Clinical correlates of nucleus accumbens volume in drug-naïve, adult patients with obsessive–compulsive disorder. (October 2013)

• Record Type: Journal Article
• Authors: Narayanaswamy, Janardhanan C; Jose, Dania; Kalmady, Sunil; Venkatasubramanian, Ganesan; Reddy, YC Janardhan
• Is Part Of: Australian and New Zealand journal of psychiatry. Volume 47:Number 10(2013)
• Page Start: 930
• Page End: 937
• Publication Date: 2013-10
• Subjects: Nucleus accumbens -- obsessive compulsive disorder -- reward pathway; Psychiatry -- Periodicals; Psychiatry -- Australia -- Periodicals; Psychiatry -- New Zealand -- Periodicals; 616.89005
• DOI: 10.1177/0004867413491153
• Languages: English
• ISSNs: 0004-8674

Abstract

Background: Reward-processing deficits have been demonstrated in obsessive–compulsive disorder (OCD) and this has been linked to ventral striatal abnormalities. However, volumetric abnormalities of the nucleus accumbens (NAcc), a key structure in the reward pathway, have not been examined in OCD. We report on the volumetric abnormalities of NAcc and its correlation with illness severity in drug-naïve, adult patients with OCD. Method: In this cross-sectional study of case–control design, the magnetic resonance imaging (MRI) 1.5-T (1-mm) volume of NAcc was measured using 3D Slicer software in drug-naïve OCD patients ( n = 44) and age, sex and handedness-matched healthy controls (HCs) ( n = 36) using a valid and reliable method. OCD symptoms were assessed using the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) Symptom checklist and severity and the Clinical Global Impression-Severity (CGI-S) scale. Results: There was no significant difference in NAcc volumes on either side between OCD patients and HCs ( F = 3.45, p = 0.07). However, there was significant negative correlation between the right NAcc volume and Y-BOCS compulsion score ( r = −0.48, p = 0.001). Conclusions: Study observations suggest involvement of the NAcc in the pathogenesis of OCD, indicating potential reward-processing deficits. Correlation between the right NAcc volume deficit and severity of compulsions offers further support for this region as a candidate for deep brain stimulation treatment in OCD.