Voxel-Based Morphometry Study of Gray Matter Abnormalities in Neurodegenerative Disease with Obsessive-Compulsive Behaviors / 정신신체의학

OBJECTIVES: Obsessive-compulsive(OC) symptoms have yet to be directly studied in neurodegenerative conditions involving behavioral changes. To examine regional abnormalities in the brains of dementia patients with OC symptoms, we assessed the gray matter density using voxel-based morphometry(VBM). METHODS: We performed brain magnetic resonance imaging(MRI) with VBM analysis in 106 dementia patients with OC behaviors. In this study, OC behaviors were investigated in patients with neurodegenerative disease using the modified Manchester Behavior Questionnaire. RESULTS: The OC behavior scores were correlated with structural brain volume using VBM. The total OC symptom score correlated negatively with the volume of both putamens, the right middle orbitofrontal gyrus, both anterior cingulate cortices, and the left insula(p<0.001, uncorrected). No gray matter reductions were associated specifically with the OC symptom sub-categories. CONCLUSIONS: Our results suggest that abnormalities in these brain regions may play an important role in the pathophysiology of OCD in neurodegenerative disease. This is the first lesion study to investigate the neural basis of OCD behaviors in neurodegenerative disease.

Voxel-Based Morphometry Study of Neurodegenerative Disease with Abnormal Eating Behaviors

OBJECTIVES: The abnormal eating behaviors are revealed in neurodegenerative disease, especially frontotemporal dementia. Several studies have demonstrated that structural changes are related to functional changes in regulation of feeding. But areas in determining eating disorder in dementia remain unclear. We applied voxel-based morphometry (VBM) to assess brain tissue abnormalities in neurodegenerative patients with abnormal eating behaviors. METHODS: We assessed abnormal eating behaviors of sixty three patients with dementia using the modified Manchester Behavior Questionnaire. Volumetric brain magnetic resonance imaging was performed in all patients and gray matter changes were assessed using VBM. RESULTS: Dementia patients with eating problems showed gray matter loss predominantly involving right insula, right anterior cingulate, right superior medial frontal cortex, right orbitofrontal cortex. Overeats scores were associated with atrophy of right anterior cingulate, right superior orbitofrontal cortex, right superior medial frontal cortex, right insula, and right putamen. CONCLUSION: This results suggest that right orbitofrontal cortex, insula, anterior cingulate, striatum regions integrate sensory and motivational information regarding food. The dementia patients with abnormal eating behaviors may be explained by disruption of this integrating system.