RT Journal Article
T1 Serotonergic underpinnings of obsessive-compulsive disorder: A systematic review and meta-analysis of neuroimaging findings
A1 Pastre, Martin
A1 Occéan, Bob-Valéry
A1 Boudousq, Vincent
A1 Conejero, Ismael
A1 Fabbro-Peray, Pascale
A1 Collombier, Laurent
A1 Mallet, Luc
A1 López Castromán, Jorge
K1 5-HT2A binding
K1 Molecular imaging
K1 Obsessions
K1 Serotonin
K1 SERT binding
AB Obsessive-compulsive disorder (OCD) is a frequent and disabling condition, with many patients being treatment-resistant. Improved understanding of its neurobiology is vital for better therapies. Evidence is still conflicting regarding specific serotonergic-related dysfunctions in OCD. We systematically reviewed the literature to provide a quantitative assessment of the role of serotonin (5-HT) in patients with untreated OCD through imaging. We searched for neuroimaging studies investigating central 5-HT tonus in unmedicated patients with OCD, excluding studies comprising treated patients to prevent bias from antidepressant-induced changes in serotonergic tonus. We also conducted a meta-analysis using a homogeneous group of positron emission tomography and single photon emission computed tomography articles that compared 5-HT transporter (SERT) and 5-HT2A receptor (HT2AR) binding potential in different brain regions of patients with untreated OCD and healthy controls. The systematic review encompassed 18 articles, with 13 included in the subsequent meta-analysis. Risk of bias was assessed by a revised form of the Newcastle-Ottawa Scale. We provided standardized mean difference (SMD) values for SERT and 5-HT2AR binding potential measures across 15 different brain regions. Patients with OCD showed lower SERT binding potential in the brainstem (SMD = −1.13, 95% CI [−1.81 to −0.46]), midbrain (SMD = −0.54, 95% CI [−0.92 to −0.16]), and thalamus/hypothalamus regions (SMD = −0.58, 95% CI [−0.99 to −0.18]) with neglectable to moderate heterogeneity. By combining results from 2 decades of molecular imaging studies, we show that individuals with OCD exhibit lower SERT binding potential in specific brain regions, providing compelling evidence of a 5-HT system dysfunction. However, the exact mechanisms underlying this phenotype remain elusive. The limitations include heterogeneity across studies in populations, imaging techniques, and radiotracer usage.
PB Wiley
YR 2024
FD 2024-11-07
LK https://hdl.handle.net/10347/46392
UL https://hdl.handle.net/10347/46392
LA eng
NO Pastre, M., Occéan, B.-V., Boudousq, V., Conejero, I., Fabbro-Peray, P., Collombier, L., Mallet, L. and Lopez-Castroman, J. (2025), Serotonergic underpinnings of obsessive-compulsive disorder: A systematic review and meta-analysis of neuroimaging findings. Psychiatry Clin. Neurosci., 79: 48-59. https://doi.org/10.1111/pcn.13760
DS Minerva
RD 23 abr 2026