Functional MRI study of brain activation alterations in patients with obsessive-compulsive disorder after symptom improvement.
ABSTRACT Dysfunction of the frontal-subcortical circuits has been the most common finding in the pathophysiology of obsessive-compulsive disorder (OCD), and recent neuropsychological studies have shown cognitive impairments in OCD. To clarify the pathophysiology of OCD without the confounding effects of medication, we investigated the alterations of brain function in OCD patients and changes after clinical improvement due solely to behavior therapy. The participants were 11 outpatients with OCD and 19 normal controls. The patients received 12 weeks of behavior therapy. We investigated the differences in the behavioral performance and functional magnetic resonance imaging results during the Stroop test in the patients and normal controls, and their changes after treatment in the patients. The patients showed less activation in the anterior cingulate gyrus and cerebellum than control subjects. Following significant improvement in OC symptoms, the cerebellum and parietal lobe showed increased activation, and the orbitofrontal cortex, middle frontal gyrus, and temporal regions showed decreased activation during the Stroop task, and performance of the task itself improved. Our findings suggest that dysfunction of the posterior brain regions, especially the cerebellum, is involved in the pathogenesis of OCD, and that normalization in function can occur with improvement of OC symptoms.
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ABSTRACT: This paper presents evidence that on an information processing task, designed to investigate putative inhibitory mechanisms in selective attention, obsessive-compulsive disordered individuals can be clearly distinguished from other anxiety disorder clients and show significantly higher scores on questionnaire measures designed to detect schizotypy in the normal population. It is suggested that these results provide some support for the idea that obsessive-compulsive disorder may be misclassified as an anxiety disorder and may in fact be categorically more closely aligned to the schizophrenic constellation of disorders.Psychological Medicine 09/1990; 20(3):621-7. · 5.59 Impact Factor
Article: Obsessional-compulsive complaints.[show abstract] [hide abstract]
ABSTRACT: A simple questionnaire was developed as an instrument for assessing the existence and extent of different obsessional-compulsive complaints. Two major types of complaint, checking and washing compulsions, and two minor types, slowness and doubting, were established. The final form of the questionnaire, and major properties, are presented.Behaviour Research and Therapy 02/1977; 15(5):389-95. · 3.30 Impact Factor
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ABSTRACT: The cerebral metabolic rate for glucose was studied in 18 adults with childhood-onset obsessive-compulsive disorder (OCD) and in age- and sex-matched controls using positron emission tomography and fludeoxyglucose F 18. Both groups were scanned during rest, with reduced auditory and visual stimulation. The group with OCD showed an increased glucose metabolism in the left orbital frontal, right sensorimotor, and bilateral prefrontal and anterior cingulate regions as compared with controls. Ratios of regional activity to mean cortical gray matter metabolism were increased for the right prefrontal and left anterior cingulate regions in the group with OCD as a whole. Correlations between glucose metabolism and clinical assessment measures showed a significant relationship between metabolic activity and both state and trait measurements of OCD and anxiety as well as the response to clomipramine hydrochloride therapy. These results are consistent with the suggestion that OCD may result from a functional disturbance in the frontal-limbic-basal ganglia system.Archives of General Psychiatry 07/1989; 46(6):518-23. · 13.77 Impact Factor