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48 patients with unilateral frontal or non-frontal cortical lesions were given a go - no go learning task. Patients with frontal lesions in either hemisphere took longer to learn the task and made more false "go" responses than control patients. They also, unlike controls, took longer to make in correct positive responses than correct positive ones. Medial frontal lesions were found to be particularly important in giving rise to poor performance on this task. It is suggested that this task is non-unitary in nature and that the medial area may be important for more than one ability.

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This paper reports a case which is noteworthy for two unrelated reasons, one genetic and the other therapeutic. The genetic interest lies in the rare instance of an identical twin with obsessive compulsive neurosis whose twin brother had a similar illness. The therapeutic interest focuses on clinical changes which occurred during unsuccessful treatment by desensitization and by aversion relief. These changes aid our understanding of compulsive behaviour and the difficulties in its treatment. At one stage in treatment independence was noted between anxiety and compulsions which suggested that compulsive behaviour need not always be maintained by its anxiety-reducing properties. The case history will first be described and discussed from the genetic point of view. The second part of this paper will focus on the unrelated aspect of treatment.

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