MILD WHITE MATTER CHANGES IN UN-MEDICATED OBSESSIVE-COMPULSIVE DISORDER PATIENTS AND THEIR UNAFFECTED SIBLINGS

Objective Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disorder with moderate genetic influences and white matter (WM) abnormalities in frontal-striatal and limbic regions. Inconsistencies in reported WM results from diffusion tensor imaging (DTI) studies can be explained, at least partly, by medication use and between-group differences in disease profile and stage. We used a family design aiming to establish whether WM abnormalities, if present in un-medicated OCD patients, also exist in their unaffected siblings. Method Forty-four un-medicated OCD patients, 15 of their unaffected siblings and 37 healthy controls (HC) underwent DTI using a 3-Tesla MRI-scanner. Data analysis was done using tract-based spatial statistics (TBSS). Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) values were compared within seven skeletonised regions of interest (ROIs), i.e., corpus callosum (CC), bilateral cingulum bundle (CB), bilateral inferior longitudinal fasciculus/frontal-occipital fasciculus (ILF/FOF) and bilateral superior longitudinal fasciculus (SLF). Results Un-medicated OCD patients, compared with HC, had significantly lower FA in the left CB. FA was trend-significantly lower in all other ROIs, except for the CC. Significant three-group differences in FA (and in RD at trend-significant level) were observed in the left CB, with the unaffected siblings representing an intermediate group between OCD patients and HC. Conclusions OCD patients showed lower FA in the left CB, partly driven by trend-significantly higher values in RD. Since the unaffected siblings were found to be an intermediate group between OCD patients and HC, this WM alteration may be considered an endophenotype for OCD.