Hoexter, M. Q. | Search bioRxiv

bioRxiv2020

Cognitive performance in children and adolescents at high-risk for obsessive-compulsive disorder

BackgroundCognitive performance has been studied in subclinical obsessive-compulsive (OC) adults and in adults relatives of OCD patients. Meanwhile, no study has been conducted with children under the same conditions. Across a sample with 49 participants, we investigated whether children and adolescents at high-risk (HR) for OCD (n=18) would present an impaired performance on neurocognitive domains compared to healthy controls (HC, n=31), especially in visuoconstructive ability, executive functions, and intellectual efficiency, functions previously associated with OCD. MethodsFor the HR group, we considered the first-degree children relatives of patients with OCD that present obsessive-compulsive symptoms (OCS), but do not meet diagnostic criteria for OCD. Child psychiatric diagnoses were assessed by the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) by experienced and trained psychologists and OCS were measured by Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). ResultsAlthough we did not find differences in the domains previously hypothesized, a Multivariate Analysis of Variance (MANOVA) revealed impairments in processing speed in HR group (p =0.019; F=3.115), and a t-test identified a higher IQ discrepancy in HR group when compared to HC (p =0.030; t =-2.239), and a discrepancy in verbal and non-verbal abilities as in the memory and working memory tasks. ConclusionsOur results suggest that differences in motor and processing speed and in IQ discrepancy are already present and were identified in a non-clinical sample of HR subjects. Further studies should investigate neurocognitive domains as possible predictors of pediatric OCD.

neuroscience↗

bioRxiv2019

White Matter Microstructure and its Relation to Clinical Features of Obsessive-Compulsive Disorder: Findings from the ENIGMA OCD Working Group

ImportanceMicrostructural alterations in cortico-subcortical connections are thought to be present in Obsessive-Compulsive Disorder (OCD). However, prior studies have yielded inconsistent findings, perhaps because small sample sizes provided insufficient power to detect subtle abnormalities. ObjectiveTo investigate microstructural white matter alterations and their relation to clinical features in the largest dataset of adult and pediatric OCD to date. Design, Setting, and ParticipantsIn this cross-sectional case-control magnetic resonance study, we investigated diffusion tensor imaging metrics from 700 adult patients and 645 adult controls, as well as 174 pediatric patients and 144 pediatric controls across 19 sites participating in the ENIGMA-OCD Working Group. Main Outcomes and MeasuresWe extracted measures of fractional anisotropy (FA) as main outcome, and mean diffusivity, radial diffusivity, and axial diffusivity as secondary outcomes for 25 white matter regions. We meta-analyzed patient-control group differences (Cohens d) across sites, after adjusting for age and sex, and investigated associations with clinical characteristics. ResultsAdult OCD patients showed significant FA reduction in the sagittal stratum (d=-0.21, z=-3.21, p=0.001) and posterior thalamic radiation (d=-0.26, z=-4.57, p<0.0001). In the sagittal stratum only, lower FA was associated with a younger age of onset (z=2.71, p=0.006), longer duration of illness (z=-2.086, p=0.036) and a higher percentage of medicated patients in the cohorts studied (z=-1.98, p=0.047). No significant association with symptom severity was found. Pediatric OCD patients did not show any detectable microstructural abnormalities compared to matched controls. Conclusions and RelevanceMicrostructural alterations in projection and association fibers to posterior brain regions were found in adult OCD, and related to disease course and medication status. Such results are relevant to models positing deficits in connectivity as a crucial mechanism in OCD. KEY POINTSO_ST_ABSQuestionC_ST_ABSDo patients with Obsessive-Compulsive Disorder (OCD) show white matter microstructural alterations, and are these alterations related to clinical features? FindingsData from 19 sites of the ENIGMA-OCD Consortium were included, involving 700 adult patients and 645 adult controls, 174 pediatric patients and 144 pediatric controls. Diffusion tensor imaging data were meta-analyzed using a harmonized data processing and analysis protocol. Adult, but not pediatric, patients showed alterations in the sagittal stratum and posterior thalamic radiation; sagittal stratum differences were associated with clinical features. MeaningMicrostructural abnormalities found in adult but not in the pediatric cohort, are related to illness duration and medication status.

neuroscience↗