Reduced brain white matter integrity in trichotillomania: a diffusion tensor imaging study

Arch Gen Psychiatry. 2010 Sep;67(9):965-71. doi: 10.1001/archgenpsychiatry.2010.109.


Context: Trichotillomania is an Axis I disorder characterized by repetitive, pathological hair pulling.

Objective: To assess the integrity of white matter tracts in subjects with the disorder.

Design: Between-group comparison using permutation cluster analysis, with stringent correction for multiple comparisons.

Setting: Academic psychiatry department.

Participants: Eighteen volunteers meeting DSM-IV criteria for trichotillomania and 19 healthy control subjects.

Main outcome measures: Fractional anisotropy (measured using diffusion tensor imaging), trichotillomania disease severity (Massachusetts General Hospital Hairpulling Scale score), and dysphoria (Montgomery-Asberg Depression Rating Scale score).

Results: Subjects with trichotillomania exhibited significantly reduced fractional anisotropy in anterior cingulate, presupplementary motor area, and temporal cortices. Fractional anisotropy did not correlate significantly with trichotillomania disease severity or depressive mood scores.

Conclusions: These data implicate disorganization of white matter tracts involved in motor habit generation and suppression, along with affective regulation, in the pathophysiology of trichotillomania.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anisotropy
  • Atrophy / pathology
  • Brain / pathology*
  • Cluster Analysis
  • Depressive Disorder / pathology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Diffusion Tensor Imaging / statistics & numerical data*
  • Female
  • Gyrus Cinguli / pathology
  • Humans
  • Male
  • Motor Cortex / pathology
  • Neural Pathways / pathology
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Temporal Lobe / pathology
  • Trichotillomania / diagnosis
  • Trichotillomania / pathology*