Elsevier

Biological Psychiatry

Volume 82, Issue 2, 15 July 2017, Pages 83-102
Biological Psychiatry

Archival Report
Comparative Multimodal Meta-analysis of Structural and Functional Brain Abnormalities in Autism Spectrum Disorder and Obsessive-Compulsive Disorder

https://doi.org/10.1016/j.biopsych.2016.10.006Get rights and content

Abstract

Background

Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) share inhibitory control deficits possibly underlying poor control over stereotyped and repetitive and compulsive behaviors, respectively. However, it is unclear whether these symptom profiles are mediated by common or distinct neural profiles. This comparative multimodal meta-analysis assessed shared and disorder-specific neuroanatomy and neurofunction of inhibitory functions.

Methods

A comparative meta-analysis of 62 voxel-based morphometry and 26 functional magnetic resonance imaging (fMRI) studies of inhibitory control was conducted comparing gray matter volume and activation abnormalities between patients with ASD (structural MRI: 911; fMRI: 188) and OCD (structural MRI: 928; fMRI: 247) and control subjects. Multimodal meta-analysis compared groups across voxel-based morphometry and fMRI.

Results

Both disorders shared reduced function and structure in the rostral and dorsomedial prefrontal cortex including the anterior cingulate. OCD patients had a disorder-specific increase in structure and function of left basal ganglia (BG) and insula relative to control subjects and ASD patients, who had reduced right BG and insula volumes versus OCD patients. In fMRI, ASD patients showed disorder-specific reduced left dorsolateral-prefrontal activation and reduced posterior cingulate deactivation, whereas OCD patients showed temporoparietal underactivation.

Conclusions

The multimodal comparative meta-analysis shows shared and disorder-specific abnormalities. Whereas the rostrodorsomedial prefrontal cortex was smaller in structure and function in both disorders, this was concomitant with increased structure and function in BG and insula in OCD patients, but a reduction in ASD patients, presumably reflecting a disorder-specific frontostriatoinsular dysregulation in OCD in the form of poor frontal control over overactive BG, and a frontostriatoinsular maldevelopment in ASD with reduced structure and function in this network. Disorder-differential mechanisms appear to drive overlapping phenotypes of inhibitory control abnormalities in patients with ASD and OCD.

Section snippets

Study Selection

A comprehensive literature search was conducted by COC, LJN, and SSL for papers published up to December 2015 for whole-brain imaging studies using VBM or fMRI of inhibitory control in pediatric and adult ASD and OCD subjects (using stop, go/no-go, Simon, Stroop, Eriksen flanker, or switching tasks). For details and search terms see the Supplement. Studies meeting the following criteria were included: 1) comparison with a control group; 2) for fMRI, use of a task investigating inhibitory

Included Studies

Included were 32 VBM studies comparing ASD individuals to control subjects (ASD = 911; control = 932), 30 VBM studies comparing OCD patients to control subjects (OCD = 928; control = 942), 12 inhibitory control fMRI studies comparing ASD patients to control subjects (ASD = 188; control = 196), and 14 fMRI studies comparing OCD patients to control subjects (OCD = 247; control = 244) (Table 1, Table 2, Table 3, Table 4; Supplement).

Group Differences in Demographics

Across all studies, patients were age- and sex-matched to control

Discussion

This first comparative multimodal meta-analysis of imaging studies of ASD and OCD shows both shared and disorder-specific abnormalities in brain structure and function during inhibitory control. Given group differences in age and sex distribution in the included studies, only findings that survived age- and sex-matched subgroup meta-analyses are discussed.

Both disorders shared decreased volume and inhibitory activation in r/dACC/MPFC relative to control subjects. The most prominent

Acknowledgments and Disclosures

COC is supported by a National Institute for Health Research Biomedical Research Centre Ph.D. studentship and a King’s College London overseas graduate award. LJN and SSL are supported by Medical Research Council and Institute of Psychiatry, Psychology, and Neuroscience Ph.D. Excellence awards. The study was supported by an MRC Career Establishment grant (Grant No. G0300155 to KR) and by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley

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