Marta Subirà1, João R Sato2, Pino Alonso1, Maria C do Rosário3, Cinto Segalàs4, Marcelo C Batistuzzo5, Eva Real4, Antonio C Lopes5, Ester Cerrillo6, Juliana B Diniz5, Jesús Pujol7, Rachel O Assis5, José M Menchón1, Roseli G Shavitt5, Geraldo F Busatto5, Narcís Cardoner1, Euripedes C Miguel5, Marcelo Q Hoexter5, Carles Soriano-Mas8. 1. Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL); Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); and Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain. 2. Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil. 3. Children and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil. 4. Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL); and Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain. 5. Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. 6. Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain. 7. MRI Research Unit, CRC Mar, Hospital del Mar, CIBERSAM-G21, Barcelona, Spain. 8. Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL); Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM); and Department of Psychobiology and Methodology in Health Sciences, Autonomous University of Barcelona, Spain.
Abstract
BACKGROUND: Sensory phenomena (SP) are uncomfortable feelings, including bodily sensations, sense of inner tension, "just-right" perceptions, feelings of incompleteness, or "urge-only" phenomena, which have been described to precede, trigger or accompany repetitive behaviours in individuals with obsessive-compulsive disorder (OCD). Sensory phenomena are also observed in individuals with tic disorders, and previous research suggests that sensorimotor cortex abnormalities underpin the presence of SP in such patients. However, to our knowledge, no studies have assessed the neural correlates of SP in patients with OCD. METHODS: We assessed the presence of SP using the University of São Paulo Sensory Phenomena Scale in patients with OCD and healthy controls from specialized units in São Paulo, Brazil, and Barcelona, Spain. All participants underwent a structural magnetic resonance examination, and brain images were examined using DARTEL voxel-based morphometry. We evaluated grey matter volume differences between patients with and without SP and healthy controls within the sensorimotor and premotor cortices. RESULTS: We included 106 patients with OCD and 87 controls in our study. Patients with SP (67% of the sample) showed grey matter volume increases in the left sensorimotor cortex in comparison to patients without SP and bilateral sensorimotor cortex grey matter volume increases in comparison to controls. No differences were observed between patients without SP and controls. LIMITATIONS: Most patients were medicated. Participant recruitment and image acquisition were performed in 2 different centres. CONCLUSION: We have identified a structural correlate of SP in patients with OCD involving grey matter volume increases within the sensorimotor cortex; this finding is in agreement with those of tic disorder studies showing that abnormal activity and volume increases within this region are associated with the urges preceding tic onset.
BACKGROUND: Sensory phenomena (SP) are uncomfortable feelings, including bodily sensations, sense of inner tension, "just-right" perceptions, feelings of incompleteness, or "urge-only" phenomena, which have been described to precede, trigger or accompany repetitive behaviours in individuals with obsessive-compulsive disorder (OCD). Sensory phenomena are also observed in individuals with tic disorders, and previous research suggests that sensorimotor cortex abnormalities underpin the presence of SP in such patients. However, to our knowledge, no studies have assessed the neural correlates of SP in patients with OCD. METHODS: We assessed the presence of SP using the University of São Paulo Sensory Phenomena Scale in patients with OCD and healthy controls from specialized units in São Paulo, Brazil, and Barcelona, Spain. All participants underwent a structural magnetic resonance examination, and brain images were examined using DARTEL voxel-based morphometry. We evaluated grey matter volume differences between patients with and without SP and healthy controls within the sensorimotor and premotor cortices. RESULTS: We included 106 patients with OCD and 87 controls in our study. Patients with SP (67% of the sample) showed grey matter volume increases in the left sensorimotor cortex in comparison to patients without SP and bilateral sensorimotor cortex grey matter volume increases in comparison to controls. No differences were observed between patients without SP and controls. LIMITATIONS: Most patients were medicated. Participant recruitment and image acquisition were performed in 2 different centres. CONCLUSION: We have identified a structural correlate of SP in patients with OCD involving grey matter volume increases within the sensorimotor cortex; this finding is in agreement with those of tic disorder studies showing that abnormal activity and volume increases within this region are associated with the urges preceding tic onset.
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