• L Besiroglu, M Sozen, O Ozbebit, S Avcu, Y Selvi, A Bora, A Atli, O Unal, and M D Bulut.
• Department of Psychiatry, Yuzuncu Yil University, Van, Turkey. lbesiroglu@gmail.com
• Acta Psychiatr Scand. 2011 Aug 1; 124 (2): 141-51.

ObjectiveTo investigate the regional metabolite abnormalities and changes after treatment in patients with OCD with autogenous and reactive obsessions.MethodWe assessed right anterior cingulate cortex (ACC) and amygdala-hippocampal region (Am + Hpp) N-acetyl-aspartate (NAA), choline (Cho) and creatine (Cr) concentrations and NAA/Cr and Cho/Cr ratios using single-voxel proton magnetic resonance spectroscopy in 15 patients with autogenous obsessions (OCD-A), 15 patients with reactive obsessions (OCD-R) and 15 healthy controls (HC). Measurements were repeated after 16 weeks of fluoxetine treatment.ResultsBaseline ACC NAA/Cr ratios of both OCD groups were significantly lower than HC. OCD-A group had significantly lower baseline NAA/Cr ratios in the Am + Hpp than other groups. These differences were more likely to be explained by higher Cr levels in ACC. We found no significant differences and changes for Cho levels and Cho/Cr ratios between groups and within groups. Significant increase in NAA/Cr ratios of OCD-A group found in the Am + Hpp was more likely to be explained by increased NAA levels. No significant changes were found in ACC NAA/Cr ratios.ConclusionWhile disturbed energy metabolism in ACC might reflect a common pathology in patients with OCD regardless of symptom dimension, alterations in mesiotemporal lobe are more likely for autogenous obsessions.© 2011 John Wiley & Sons A/S.

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