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Increased Medial Thalamic Choline in Pediatric Obsessive-Compulsive Disorder as Detected by Quantitative in Vivo Spectroscopic Imaging

Departments of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine Detroit, MI, drosen{at}med.wayne.edu, Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI

Akua Amponsah, BS

Departments of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine Detroit, MI

April Sullivan, BA

Departments of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine Detroit, MI

Shauna MacMillan, BS

Departments of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine Detroit, MI

Gregory J. Moore, PhD

Departments of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine Detroit, MI, Department of Radiology, Wayne State University School of Medicine, Detroit, MI

The thalamus has been implicated in the pathophysiology of obsessive-compulsive disorder. Using a multislice spectroscopic imaging sequence, we reported reductions in right and left medial thalamic N-acetylaspartate/cytosolic choline + creatine/phosphocreatine and N-acetylaspartate/cytosolic choline levels in 11 pediatric patients with obsessive-compulsive disorder, 8 to 15 years, versus 11 case-matched healthy controls. These changes may reflect a change in N-acetylaspartate, cytosolic choline, or creatine concentrations. Therefore, using a validated phantom replacement methodology, we obtained absolute measures (mmol/L) of N-acetylaspartate, a putative marker of neuronal viability, cytosolic choline, and creatine in these subjects. A significant increase in cytosolic choline was observed in right and left medial but not lateral thalami in patients with obsessive-compulsive disorder versus controls. N-acetylaspartate and creatine did not differ significantly between case-control pairs in the medial or lateral thalamus. These findings provide new evidence of cytosolic choline abnormalities in the thalamus in pediatric obsessive-compulsive disorder. (J Child Neurol 2001;16:636-641).

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