Correlates of N-acetylaspartate and Cognitive Dysfunctions in Drug-naive Patients with Obsessive-compulsive Disorder: A Proton MRSI Study.
- Author:
Joon Hwan JANG
1
;
Dong Pyo JANG
;
Won Jin MOON
;
Jong Min LEE
;
Hee Soo PARK
;
Tae Hyun HA
;
Eun Chul CHUNG
;
In Young KIM
;
Sun I KIM
;
Jun Soo KWON
Author Information
1. Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea. kwonjs@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Obsessive-compulsive disorder;
Magnetic resonance spectroscopy;
N-acetylaspartate
- MeSH:
Brain;
Diagnostic and Statistical Manual of Mental Disorders;
Humans;
Magnetic Resonance Imaging;
Magnetic Resonance Spectroscopy;
Neurons;
Obsessive-Compulsive Disorder*;
Protons*;
Rabeprazole
- From:Journal of Korean Neuropsychiatric Association
2004;43(6):719-725
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: Reductions of N-acetylaspartate (NAA), a putative marker of neuronal viability, within the subcortical structures in patients with obsessive-compulsive disorder (OCD) are well documented. However, there has been no report of the NAA level in cortical structures. The authors used proton magnetic resonance spectroscopic imaging (1H-MRSI) to assess potential reductions of NAA in the frontal white matter, prefrontal gray matter, parietal gray and white matter, and the cingulate in drugnaive patients with OCD and explored the relationship between the brain metabolites and the degree to the dysfunction on the neuropsychological performances. METHODS : Thirteen drug-naive patients who met DSM-IV criteria for OCD and 13 healthy age-, sex-, handness- matched control subjects were studied. Subjects underwent MRI and 1H-MRSI and the peaks of NAA, creatine+phosphocreatine (Cr), and choline-containing compounds (Cho) were measured. Differences between patients and control subjects were tested for each metabolite ratio, and the relations between metabolite ratios and clinical symptoms, neuropsychological performances were examined. RESULTS : Upon comparison with normal controls, NAA/Cr ratio was significantly reduced in patients for the prefrontal gray matter, frontal white matter and anterior cingulate. There was no difference in Cho/Cr or NAA/Cho in any region. Also, a significant positive correlation was found between prefrontal NAA/Cr ratio and the delayed recall score of the Rey-Osterrieth Complex Figure Test in patients with OCD. CONCLUSION : The reduced NAA/Cr ratio in the prefrontal gray matter and frontal white matter suggests that OCD patients have lower neuronal viability than normal comparisons and it may be related to impaired organizational strategies in patients with OCD. These results support a role for the frontal-subcortical circuitry in a neurobiologic model of OCD.
