J Psychiatry Neurosci 2015;40(4):232-240
Marta Subirà, MD; João R. Sato, PhD; Pino Alonso, MD, PhD; Maria C. do Rosário, MD, PhD; Cinto Segalàs, MD, PhD; Marcelo C. Batistuzzo, PhD; Eva Real, MD, PhD; Antonio C. Lopes MD, PhD; Ester Cerrillo, MD; Juliana B. Diniz, MD, PhD; Jesús Pujol, MD, PhD; Rachel O. Assis, MS; José M. Menchón, MD, PhD; Roseli G. Shavitt, MD, PhD; Geraldo F. Busatto, MD, PhD; Narcís Cardoner, MD, PhD; Euripedes C. Miguel, MD, PhD; Marcelo Q. Hoexter, MD, PhD; Carles Soriano-Mas, PhD
Background: Sensory phenomena (SP) are uncomfortable feelings, including bodily sensations, sense of inner tension, “just-right” perceptions, feelings of incompleteness, or “urge-only” phenomena, which have been described to precede, trigger or accompany repetitive behaviours in individuals with obsessive–compulsive disorder (OCD). Sensory phenomena are also observed in individuals with tic disorders, and previous research suggests that sensorimotor cortex abnormalities underpin the presence of SP in such patients. However, to our knowledge, no studies have assessed the neural correlates of SP in patients with OCD.
Methods: We assessed the presence of SP using the University of São Paulo Sensory Phenomena Scale in patients with OCD and healthy controls from specialized units in São Paulo, Brazil, and Barcelona, Spain. All participants underwent a structural magnetic resonance examination, and brain images were examined using DARTEL voxel-based morphometry. We evaluated grey matter volume differences between patients with and without SP and healthy controls within the sensorimotor and premotor cortices.
Results: We included 106 patients with OCD and 87 controls in our study. Patients with SP (67% of the sample) showed grey matter volume increases in the left sensorimotor cortex in comparison to patients without SP and bilateral sensorimotor cortex grey matter volume increases in comparison to controls. No differences were observed between patients without SP and controls.
Limitations: Most patients were medicated. Participant recruitment and image acquisition were performed in 2 different centres.
Conclusion: We have identified a structural correlate of SP in patients with OCD involving grey matter volume increases within the sensorimotor cortex; this finding is in agreement with those of tic disorder studies showing that abnormal activity and volume increases within this region are associated with the urges preceding tic onset.
Submitted May 5, 2014; Revised Sept. 12, 2014; Accepted Oct. 25, 2014; Early-released Feb. 3, 2015.
Acknowledgements: This study received financial support from the Carlos III Health Institute and the Agència de Gestió d’Ajuts Universitaris i de Recerca-AGAUR (Spain; grant nos. PI09/01331, CP10/00604, PI10/01753, PI12/01306, PI13/00918, PI13/01958, PI14/00413, CIBER-CB06/03/0034, 2014SGR1672), and from a grant of the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, Foundation for the Support of Research in the State of São Paulo, Brazil) to E. Miguel (2011/21357-9). E. Miguel has also received support from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, National Council for Scientific and Technological Development) (302463/2011-9). J. Sato is supported by grants from FAPESP (2013/10498-6 and 2013/00506-1). J. Diniz is supported by a postdoctoral scholarship from FAPESP (2011/00968- 0). R. Assis is supported by a scientific initiation scholarship from FAPESP (2013/22536-0). M. Hoexter is supported by a postdoctoral scholarship from FAPESP (2013/16864-4). M. Subirà and E. Cerrillo are supported by a predoctoral grant from IDIBELL (Bellvitge Biomedical Research Institute). C. Soriano-Mas is funded by a Miguel Servet contract from the Carlos III Health Institute (CP10/00604).
Affiliations: From the Psychiatry Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain (Soriano-Mas, Subirà, Alonso, Segalàs, Real, Cerrillo, Menchón, Cardoner); Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (Subirà, Alonso, Segalàs, Real, Menchón, Cardoner, Soriano-Mas); Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain (Subirà, Alonso, Menchón, Cardoner); Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil (Sato); Children and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil (do Rosário); Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil (Batistuzzo, Lopes, Diniz, Assis, Shavitt, Busatto, Miguel, Hoexter); MRI Research Unit, CRC Mar, Hospital del Mar, CIBERSAM-G21, Barcelona, Spain (Pujol); and the Department of Psychobiology and Methodology in Health Sciences, Autonomous University of Barcelona, Spain (Soriano-Mas).
Competing interests: None declared.
Contributors: M. Subirà, M. do Rosário, J. Menchón, G. Busatto, N. Cardoner, E. Miguel, M. Hoexter and C. Soriano-Mas designed the study. M. Subirà, P. Alonso, C. Segalàs, M. Batistuzzo, E. Real, A. Lopes, E. Cerrillo, J. Diniz, J. Pujol, R. Assis, J. Menchón, G. Busatto, E. Miguel, M. Hoexter and C. Soriano-Mas acquired the data, which M. Subirà, J. Sato, P. Alonso, C. Segalàs, E. Real, J. Menchón, R. Shavitt, N. Cardoner, M. Hoexter and C. Soriano-Mas analyzed. M. Subirà, M. do Rosário, M. Hoexter and C. Soriano-Mas wrote the article, which all authors reviewed and approved for publication.
Correspondence to: M. Hoexter, Department & Institute of Psychiatry, University of São Paulo Medical School, Rua Ovídio Pires de Campos, 785-3°andar Ala Norte-sala 9, São Paulo, Brazil, firstname.lastname@example.org, or C. Soriano-Mas, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain; email@example.com