Cortical glutamate and GABA are related to compulsive behaviour in individuals with obsessive compulsive disorder and healthy controls

There has been little analysis of neurochemical correlates of compulsive behaviour to illuminate its underlying neural mechanisms. We use 7-Tesla proton magnetic resonance spectroscopy (1H-MRS) to assess the balance of excitatory and inhibitory neurotransmission by measuring glutamate and GABA levels in anterior cingulate cortex (ACC) and supplementary motor area (SMA) of healthy volunteers and participants with Obsessive-Compulsive Disorder (OCD). Within the SMA, trait and clinical measures of compulsive behaviour are related to glutamate levels, whereas a behavioural index of habitual control correlates with the glutamate:GABA ratio. Participants with OCD also show the latter relationship in the ACC while exhibiting elevated glutamate and lower GABA levels in that region. This study highlights SMA mechanisms of habitual control relevant to compulsive behaviour, common to the healthy sub-clinical and OCD populations. The results also demonstrate additional involvement of anterior cingulate in the balance between goal-directed and habitual responding in OCD

Atelectasis as a Complication of Tuberculosis: a Case Report

Background: Tuberculosis is an infectious disease caused by a bacillus called Mycobacterium tuberculosis or Koch's Bacillus (BK). It is associated with various long-term lung complications, including: lung scarring (fibrosis), bronchiectasis, Chronic Pulmonary Aspergillosis, and more rarely, atelectasis. There is however very limited data in literature on the full spectrum of these complications, and relies mostly on case reports and small case series. Case: The authors report a case of atelectasis in a patient with previous diagnosis of Tuberculosis. Normal laboratory tests and imaging test presenting right lung atelectasis. Went under respiratory therapy, presented improve and is under clinical control. Conclusion: There is a huge importance of knowing the various methods to diagnose this disease and treat it well. Thus, it enables an improvement in the patient and a reduction in the spread of bacteria

Cortical glutamate and GABA are related to compulsive behaviour in individuals with obsessive compulsive disorder and healthy controls

Acknowledgements: This research was funded by the Wellcome Trust (Grant 104631/Z/14/Z to T.W.R.). A pilot study was funded by the NIHR Cambridge Biomedical Research Centre (BRC-1215-20014 to P.B.). For the purpose of open access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. This work was further supported by MHRUK and Angharad-Dodds Bursaries to M.B.; a Sir Henry Wellcome Trust Postdoctoral Research Fellowship (Grant 204727/Z/16/Z) to P.B.; Medical Research Council [MR N013433-1] and the Vice Chancellor's Awards to M.P.H.; Wellcome Trust Senior Investigator Award to T.W.R. supporting E.K. as a research assistant; CAPES, Angharad-Dodds and Grindley funds to A.M.F.L.P.S.; and an Alexander von Humboldt Fellowship for senior researchers (GBR 1202805 HFST-E) to K.D.E. The magnet and support staff were also funded by the NIHR Cambridge Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The Cambridge 7T MRI facility is co-funded by the University of Cambridge and the Medical Research Council (MR/M008983/1). C.T.R. was funded by a Sir Henry Dale Fellowship from the Wellcome Trust and the Royal Society [098436/Z/12/B]. We thank all participants for their contributions to this study. We would also like to acknowledge all our collaborators for their contributions to our research, particularly Professor Angela C Roberts, Professor Edward T Bullmore, Alexander G. Murley, Polytimi Frangou, Uzay Emir, Dinesh Deelchand and the staff at Wolfson Brain Imaging Centre for their help and support.There has been little analysis of neurochemical correlates of compulsive behaviour to illuminate its underlying neural mechanisms. We use 7-Tesla proton magnetic resonance spectroscopy (1H-MRS) to assess the balance of excitatory and inhibitory neurotransmission by measuring glutamate and GABA levels in anterior cingulate cortex (ACC) and supplementary motor area (SMA) of healthy volunteers and participants with Obsessive-Compulsive Disorder (OCD). Within the SMA, trait and clinical measures of compulsive behaviour are related to glutamate levels, whereas a behavioural index of habitual control correlates with the glutamate:GABA ratio. Participants with OCD also show the latter relationship in the ACC while exhibiting elevated glutamate and lower GABA levels in that region. This study highlights SMA mechanisms of habitual control relevant to compulsive behaviour, common to the healthy sub-clinical and OCD populations. The results also demonstrate additional involvement of anterior cingulate in the balance between goal-directed and habitual responding in OCD

Cortical glutamate and GABA are related to compulsive behaviour in individuals with obsessive compulsive disorder and healthy controls

There has been little analysis of neurochemical correlates of compulsive behaviour to illuminate its underlying neural mechanisms. We use 7-Tesla proton magnetic resonance spectroscopy (1H-MRS) to assess the balance of excitatory and inhibitory neurotransmission by measuring glutamate and GABA levels in anterior cingulate cortex (ACC) and supplementary motor area (SMA) of healthy volunteers and participants with Obsessive-Compulsive Disorder (OCD). Within the SMA, trait and clinical measures of compulsive behaviour are related to glutamate levels, whereas a behavioural index of habitual control correlates with the glutamate:GABA ratio. Participants with OCD also show the latter relationship in the ACC while exhibiting elevated glutamate and lower GABA levels in that region. This study highlights SMA mechanisms of habitual control relevant to compulsive behaviour, common to the healthy sub-clinical and OCD populations. The results also demonstrate additional involvement of anterior cingulate in the balance between goal-directed and habitual responding in OCD