The Psychiatry Service of the Bellvitge University Hospital-IDIBELL may enroll and do the clinical

characterization and follow-up of around 200 Obsessive-Compulsive Disorder (OCD) patients.

In addition, these patients may be scanned using 1.5T or 3T magnetic resonance imaging (MRI)
systems.
Our role in the project should also extend to the phase of MRI processing and analysis,
probably in collaboration with other partners of the project. We propose obtaining, for each
study participant, a series of three different MRI sequences, including: 1./ A high resolution
three-dimensional anatomical image; 2./ A diffusion-tensor image (DTI) of white matter tracts;
3/. An Echo Planar Imaging (EPI) of BOLD signal at rest.
From each of these sequences we should obtain different MRI derived measurements, which
should be used by other patterns to build up an imaging databank that, which is probably the
main aim of the study. Specifically, we think that from each sequence we should obtain:
1. High resolution anatomical image:
Voxel-wise density of gray matter, white matter, and Cerebrospinal
Fluid tissue type (i.e., to do voxel-wise calculations of local tissue
content)
Voxel-wise quantification of the local amount of expansion and
contraction in relation to an image template in normalized space (i.e.,
to do voxel-wise calculations of local volume change)
Vertex-wise quantification of the thickness of the gray matter mantle
(i.e., to do cortical-thickness assessments)
Semi-automatic delineation of subcortical structures (to do regional
volumetric assessments of subcortical regions).

2. DTI sequence:
Voxel-wise assessment of fractional anisotropy (FA) and mean
diffusivity (MD) values (to do a whole-brain assessment of the integrity
of white-matter tracts)
FA and MD may be also assessed in specific regions of interest.

3. Resting-state:
Whole-brain functional connectivity of specific seeds (i.e., within the
striatum)
Whole-brain assessment of the existence of resting-state networks
(i.e., using methods such as Independent Component Analysis)

 Whole brain assessment of interregional correlations across all brain

voxels (i.e., using graph theory methods or similar approaches)
Whole brain assessment of the Amplitude of Low Frequency
Fluctuations (ALFF) and fractional ALFF, to infer the level of local brain
activity at rest.

These sequences and MRI derived measurements should be also obtained for a relevant
number of healthy control subjects, with the aim of comparing MRI derived measurements
between groups for obtaining imaging biomarkers of the disorder. These same MRI derived
measurements should be also assessed in relation to the clinical information collected from
patients to obtain neuroimaging biomarkers of prognosis, disorder subtype or treatment
response.