Orbitofrontal Cortex Volumes in Patients Diagnosed with Somatic Symptom Disorder

Yıl 2023, Cilt: 5 Sayı: 1, 33 - 8, 15.01.2023

Burcu Sırlıer Emir , Murad Atmaca , Aslı Kazğan Kılıçaslan , Sevler Yıldız , Hanefi Yıldırım

https://doi.org/10.37990/medr.1161683

Öz

Aim: Somatic symptom disorder (SSD) is a psychiatric disorder with unknown etiopathogenesis that is still under investigation. The results of neuroimaging studies on SSD have shown that some brain regions may be associated with it. In this connection, this study aims to explore the orbitofrontal cortex (OFC) morphometric changes in patients with SSD to better comprehend the etiopathogenesis.
Material and Methods: The study enrolled 20 patients and 20 healthy controls. All study participants were administered a sociodemographic and clinical questionnaire, the Hamilton Depression Rating Scale (HAM-D) and the Hamilton Anxiety Rating Scale (HAM-A). The volumes of total brain, OFC, total white matter, and total gray matter were measured by a magnetic resonance imaging (MRI)-based method in studied patients.
Results: Orbitofrontal cortex volume was significantly smaller in the patient group than in healthy controls (p<0.05). No significant difference between the two groups could be observed in total brain, white matter and gray matter volumes (p>0.05).
Conclusions: The OFC was markedly smaller in SSD patients than in healthy controls, suggesting that the OFC may be associated with SSD pathophysiology. Future studies examining the functional features of the OFC using imaging and cognitive function tests will likely shed more light on this issue.

Anahtar Kelimeler

Somatic symptom disorder , volume , orbitofrontal cortex , MRI

Destekleyen Kurum

This study was financially supported by Scientific Research Appropriation of Fırat University (FÜBAP)

Proje Numarası

266

Kaynakça

• 1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5th ed. washington, DC: American Psychiatric Association; 2013
• 2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders 4th ed. text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association; 2000
• 3. Kurlansik SL, Maffei MS. Somatic Symptom Disorder. Am Fam Physician. 2016;93:49-54.
• 4. Yates WR, Dunayevich E. Somatic symptom disorders. http://emedicine.medscape.com/article/294908-over view, accessed date August 5, 2014
• 5. Guggenheim FG. Somatoform disorders. Sadock BJ, Sadock VA (editors). Comprehensive Textbook of Psychiatry. 7 th Edition, Baltimore: Williams Wilkins 2000:1504-32.
• 6. Hakala M, Karlsson H, Kurki T, et al. Volumes of the caudat nuclei in women with somatization disorder and healthy women. Psychiatry Res. 2004;131:70-1.
• 7. Atmaca M, Sırlıer B, Yıldırım H, Kayalı A. Hipocampus and amigdalar volumes in patients with somatization. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35:1699-703.
• 8. Yoshino A, Okamoto Y, Kunisato Y, et al. Distinctive spontaneous regional neural activity in patients with somatoform pain disorder: a preliminary resting-state fMRI study. Psychiatry Research. 2014;221:246–8.
• 9. de Greck M, Scheidt L, Bolter AF, et al. Altered brain activity during emotional empathy in somatoform disorder. Hum Brain Mapp. 2012;33:2666–85.
• 10. Li Q, Xiao Y, Li Y, et al. Altered regional brain function in the treatment‐naive patients with somatic symptom disorder: a resting‐state fMRI study. Brain Behav. 2016;6:e00521.
• 11. Atmaca M, Seç S, Yildirim H, et al. A Volumetric MRI analysis of hypochondriac patients. Bulletin of Clinical Psychopharmacology. 2010;20:293-9.
• 12. Atmaca M, Bingöl İ, Aydın A, et al. Brain morphology of patients with body dysmorphic disorder. J Affect Disord. 2010;123:258-63.
• 13. Kent JM, Coplan JD, Mawlawi O, et al. Prediction of panic response to a respiratory stimulant by reduced orbitofrontal cerebral blood flow in panic disorder. Am J Psychiatry. 2005;162:1379-81. 14. Rastam M, Bjure J, Vestergren E. Regional cerebral blood flow in weight-restored anorexia nervosa: a preliminary study. Dev Med Child Neurol. 2001;43:239-42.
• 15. Szeszko PR, MacMillan S, McMeniman M, et al. Amygdala volume reductions in pediatric patients with obsessive-compulsive disorder treated with paroxetine preliminary findings. NPP. 2004;29:826-32.
• 16. Konnopka A, Schaefert R, Heinrich S, et al. Economics of medically unexplained symptoms: a systematic review of the literature. Psychother Psychosom. 2012;81:265–75.
• 17. Hamilton M. A rating scale for depression. J Neurosurg Psychiatry. 1960;23:56-62.
• 18. Hamilton M. The assesment of anxiety states by rating. Br J Med Psychol. 1959;32:50-5.
• 19. Faul F, Erdfelder E, LangAG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res. Methods. 2007;39:175–91.
• 20. Kim JJ, Lee MC, Kim J, et al. Graymatter abnormalities in obsessive–compulsive disorder: statistical parametric mapping of segmented magnetic resonance images. Br J Psychiatry. 2001;179:330–4.
• 21. Atmaca M, Yıldırım H, Ozdemir H, et al. Volumetric MRI assessment of brain regions in patients with refractory obsessive–compulsive disorder: Progress in Neuro-Psychopharmacol Biol Psychiatry. 2006;30:1051-7.
• 22. Rossetti M G, Delvecchio G, Calati R, et al. Structural neuroimaging of somatoform disorders: A systematic review. Neuroscience & Biobehavioral Reviews. 2021;122:66-78.
• 23. Valet M, Gündel H, Sprenger T, et al. Patients with pain disorder show gray-matter loss in pain-processing structures: a voxel-based morphometric study. Psychosomatic Medicine. 2009;71:49-56.
• 24. Perez DL, Barsky AJ, Vago DR, et al. A neural circuit framework for somatosensory amplification in somatoform disorders. J Neuropsychiatry Clin Neurosci. 2015;27:40–50.
• 25. Köroğlu E, Güleç C. Basic Book of Psychiatry. Second Edition, Ankara: HYB Publishing. 2007:370-4.
• 26. Su Q, Yao D, Jiang M, at al. Dissociation of regional activity in default mode network in medication-naive, first-episode somatization disorder. PLoS One. 2014;9:e99273
• 27. Mainio A, Hakko H, Niemela A, et al. Somatization symptoms are related to right-hemispheric primary brain tumor: a population-based prospective study of tumor patients in northern finland. Psychosomatics. 2009;50:331–5.
• 28. Hollander E, Wong CM. Body dysmorphic disorder, pathological gambling, and sexual compulsions. J Clin Psychiatry. 1995;56:7-12.
• 29. Coffey CE, Wilkinson WE, Weiner RD, et al. Quantitative cerebral anatomy in depression. A controlled magnetic resonance imaging study. Arch Gen Psychiatry. 1993;50:7-16.
• 30. Öztürk E, Aydın H. Neuroanatomical Related to Depression Studies. Mood Sequence. 2001;3:126-31.
• 31. Koolschijn PC, Haren NE, Lensvelt-Mulders GJ, et al. Brain volume abnormalities in major depressive disorder: a meta-analysis of magnetic resonance imaging studies. Hum Brain Mapp. 2009;30:3719-35.