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Increased Medial Thalamic Creatine-Phosphocreatine Found by Proton Magnetic Resonance Spectroscopy in Children With Obsessive-Compulsive Disorder Versus Major Depression and Healthy Controls

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

Joseph O'Neill, PhD

Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, CA

Ethan A. Smith, BS

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

Aileen Russell, BA

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

Janet M. Smith, BS

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

S. Preeya Banerjee, PhD

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

Rashmi Bhandari, PhD

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

Courtney Boyd, PhD

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

Michelle Rose, BA

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

Jennifer Ivey, MA

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

Perry F. Renshaw, MD, PhD

Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA

David R. Rosenberg, MD

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

Altered brain creatine-phosphocreatine levels might reflect changes in brain energy use and have been implicated in the pathogenesis of obsessive-compulsive disorder and major depressive disorder. We used proton magnetic resonance spectroscopy to measure absolute concentrations of creatine-phosphocreatine in the right and left medial thalami in 18 pediatric patients with major depressive disorder 9 to 17 years of age, 18 case-matched healthy controls, and 27 patients with obsessive-compulsive disorder 7 to 16 years old. The two patient groups were psychotropic drug naive and were not comorbid for the diagnosis of the comparison group. We found significantly increased left and right medial thalamic creatine-phosphocreatine concentrations in patients with obsessive-compulsive disorder compared with both healthy controls and patients with major depression. Creatine-phosphocreatine concentrations did not differ significantly between patients with major depression and healthy controls. Our data suggest that increased medial thalamic creatine-phosphocreatine concentrations in patients with untreated obsessive-compulsive disorder reflect altered energy use in the medial thalamus and might differentiate patients with obsessive-compulsive disorder from healthy controls and patients with major depression. Although these results must be considered preliminary, further study of the diagnostic specificity of creatine-phosphocreatine in obsessive-compulsive disorder is indicated. (J Child Neurol 2006;21:106—111; DOI 10.2310/7010.2006.00016).

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