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Grey matter abnormalities in trichotillomania: morphometric magnetic resonance imaging study

  • Samuel R. Chamberlain (a1), Lara A. Menzies (a2), Naomi A. Fineberg (a3), Natalia del Campo (a3), John Suckling (a2), Kevin Craig (a3), Ulrich Müller (a3), Trevor W. Robbins (a4), Edward T. Bullmore (a2) and Barbara J. Sahakian (a1)...
Abstract
Background

Trichotillomania (repetitive hair-pulling) is an Axis I psychiatric disorder whose neurobiological basis is incompletely understood. Whole-brain trichotillomania neuroimaging studies are lacking.

Aims

To investigate grey and white matter abnormalities over the whole brain in patients with trichotillomania.

Method

Eighteen patients with DSM–IV trichotillomania and 19 healthy controls undertook structural magnetic resonance imaging after providing written informed consent. Differences in grey and white matter were investigated using computational morphometry.

Results

Patients with trichotillomania showed increased grey matter densities in the left striatum, left amygdalo-hippocampal formation, and multiple (including cingulate, supplementary motor, and frontal) cortical regions bilaterally.

Conclusions

Trichotillomania was associated with structural grey matter changes in neural circuitry implicated in habit learning, cognition and affect regulation. These findings inform animal models of the disorder and highlight key regions of interest for future translational research.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (http://creativecommons.org/licenses/by-nc/4.0/), which permits noncommercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Corresponding author
Correspondence: Samuel R. Chamberlain, Department of Psychiatry, University of Cambridge, Box 189, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK. Email: srchamb@gmail.com
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Declaration of Interest

None.

Funding detailed in Acknowledgements.

Footnotes
References
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1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn, text revised) (DSM–IV–TR). APA, 2000.
2 Cohen, LJ, Stein, DJ, Simeon, D, Spadaccini, E, Rosen, J, Aronowitz, B, Hollander, E. Clinical profile, comorbidity, and treatment history in 123 hair pullers: a survey study. J Clin Psychiatry 1995; 56: 319–26.
3 Christenson, GA, Pyle, RL, Mitchell, JE. Estimated lifetime prevalence of trichotillomania in college students. J Clin Psychiatry 1991; 52: 415–7.
4 Stein, DJ, Simeon, D, Cohen, LJ, Hollander, E. Trichotillomania and obsessive-compulsive disorder. J Clin Psychiatry 1995; 56(suppl 4): 2834.
5 Chamberlain, SR, Menzies, L, Sahakian, BJ, Fineberg, NA. Lifting the veil on trichotillomania. Am J Psychiatry 2007; 164: 568–74.
6 Singer, HS, Minzer, K. Neurobiology of Tourette's syndrome: concepts of neuroanatomic localization and neurochemical abnormalities. Brain Dev 2003; 25 (suppl 1): s7084.
7 Greer, JM, Capecchi, MR. Hoxb8 is required for normal grooming behavior in mice. Neuron 2002; 33: 2334.
8 Welch, JM, Lu, J, Rodriguiz, RM, Trotta, NC, Peca, J, Ding, JD, Feliciano, C, Chen, M, Adams, JP, Luo, J, Dudek, SM, Weinberg, RJ, Calakos, N, Wetsel, WC, Feng, G. Cortico-striatal synaptic defects and OCD-like behaviours in Sapap3-mutant mice. Nature 2007; 448: 894900.
9 Menzies, L, Chamberlain, SR, Laird, AR, Thelen, SM, Sahakian, BJ, Bullmore, ET. Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisited. Neurosci Biobehav Rev 2008; 32: 525–49.
10 Menzies, L, Achard, S, Chamberlain, SR, Fineberg, N, Chen, CH, del Campo, N, Sahakian, BJ, Robbins, TW, Bullmore, E. Neurocognitive endophenotypes of obsessive-compulsive disorder. Brain 2007; 130: 3223–36.
11 O'Sullivan, RL, Rauch, SL, Breiter, HC, Grachev, ID, Baer, L, Kennedy, DN, Keuthen, NJ, Savage, CR, Manzo, PA, Caviness, VS, Jenike, MA. Reduced basal ganglia volumes in trichotillomania measured via morphometric magnetic resonance imaging. Biol Psychiatry 1997; 42: 3945.
12 Stein, DJ, Coetzer, R, Lee, M, Davids, B, Bouwer, C. Magnetic resonance brain imaging in women with obsessive-compulsive disorder and trichotillomania. Psychiatry Res 1997; 74: 177–82.
13 Keuthen, NJ, Makris, N, Schlerf, JE, Martis, B, Savage, CR, McMullin, K, Seidman, LJ, Schmahmann, JD, Kennedy, DN, Hodge, SM, Rauch, SL. Evidence for reduced cerebellar volumes in trichotillomania. Biol Psychiatry 2007; 61: 374–81.
14 Grachev, ID. MRI-based morphometric topographic parcellation of human neocortex in trichotillomania. Psychiatry Clin Neurosci 1997; 51: 315–21.
15 Bullmore, ET, Suckling, J, Overmeyer, S, Rabe-Hesketh, S, Taylor, E, Brammer, MJ. Global, voxel, and cluster tests, by theory and permutation, for a difference between two groups of structural MR images of the brain. IEEE Trans Med Imaging 1999; 18: 3242.
16 Suckling, J, Bullmore, E. Permutation tests for factorially designed neuroimaging experiments. Hum Brain Mapp 2004; 22: 193205.
17 Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM–IV and ICD–10. J Clin Psychiatry 1998; 59(suppl 20): 2233.
18 Montgomery, SA, Asberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382–9.
19 Goodman, WK, Price, LH, Rasmussen, SA, Mazure, C, Fleischmann, RL, Hill, CL, Heninger, GR, Charney, DS. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry 1989; 46: 1006–11.
20 Nelson, HE. National Adult Reading Test (NART): Test Manual. nfer-Nelson, 1982.
21 Keuthen, NJ, O'Sullivan, RL, Ricciardi, JN, Shera, D, Savage, CR, Borgmann, AS, Jenike, MA, Baer, L. The Massachusetts General Hospital (MGH) Hairpulling Scale: 1. development and factor analyses. Psychother Psychosom 1995; 64: 141–5.
22 Smith, SM. Fast robust automated brain extraction. Hum Brain Mapp 2002; 17: 143–55.
23 Zhang, Y, Brady, M, Smith, S. Segmentation of brain MR images through a hidden Markov random field model and the expectation-maximization algorithm. IEEE Trans Med Imaging 2001; 20: 4557.
24 Jenkinson, M, Bannister, P, Brady, M, Smith, S. Improved optimization for the robust and accurate linear registration and motion correction of brain images. Neuroimage 2002; 17: 825–41.
25 Smith, SM, Jenkinson, M, Woolrich, MW, Beckmann, CF, Behrens, TE, Johansen-Berg, H, Bannister, PR, De Luca, M, Drobnjak, I, Flitney, DE, Niazy, RK, Saunders, J, Vickers, J, Zhang, Y, De Stefano, N, Brady, JM, Matthews, PM. Advances in functional and structural MR image analysis and implementation as FSL. Neuroimage 2004; 23 (suppl 1): s20819.
26 Pantelis, C, Velakoulis, D, McGorry, PD, Wood, SJ, Suckling, J, Phillips, LJ, Yung, AR, Bullmore, ET, Brewer, W, Soulsby, B, Desmond, P, McGuire, PK. Neuroanatomical abnormalities before and after onset of psychosis: a cross-sectional and longitudinal MRI comparison. Lancet 2003; 361: 281–8.
27 Tzourio-Mazoyer, N, Landeau, B, Papathanassiou, D, Crivello, F, Etard, O, Delcroix, N, Mazoyer, B, Joliot, M. Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage 2002; 15: 273–89.
28 Kim, JJ, Lee, MC, Kim, J, Kim, IY, Kim, SI, Han, MH, Chang, KH, Kwon, JS. Grey matter abnormalities in obsessive-compulsive disorder. Statistical parametric mapping of segmented magnetic resonance images. Br J Psychiatry 2001; 179: 330–4.
29 Etgen, T, Muhlau, M, Gaser, C, Sander, D. Bilateral grey-matter increase in the putamen in primary blepharospasm. J Neurol Neurosurg Psychiatry 2006; 77: 1017–20.
30 Singer, HS, Reiss, AL, Brown, JE, Aylward, EH, Shih, B, Chee, E, Harris, EL, Reader, MJ, Chase, GA, Bryan, RN. Volumetric MRI changes in basal ganglia of children with Tourette's syndrome. Neurology 1993; 43: 950–6.
31 Garraux, G, Goldfine, A, Bohlhalter, S, Lerner, A, Hanakawa, T, Hallett, M. Increased midbrain gray matter in Tourette's syndrome. Ann Neurol 2006; 59: 381–5.
32 Pfefferbaum, A, Mathalon, DH, Sullivan, EV, Rawles, JM, Zipursky, RB, Lim, KO. A quantitative magnetic resonance imaging study of changes in brain morphology from infancy to late adulthood. Arch Neurol 1994; 51: 874–87.
33 Steen, RG, Ogg, RJ, Reddick, WE, Kingsley, PB. Age-related changes in the pediatric brain: quantitative MR evidence of maturational changes during adolescence. AJNR Am J Neuroradiol 1997; 18: 819–28.
34 Giedd, JN, Blumenthal, J, Jeffries, NO, Castellanos, FX, Liu, H, Zijdenbos, A, Paus, T, Evans, AC, Rapoport, JL. Brain development during childhood and adolescence: a longitudinal MRI study. Nat Neurosci 1999; 2: 861–3.
35 Whitford, TJ, Rennie, CJ, Grieve, SM, Clark, CR, Gordon, E, Williams, LM. Brain maturation in adolescence: concurrent changes in neuroanatomy and neurophysiology. Hum Brain Mapp 2007; 28: 228–37.
36 Draganski, B, Gaser, C, Busch, V, Schuierer, G, Bogdahn, U, May, A. Neuroplasticity: changes in grey matter induced by training. Nature 2004; 427: 311–2.
37 Graybiel, AM. The basal ganglia and chunking of action repertoires. Neurobiol Learn Mem 1998; 70: 119–36.
38 Cromwell, HC, Berridge, KC. Implementation of action sequences by a neostriatal site: a lesion mapping study of grooming syntax. J Neurosci 1996; 16: 3444–58.
39 Knowlton, BJ, Mangels, JA, Squire, LR. A neostriatal habit learning system in humans. Science 1996; 273: 1399–402.
40 Graybiel, AM, Rauch, SL. Toward a neurobiology of obsessive-compulsive disorder. Neuron 2000; 28: 343–7.
41 Robbins, TW. From arousal to cognition: the integrative position of the prefrontal cortex. Prog Brain Res 2000; 126: 469–83.
42 Stanley, MA, Hannay, HJ, Breckenridge, JK. The neuropsychology of trichotillomania. J Anxiety Disord 1997; 11: 473–88.
43 Chamberlain, SR, Fineberg, NA, Blackwell, AD, Robbins, TW, Sahakian, BJ. Motor inhibition and cognitive flexibility in obsessive-compulsive disorder and trichotillomania. Am J Psychiatry 2006; 163: 1282–4.
44 Bohne, A, Savage, CR, Deckersbach, T, Keuthen, NJ, Wilhelm, S. Motor inhibition in trichotillomania and obsessive-compulsive disorder. J Psychiatr Res 2008; 42: 141–50.
45 Chamberlain, SR, Sahakian, BJ. The neuropsychiatry of impulsivity. Curr Opin Psychiatry 2007; 20: 255–61.
46 McGaugh, JL. The amygdala modulates the consolidation of memories of emotionally arousing experiences. Annu Rev Neurosci 2004; 27: 128.
47 Christenson, GA, Mackenzie, TB, Mitchell, JE. Characteristics of 60 adult chronic hair pullers. Am J Psychiatry 1991; 148: 365–70.
48 Christenson, GA, Ristvedt, SL, Mackenzie, TB. Identification of trichotillomania cue profiles. Behav Res Ther 1993; 31: 315–20.
49 du Toit, PL, van Kradenburg, J, Niehaus, DJ, Stein, DJ. Characteristics and phenomenology of hair-pulling: an exploration of subtypes. Compr Psychiatry 2001; 42: 247–56.
50 Boughn, S, Holdom, JJ. The relationship of violence and trichotillomania. J Nurs Scholarsh 2003; 35: 165–70.
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Grey matter abnormalities in trichotillomania: morphometric magnetic resonance imaging study

  • Samuel R. Chamberlain (a1), Lara A. Menzies (a2), Naomi A. Fineberg (a3), Natalia del Campo (a3), John Suckling (a2), Kevin Craig (a3), Ulrich Müller (a3), Trevor W. Robbins (a4), Edward T. Bullmore (a2) and Barbara J. Sahakian (a1)...
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