Cognitive Function And White Matter Microstructure In Patients With Obsessive-compulsive Disorder With Childhood Trauma

Objective: This study aimed to(1)understand the influence of childhood trauma(CT)on the cognitive function of patients with obsessive-compulsive disorder(OCD);(2)understand the effect of CT on the characteristics of the white matter(WM)microstructure of the brain in patients with OCD;(3)explore the relationship between childhood traumarelated white matter microstructural abnormalities and cognitive impairment in patients with OCD.Method: The participants consisted of 28 patients with childhood traumatic obsessive-compulsive disorder(CTOCD),30 patients without childhood traumatic obsessive-compulsive disorder(NCTOCD),27 healthy controls with childhood trauma(CTHC)and 34 healthy controls without childhood trauma(NCTHC).The Beck Depression Inventory and State-Trait Anxiety Inventory were used to assessing the participants’ depressive and anxiety symptoms,respectively.All participants completed a series of cognitive assessment,including Logical Memory and Visual Reproduction tests,Letter-Number Span Test,Sustained Attention Response Task,Verbal Fluency Task and The Chinese version of Dysexecutive Questionnaire.Two-way ANOVA was used to analyse the differences in both clinical data and cognitive function of every group.Head MRI scans were performed on every group of subjects to collect diffusion tensor imaging data,and the data were analysed by tract-based spatial statistics(TBSS)method.Twoway ANOVA was used to compare the differences in fractional anisotropy(FA),mean diffusivity(MD),radial diffusivity(RD),and axial diffusivity(AD)of brain WM fibres of each group.Pearson correlation analysis was used to investigate the relationship between abnormal changes in WM microstructure associated with childhood trauma and cognitive impairment in OCD patients.Results:(1)In terms of delayed logical memory,there was a significant interaction between CT and OCD diagnosis(p < 0.05),and simple effects analysis showed that the scores in delayed logical memory test of CTOCD patients(6.64 ± 3.55)were significantly lower than that of NCTOCD(10.43 ± 3.68)and CTHC(10.22 ± 3.90)groups.The scores of delayed logical memory test for OCD patients were significantly negatively correlated with the scores of Childhood Trauma Questionnaire(CTQ),emotional neglect,and physical neglect.(2)In terms of the FA index,there was a significant interaction between CT and OCD diagnosis in the body of corpus callosum and the left superior corona radiata(p < 0.05).The pairwise comparison showed that the FA values of the CTOCD group were all significantly lower than that of NCTOCD and the CTHC groups.In OCD patients,the FA index of the brain region in the interaction between CT and OCD diagnosis had a significant negative correlation with the scores of CTQ,emotional abuse,sexual abuse,and physical neglect,and a significant positive correlation with the scores of delayed logical memory(p < 0.05).However,no significant interaction between CT and OCD diagnosis in other indexes was found.Conclusion:(1)Childhood trauma can affect the memory function of patients with OCD,mainly in the aspect of delayed logical memory.Compared with NCTOCD patients,CTOCD group had impairments in delayed logical memory.(2)CT can affect the integrity of WM microstructure in patients with OCD,mainly manifested in the body of corpus callosum and the left superior corona radiata.Compared with NCTOCD patients,CTOCD group had abnormal changes in the integrity of WM fibres in the body of corpus callosum and left superior corona radiata.In OCD patients,cognitive impairment associated with CT may be related to the abnormal changes in WM microstructure.