Cerebral glucose metabolism in obsessive-compulsive hoarding

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Compulsive hoarding is a complex condition often associated with obsessive-compulsive disorder (OCD).
• Hoarding symptoms are linked to indecisiveness, disorganization, and poor treatment response.
• Identifying specific neurobiological markers is crucial for understanding hoarding.

Purpose of the Study:

• To investigate cerebral metabolic patterns in patients with compulsive hoarding syndrome.
• To differentiate hoarding-related metabolic activity from general OCD and healthy controls.
• To utilize positron emission tomography (PET) for regional glucose metabolism assessment.

Main Methods:

• Positron emission tomography (PET) scans using [(18)F]Fluorodeoxyglucose were performed.
• 45 adult subjects with DSM-IV criteria for OCD were studied (12 with prominent hoarding).
• 17 healthy subjects served as controls; all participants were medication-free for at least 4 weeks.

Main Results:

• Compulsive hoarders showed significantly lower glucose metabolism in the posterior cingulate gyrus and cuneus compared to controls.
• Non-hoarding OCD patients had higher metabolism in the bilateral thalamus and caudate versus controls.
• Hoarders exhibited lower dorsal anterior cingulate gyrus metabolism than non-hoarding OCD patients; this correlated negatively with hoarding severity.

Conclusions:

• Obsessive-compulsive hoarding presents a distinct cerebral metabolic pattern compared to non-hoarding OCD and controls.
• Compulsive hoarding may represent a neurobiologically distinct subtype of OCD.
• Reduced cingulate cortex activity might underlie hoarding symptoms and treatment resistance.