1H-magnetic resonance spectroscopy in obsessive-compulsive disorder: effects of 12 weeks of sertraline treatment on brain metabolites

Several neuroimaging studies have investigated brain metabolite abnormalities in patients with obsessive-compulsive disorder (OCD) and also explored metabolic changes after OCD treatments using proton magnetic resonance spectroscopy (H-1-MRS). The main objective of this study was to investigate the effects of a selective serotonin re-uptake inhibitor (SSRI) treatment on the neurochemical levels in patients with OCD. In the present study, levels of N-acetylaspartate (NAA), choline, and myo-Inositol were measured in terms of their ratios with creatine (Cr) using H-1-MRS. The ratios of metabolite levels in the three brain regions for 19 unmedicated patients with OCD, including 10 who were drug-na < ve, at baseline and following 12 weeks of sertraline treatment and for 19 healthy control subjects were compared with ANOVA. In post hoc analysis, the NAA/Cr levels were significantly lower in patients with OCD at baseline than in healthy controls in the anterior cingulate and in the caudate. On the other hand, no significant differences were detected in terms of the NAA/Cr in the anterior cingulate, caudate, and putamen between the patients with OCD after 12 weeks of sertraline treatment and healthy controls. The paired t test revealed that NAA/Cr levels were significantly higher in patients with OCD after 12 weeks of sertraline treatment compared with those at baseline in the anterior cingulate and in the caudate. Our results suggest that reductions in NAA can be reversed with SSRI treatment, which may indicate an improvement in neuronal integrity.