Regional cerebral blood flow and cognitive function in patients with obsessive-compulsive disorder

Abstract

Objective: To explore the relationship between regional cerebral blood flow (CBF) and cognitive function in obsessive-compulsive disorder (OCD). Method: Single-photon emission computed tomography (SPECT) was performed for 139 OCD patients and 139 controls, and the radioactivity rate (RAR) was calculated. Cognitive function was assessed by the Wisconsin Card Sorting Test (WCST). Results: The RARs of the prefrontal, anterior temporal, and right occipital lobes were higher in patients than controls. For the WCST, correct and classification numbers were significantly lower, and errors and persistent errors were significantly higher in OCD patients. Right prefrontal lobe RAR was negatively correlated with correct numbers, right anterior temporal lobe RAR was positively correlated with errors, and the RARs of the right prefrontal lobe and left thalamus were positively correlated with persistent errors. Conclusion: OCD patients showed higher CBF in the prefrontal and anterior temporal lobes, suggesting that these areas may be related with cognitive impairment.Keywords: obsessive-compulsive disorder, regional cerebral blood flow, cognitive function. ResumoObjetivo: Estudar a relação entre a perfusão sanguínea regional cerebral e as funções cognitivas em pacientes com transtorno obsessivo compulsivo (TOC). Método: Foram estudados 139 pacientes com TOC e 139 controles. As imagens do fluxo sanguíneo cerebral foram feitas por single photon emission computed tomography e o radioactivity rate (RAR) foi calculado usando como referência a radioatividade do córtex cerebelar. As funções cognitivas foram avaliadas através do Wisconsin Card Sorting Test (WCST). Resultados: O RAR do lobo pré-frontal, do lobo temporal anterior e do lobo occipital direito foram mais elevados nos pacientes do que nos controles (P<0.05). Quanto ao WCST, os escores de números corretos (P<0.01) e de classificação (P<0.05) foram menores no grupo TOC do que nos controles; entretanto, os escores de erros e de erros persistentes nos controles foram mais elevados do que nos pacientes (P<0.01). O RAR do lobo pré-frontal direito estava relacionado de modo negativo com os números corretos; o RAR do lobo temporal anterior apresentava correlação positiva com os erros; o RAR do lobo pré-frontal direito e do tálamo esquerdo apresentavam correlação positiva com erros persistentes. Conclusão: Pacientes com TOC apresentaram perfusão sanguínea cerebral mais intensa no lobo pré-frontal e no lobo temporal anterior. O lobo pré-frontal direito, o lobo temporal e o tálamo esquerdo podem estar relacionados com alterações cognitivas.Palavras-chave: transtorno obsessivo-compulsivo, fluxo sanguíneo regional cerebral, função cognitiva.Obsessive-compulsive disorder (OCD) is an intractable psychiatric condition. OCD morbidity is 2-3%, which severely affects patients' quality of life 1 . In order to investigate the biological basis underlying changes in cerebral function in patients with OCD, we assessed cerebral blood flow (CBF) with single-photon emission computed tomograph...

A voxel-based analysis of cerebral blood flow abnormalities in obsessive-compulsive disorder using pseudo-continuous arterial spin labeling MRI

“…The absence of significant findings involving other areas of the CSTC in the present patients was unexpected, since many studies have reported the presence of rCBF alterations in the CSTC [4][5][6][7][8][9][10][11][12][13]. It is possible that the discrepancy between our findings and previous findings is related to unknown differences in clinical characteristics of the patients studied.…”

“…demonstrated reduced rCBF in the right putamen, right frontal operculum, left midcingulate cortex, and right temporal pole in the OCD patients. Many studies using PET or SPECT have been undertaken to assess rCBF changes in OCD (S5 Appendix) [4][5][6][7][8][9][10][11][12][13], and although these studies vary regarding the number of subjects, neuroimaging modality, and analytic method, rCBF abnormalities have consistently been identified in the CSTC of OCD patients, including the orbitofrontal cortex [4,7,9,12], the anterior cingulate cortex [5-7, 11, 12], the caudate nucleus [6,10,11], and the thalamus [6,8,9]. Our present findings are partially consistent with these reports in terms of the rCBF abnormality in the putamen observed in the OCD patients, but we observed no significant abnormalities in the other areas of the CSTC.…”

“…Two analytical methods have been used to assess rCBF abnormalities in OCD patients in prior investigations: an ROI-based approach or a voxel-based approach [4][5][6][7][8][9][10][11][12][13]. We performed an ROI-based analysis in addition to the main voxel-based analysis in order to compare the two analytical methods, and the results demonstrated that the ROI-based analysis failed to detect rCBF decreases in the right frontal operculum and the left midcingulate cortex.…”

“…Although studies using positron emission tomography (PET) or single photon emission tomography (SPECT) have been conducted to examine abnormalities of regional cerebral blood flow (rCBF) in individuals with OCD [4][5][6][7][8][9][10][11][12][13], the majority of these studies assessed rCBF by using regions of interest (ROI), which might generally lack efficient reproducibility and reliability [14]. Moreover, the ROIs used in the studies tended to lump together heterogeneous subregions with separate functional roles.…”

Cognitive impairment and electroencephalographic changes in patients with obsessive compulsive disorder

“…The impairments on the WCST found in this study have been reported in many studies [48][49][50][51] and each study has implicated different aspects: total errors, perseverative errors, perseverative responses, nonperseverative errors, conceptual level responses, and number of categories completed. Furthermore, some of those studies reported significant correlations between the performance of OCD patients on the WCSTwith both cerebral blood flow [52,53] and the functional integrity of the frontal-subcortical circuits [54]. Even unaffected relatives of OCD patients were reported to have more errors on the WCST compared with healthy controls [55].…”