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Philip R. Szeszko, PhD; Delbert Robinson, MD; Jose Ma. J. Alvir, DrPH; Robert M. Bilder, PhD; Todd Lencz, PhD; Manzar Ashtari, PhD; Houwei Wu, MD; Bernhard Bogerts, MD

Arch Gen Psychiatry. 1999;56:913-919.

Background  Functional neuroimaging studies have implicated the frontal lobes and the hippocampus-amygdala complex in the pathophysiology of obsessive-compulsive disorder (OCD). These brain regions have not been well investigated in patients with OCD, however, using magnetic resonance imaging.

Methods  Volumes of the superior frontal gyrus, anterior cingulate gyrus, orbital frontal region, hippocampus, and amygdala were computed from contiguous magnetic resonance images in a sample of 26 patients with OCD and 26 healthy comparison subjects.

Results  Patients with OCD had significantly reduced bilateral orbital frontal and amygdala volumes compared with healthy comparison subjects and lacked the normal hemispheric asymmetry of the hippocampus-amygdala complex. Neither brain structure volumes nor asymmetry indices were significantly correlated with total illness duration or length of current OCD episode.

Conclusions  Findings of reduced orbital frontal and amygdala volumes in patients implicate a structural abnormality of these brain regions in the pathophysiology of OCD. Absence of the normal hemispheric asymmetry of the hippocampus-amygdala complex in patients is consistent with an anomalous neurodevelopmental process.

From the Department of Psychiatry Research, Hillside Hospital, North-Shore Long Island Jewish Health System, Glen Oaks, NY (Drs Szeszko, Robinson, Alvir, Bilder, Lencz, and Wu), Albert Einstein College of Medicine, Bronx, NY (Drs Szeszko, Robinson, Alvir, Bilder, and Wu); Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY (Dr Bilder); Department of Radiology, North-Shore Long Island Jewish Health System, New Hyde Park, NY (Dr Ashtari); and the Department of Psychiatry, University of Magdeburg, Magdeburg, Germany (Dr Bogerts).

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