N-acetyl-l-aspartate values of hippocampus are reduced in patients with hypochondriasis

Huseyin Ozdemir, Osman Mermi, M. Gurkan Gurok, Sema Saglam, Hanefi Yildirim, Semih Sec, Specialist Murad Atmaca

Department of Psychiatry, Elazig Educational and Investigational Hospital, Elazig, Turkey.
Department of Psychiatry, School of Medicine, Firat University, Elazig, Turkey.
Department of Radiology, School of Medicine, Firat University, Elazig, Turkey.

DOI: 10.4236/jbise.2013.66084                

Abstract

Background: Given that on the one side considerable similarities between hypochondriasis and obsessive- compulsive disorder (OCD) by means of sharing a number of features, including intrusive thoughts and repeated checking (Barsky, 1992), on the other side similar structural neuroimaging data that found hypochondriac patients to have significantly smaller mean left and right OFC, and greater left thalamus volumes compared to those of healthy controls. Aims: We considered to investigate the hippocampal neurochemicals, found changed in OCD patients, in hypochondriac patients. Methods: Fifteen patients with hypochondriasis, recruited from our out- or in-patient clinics, were compared with 15 healthy control comparisons in regard to proton magnetic resonance spectroscopy (¹H-MRS) imaging of hippocampus. Results: The patients with hypochondriasis had lower right and left NAA/CHO, and NAA/CRE, and near-significant lower right CHO/CRE hippocampal ratios than healthy matched comparison subjects. Conclusion: The data of the present investigation in patients with hypochondriasis provide preliminary evidence of lower right and left NAA/CHO, and NAA/CRE, near-significant lower right CHO/CRE hippocampal ratios, revealing neurochemical alterations in hippocampus and a further support the notion that hypochondriasis shares a variety of neurobiological similarities with OCD.

Keywords

Hypochondriasis; NAA/CHO; NAA/CRE; CHO/CRE; MRS

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Atmaca, M., Yildirim, H., Sec, S. and Kayali, A. (2010) Pituitary volumes in hypochondriac patients. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 34, 344-347. doi:10.1016/j.pnpbp.2009.12.012
[2]	Atmaca, M., Yildirim, H., Ozdemir, H., Ozler, S., Kara, B., Ozler, Z., Kanmaz, E., Mermi, O. and Tezcan, E. (2008) Hippocampus and amygdalar volumes in patients with refractory obsessive-compulsive disorder. Progress in NeuroPsychopharmacology and Biological Psychiatry, 1, 12831286. doi:10.1016/j.pnpbp.2008.04.002
[3]	Barsky, A.J. (1992) Hypochondriasis and obsessive compulsive disorder. Psychiatric Clinics of North America, 15, 791-801.
[4]	Çorapçioglu, A., Aydemir, Ö., Yildiz, M., Esen, A. and Köroglu, E. (1999) DSM-IV Eksen I bozukluklari için Yapilandirilmis Klinik Görüsme, Klinik Versiyon. Hekimler Yayin Birligi, Ankara.
[5]	Duvernoy, H.M. and Cabanis, E.A. (1991) The human brain: Surface, three-dimensional sectional anatomy and MRI. Springer-Verlag, New York.
[6]	Bertolino, A., Nawroz, S., Mattay, V.S., Barnett, A.S., Duyn, J.H., Moonen, C.T., Frank, J.A., Tedeschi, G. and Weinberger, D.E. (1996) Regionally specific pattern of neurochemical pathology in schizophrenia as assessed by multislice proton magnetic resonance spectroscopic imaging. American Journal of Psychiatry, 153, 1554-1563.
[7]	Talairach, J. and Tournoux, P. (1998) Coplanar stereotaxic atlas of the human brain. Thieme Medical Publishers, New York.
[8]	Caetano, S.C., Hatch, J.P., Brambilla, P., Sassi, R.B., Nicoletti, M., Mallinger, A.G., Frank, E., Kupfer, D.J., Keshavan, M.J. and Soares, J.C. (2004) Anatomical MRI study of hippocampus and amygdala in patients with current and remitted major depression. Psychiatry Research, 15, 141-147.
[9]	Brambilla, P., Hardan, A., di Nemi, S.U., Perez, J., Soares, J.C. and Barale, F. (2003) Brain anatomy and development in autism: Review of structural MRI studies. Brain Research Bulletin, 15, 557-569. doi:10.1016/j.brainresbull.2003.06.001
[10]	Atmaca, M., Yildirim, H., Ozdemir, H., Koc, M., Ozler, S. and Tezcan, E. (2009) Neurochemistry of the hippocampus in patients with obsessive-compulsive disorder. Psychiatry and Clinical Neurosciences, 63, 486-490. doi:10.1111/j.1440-1819.2009.01993.x
[11]	Atmaca, M., Yildirim, H., Gurok, M.G., Akyol, M. and Koseoglu, F. (2012) Hippocampal neurochemical pathology in patients with panic disorder. Psychiatry Investigation, 9, 161-165. doi:10.4306/pi.2012.9.2.161
[12]	Sheline, Y.I., Wang, P.W., Gado, M.H., Csernansky, J.G. and Vannier, M.W. (1996) Hippocampal atrophy in recurrent major depression. Proceedings of the National Academy of Sciences of USA, 30, 3908-3913. doi:10.1073/pnas.93.9.3908
[13]	Höschl, C. and Hajek, T. (2001) Hippocampal damage mediated by corticosteroids—A neuropsychiatric research challenge. European Archives of Psychiatry and Clinical Neuroscience, 2, 81-88. doi:10.1007/BF03035134
[14]	Mizoguchi, K., Ishige, A., Aburada, M. and Tabira, T. (2003) Chronic stress attenuates glucocorticoid negative feedback: Involvement of the prefrontal cortex and hippocampus. Neuroscience, 119, 887-897. doi:10.1016/S0306-4522(03)00105-2