Individualized gray matter morphological abnormalities unveil two neuroanatomical obsessive-compulsive disorder subtypes

Motivation: Obsessive-compulsive disorder (OCD) is a highly heterogeneous disorder, with notable variations among cases in structural brain abnormalities. Goal(s): we aimed to identify distinct OCD subtypes based on individualized gray matter morphological abnormalities compared to normative expectations Approach: We recruited 100 untreated, first-episode OCD patients and 106 healthy controls for structural imaging scans and identified subtype. Results: Our findings revealed two distinct OCD subtypes exhibiting divergent patterns of structural brain abnormalities. Structural brain abnormalities in these subtypes displayed distinct associations with neurotransmitter receptors/transporters. The identified subtypes offer novel insights into nosology and the heterogeneous nature of OCD. Impact: Two subtypes manifest opposite gray matter morphological abnormalities. Subtype exhibit divergent structural covariance network-informed disease epicenters. Gray matter morphological abnormalities of subtypes exhibit distinct associations with neurotransmitter receptors/transporters. Novel insights are offered into nosology and heterogeneous nature of OCD.