volume alterations in pediatric and adult OCD: A worldwide meta- and mega-analysis

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 Cho, Sara Dallaspezia, Damiaan Denys, Kate D. Fitzgerald, Jean Paul Fouche, Mònica Giménez, Patricia GrunerGregory 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

Research output: Contribution to journalArticlepeer-review

235 Scopus citations


Objective: Structural brain imaging studies in obsessivecompulsive 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 metaand 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 OCDpatientsandhealthy subjects.Theauthorsperformedametaanalysis on themean 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 potentialmodulating 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=20.13; % difference=22.80) 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=20.29,%difference=24.18, 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.

Original languageEnglish
Pages (from-to)60-70
Number of pages11
JournalAmerican Journal of Psychiatry
Issue number1
StatePublished - 1 Jan 2017
Externally publishedYes


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