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Review
.2021 Feb 10;10(1):55-64.
doi: 10.1556/2006.2021.00002.

White matter microstructural and Compulsive Sexual Behaviors Disorder - Diffusion Tensor Imaging study

Affiliations
Review

White matter microstructural and Compulsive Sexual Behaviors Disorder - Diffusion Tensor Imaging study

Małgorzata Draps et al. J Behav Addict..

Abstract

Background and aims: Even though the Compulsive Sexual Behavior Disorder (CSBD) was added to the ICD-11 under the impulse control category in 2019, its neural mechanisms are still debated. Researchers have noted its similarity both to addiction and to Obssesive-Compulsive Disorder (OCD). The aim of our study was to address this question by investigating the pattern of anatomical brain abnormalities among CSBD patients.

Methods: Reviewing 39 publications on Diffusion Tensor Imaging (DTI) we have identified main abnormalities specific for addictions and OCD. Than we have collected DTI data from 36 heterosexual males diagnosed with CSBD and 31 matched healthy controls. These results were then compared to the addiction and OCD patterns.

Results: Compared to controls, CSBD individuals showed significant fractional anisotropy (FA) reduction in the superior corona radiata tract, the internal capsule tract, cerebellar tracts and occipital gyrus white matter. Interestingly, all these regions were also identified in previous studies as shared DTI correlates in both OCD and addiction.

Discussion and conclusions: Results of our study suggest that CSBD shares similar pattern of abnormalities with both OCD and addiction. As one of the first DTI study comparing structural brain differences between CSBD, addictions and OCD, although it reveals new aspects of CSBD, it is insufficient to determine whether CSBD resembles more an addiction or OCD. Further research, especially comparing directly individuals with all three disorders may provide more conclusive results.

Keywords: Compulsive Sexual Behaviors Disorder; Diffusion Tensor Imaging; Obssesive-Compulsive Disorder; addictions; hypersexuality; white matter microstructure.

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Conflict of interest statement

The authors declare no conflicts of interest with respect to the content of this manuscript.

Figures

Fig. 1.
Fig. 1.
Results of literature review. Fractional anisotropy (FA) reductions specific for Addiction (blue), FA reductions specific for OCD (green), and regions differentiating both Addiction and OCD patients from healthy controls (yellow)
Fig. 2.
Fig. 2.
Differences in fractional anisotropy (FA) between CSBD patients and controls. Mean FA skeleton across all subjects is shown in green over the FMRIB58_FA_1mm template. Results have been thickened for visualization purposes using the standard tbss_fill FSL command. Clusters with higher FA values (P < 0.02, clusters size >50) in the control group in comparison to CSBD patients is shown in red. There were no significant results for reverse contrast (CSBD patients > control group)
Fig. 3.
Fig. 3.
Overlapping results from literature review on fractional anisotropy (FA) in Addiction and OCD, and results of our DTI study on CSBD patients. FA reductions specific for Addiction (blue), FA reductions specific for OCD (green), regions differentiating both Addiction and OCD patients from healthy controls (yellow), and regions differentiating CSBD patients from healthy controls (red):3 tracts in cerebellum, retrolenticular part of the internal capsule tract, superior part of the corona radiata tract and part of the occipital gyrus white matter
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