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Amygdala volume
reductions in pediatric patients with obsessive-compulsive disorder
treated with paroxetine: preliminary
findings.
Szeszko PR, MacMillan S, McMeniman M,
Lorch E, Madden R, Ivey J, Banerjee SP, Moore GJ, Rosenberg
DR.
Department of Psychiatry Research, Zucker Hillside
Hospital, North Shore - Long Island Jewish Health System, Glen Oaks, NY
11004, USA. szeszko@lij.edu
The amygdala is believed to be highly
relevant to the pathophysiology of obsessive-compulsive disorder (OCD)
given its prominent role in fear conditioning and because it is an
important target of the serotonin reuptake inhibitors (SRIs), the
pharmacotherapy of choice for OCD. In the present study, we measured in
vivo volumetric changes in the amygdala in pediatric patients with OCD
following 16 weeks of monotherapy with the selective SRI, paroxetine
hydrochloride. Amygdala volumes were computed from contiguous 1.5 mm
magnetic resonance (MR) images in 11 psychotropic drug-naive patients
with OCD prior to and then following treatment. Eleven healthy pediatric
comparison subjects also had baseline and follow-up scans, but none of
these subjects received medication. Patients demonstrated significant
asymmetry of the amygdala (L>R) prior to pharmacologic intervention
in contrast to healthy comparison subjects who showed no asymmetry at
the time of their baseline scan. Mixed model analyses using age and
total brain volume as time varying covariates indicated that left
amygdala volume decreased significantly in patients following treatment.
The reduction in left amygdala volume in patients correlated
significantly with higher paroxetine dosage at the time of the follow-up
scan and total cumulative paroxetine exposure between the scans. No
significant changes in either right or left amygdala volume were evident
among healthy comparison subjects from the baseline to the follow-up
scan. These preliminary findings suggest that abnormal asymmetry of the
amygdala may play a role in the pathogenesis of OCD and that paroxetine
treatment may be associated with a reduction in amygdala
volume.
Publication Types:
PMID: 14970831 [PubMed - indexed for
MEDLINE]
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