Brain Morphology Associated With Obsessive-Compulsive Symptoms in 2,551 Children From the General Population

Cees J. Weeland*, Tonya White, Chris Vriend, Ryan L. Muetzel, Julia Starreveld, Manon H.J. Hillegers, Henning Tiemeier, Odile A. van den Heuvel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Objective: Obsessive-compulsive (OC) symptoms are common in the general population, but it is unclear whether subclinical OC symptoms and obsessive-compulsive disorder (OCD) are part of a neuroanatomical continuum. The goal of this study was to investigate the relation between OC symptoms and subcortical and cortical morphology in a population-based sample of children. Method: The study included 2,551 participants, aged 9–12 years, from the population-based Generation R Study. OC symptoms were measured using the 7-item caregiver-rated Short Obsessive-Compulsive Disorder Screener (SOCS). Structural (3T) magnetic resonance imaging scans were processed using FreeSurfer to study the thalamus and other subcortical volumes, intracranial volume, vertexwise cortical thickness, and surface area. We used linear regression models to investigate the association between OC symptoms and brain morphology. Emulating case-control studies from the literature, we compared children scoring above the clinical cutoff of the SOCS (probable OCD cases, n = 164) with matched children without symptoms. Results: Children with probable OCD had larger thalami compared with the control group (d 0.16, p = .044). Vertexwise analysis showed a positive association between OC symptoms and thickness of the right inferior parietal cortex, which disappeared after adjusting for total behavioral problems. SOCS scores correlated negatively with intracranial volume (B = −2444, p = .038). Conclusion: Children with probable OCD showed thalamus alterations similar to those previously reported in unmedicated children with OCD. OC symptoms showed a stronger association with total intracranial volume than regional brain measures. Longitudinal studies are needed to further elucidate similarities and distinctions between neural correlates of subclinical and clinical OC symptoms.

Original languageEnglish
Pages (from-to)470-478
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number4
Publication statusPublished - 1 Apr 2021

Bibliographical note

This study was supported by grants from The Netherlands Organisation for Health Research and Development ( ZonMw ), VIDI grant awarded to O.A. van den Heuvel (project number 91717306), VICI grant awarded to H. Tiemeier (project number 016.VICI.170.200), and MARIO study grant awarded to M.H.J. Hillegers (project number 636100004). C. Vriend received a grant from Hersenstichting, Netherlands (HA-2017-00227). R.L. Muetzel was supported by the Sophia Foundation (S18-20) and the Erasmus University Fellowship.

The general design of the Generation R Study is made possible by financial support from the Erasmus Medical Center , Rotterdam, the Erasmus University Rotterdam , ZonMw , the Netherlands Organisation for Scientific Research ( NWO ), and the Dutch Ministry of Health , Welfare and Sport, . Neuroimaging and the neuroimaging infrastructure were supported by ZonMw TOP grant awarded to T. White (project number 91211021). Supercomputing resources were provided by NWO (, Cartesius).

Publisher Copyright: © 2020 The Authors


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