We aimed to investigate white matter (WM) integrity and structural differences in schizophrenia patients with clozapine-induced obsessive compulsive symptoms (S-OCS) comparing them those without symptoms (S) and healthy controls (HC). Tract-based-spatial-statistic/diffusion-tensor-imaging, voxel-based morphometry, and caudate volume measurements were performed to reveal underlying WM and gray matter (GM) alterations. S-OCS showed less fractional anisotropy (FA) reductions in WM and less areas of reduced GM density than S when compared to HC. FA elevations and increased GM density were observed in S-OCS compared with S. The results may suggest differential effect of clozapine, and/or different baseline pathophysiology in a subgroup of patients.
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