Abnormality Of Gray And White Matter In Young Man With Obsessive-compulsive Personality Disorder:a MRI Study

Objective: The purpose of this study is to identify the difference of brain microstructure between young man with obsessive-compulsive personality disorder(OCPD)and matched healthy control group(HC).Participants: With informed consent,2,000 male volunteers from a university were recruited and screened with "Personality Disorders Diagnostic Questionnaire(PDQ-4+)" and "Edinburgh Handy Questionnaire(EHI)".43 right-hand Youth man with higher OCPD scores were selected.The SCID-II-PD was applied to reevaluated the higher score patients.And then 2 psychiatric experts carried out clinical review and made diagnosis according to DSM-5 criteria.The MMPI-566 was used to exclude other comorbidities mental diseases.Finally,20 OCPD patients entered the experimental group of Magnetic Resonance Scanning.In the HC group,20 healthy students were matched with the study group in age,sex and education level,and were evaluated by MMPI-566 to except mental problem.Methods: 40 participants received magnetic resonance scanning by German Siemens Verio 3.0T equipment in X-ray center affiliated to one hospital.In OCPD,4 person were excluded due to ghost shadow and 1 person were excluded due to white matter lesions.Finally,15 participants from each group met the data processing standard.White matter data of diffusion tensor imaging(DTI)are processed by Tract-based spatial statistics(TBSS)based on fiber bundle tracking,and to find the differ regions in fractional anisotropy(FA),mean diffusivity(MD),radial diffusivity(RD)and axial diffusivity(AD)of white matter fibers between the OCPD and the HC group.The gray matter volume were processed by voxel-based morphometry(VBM)to identify the volume differences between the two groups.In addition,Pearson correlation analysis was carried out between the gray and white matter index and the total scores of Interaction Anxiousness Scale(IAS)and Interpersonal Relationship Scale(IRS).Results: 1.Abnormal cerebral regions of the white matter fiber between the OCPD and HC groups: Compared with HC group,FA value of white matter fiber in anterior corona radiate,external capsule,uncinate fasciculus,Fornix(cres)/ Stria terminalis,and genu of corpus callosum in right brain in OCPD group are significantly reduced;The RD values of anterior and posterior corona radiate,corpus callosum(body,splenium and genu),retrolenticular part of internal capsule,posterior thalamic radiation,cingulum,superior longitudinal fasciculus and sagittal stratum(inferior longitudinal fasciculus and inferior frontal-occipital fasciculus)in the left brain are significantly increased(p<0.05).The AD values of anterior and posterior corona radiate,posterior thalamic radiation,external capsule,and sagittal stratum(inferior longitudinal fasciculus and inferior frontal-occipital fasciculus)in the right brain tend to decrease(p = 0.094).There are no significant difference in MD between the two groups.2.Abnormal cerebral regions of the gray matter volume between the OCPD and HC groups: compared with HC group,the volume of gray matter in the right cerebelum and cerebelum crus,right lingual gyrus,right inferior occipital gyrus,right superior occipital gyrus,left thalamus and left caudate nucleus in OCPD group increased(p<0.05),while the volume in right superior temporal gyrus,opercular part of inferior frontal gyrus,and right hippocampus gyrus decreased significantly(p<0.05).3.FA values of right anterior corona radiate,right external capsule,right uncinate fasciculus and right fornix(cres)are significantly negatively correlated with the total score of IAS(p<0.05),RD values of genu and body of corpus callosum,left anterior corona radiate,and left cingulum were significantly positively correlated with the total score of IRS(p<0.05).Conclusion: Compared with HC,OCPD patients have significantly increased gray matter volume in cerebellum and occipital lobe in the right brain,in thalamus and caudate nucleus in the left brain,while decreased gray matter volume in inferior temporal gyrus,opercular part of inferior frontal gyrus and hippocampus in the right brain.Moreover,The integrity of white matter fibers in the right brain is damaged,such as external capsule,uncinate fasciculus,corpus callosum and corona radiate,which are synergistic changes with the gray matter structural abnormality in our study.We found abnormal gray and white matter structural changes mainly in the nerve circles of "prefronto-striato-thalamo-cortical"(PSTC),"prefronto-insula-temporo-occipital" and "prefronto-limbic system".In addition,interaction anxiousness experience of OCPD patients may be related to the impairment of fiber integrity of anterior corona radiate,external capsule,uncinate fasciculus and stria terminalis;and interpersonal relationship disturbance is related to demyelination of the fiber include genu and body of corpus callosum,left anterior corona radiate and left cingulum.