Anatomical Alterations and Symptom-Related Functional Activity in Obsessive-Compulsive Disorder Are Correlated in the Lateral Orbitofrontal Cortex

Structural Brain MR Imaging Changes Associated with Obsessive-Compulsive Disorder in Patients with Multiple Sclerosis

“…In a single case, the development of obsessivecompulsive symptoms after the diagnosis of MS was found to be associated with the emergence of a right parietal white matter multiple sclerosis plaque. 33 In primary OCD, morphometric alterations have been consistently found not only in the frontal lobe (dorsolateral, orbitofrontal, and anterior cingulate cortices) and the basal ganglia 34,35 but also in the supramarginal gyrus, 36 anterior superior temporal cortex, 25 hippocampus, and amygdala. 31 Some evidence of the role of the temporal lobe in the pathophysiology of OCD has been yielded by studies on OCD associated with neurologic disorders, particularly with epilepsy.…”

“…4 The lifetime rate of anxiety disorders in the MS population was reported by the National Comorbidity Survey as 25%. 5 More recently, Korostil and Feinstein 6 found that 35.7% of their sample of 140 patients with MS had an anxiety disorder at some time during their lifetime, attributable to one of the following 3 disorders: generalized anxiety disorder, OCD, and panic disorder. In particular, the lifetime prevalence of OCD in MS was 8.6% compared with 2.5% in the general population.…”

Le trouble obsessionnel compulsif

“…Au niveau sous-cortical, des différences volumétriques de la substance grise sont retrouvées au niveau du thalamus et du noyau caudé, corrélées à la sévérité des symptômes et la normalisation de l'activité métabolique basale après traitement efficace [15,20,22]. Ces modifications, retrouvées aux niveaux cortical et du système des ganglions de la base, évoquent un dysfonctionnement d'une boucle noyaux gris centraux-thalamo-cortical dont l'origine pourrait provenir du cortex orbitofrontal [15,17,23]. Des changements de la substance blanche sont aussi mis en évidence par l'imagerie en tenseur de diffusion, avec une corrélation positive entre la sévérité des symptômes et les valeurs d'anisotropie fractionnelle des fibres nerveuses, évoquant ainsi une « hyperconnectivité » dans le TOC [24].…”

Dissecting OCD Circuits: From Animal Models to Targeted Treatments

“…Over the past 20 years, functional and structural imaging has led to discovery of aberrant neural circuits in OCD. Despite some discrepancies, particularly regarding directionality of findings (which may be dependent on developmental stage assessed), there is remarkable convergence of neuroanatomy, circuit function, and OCD neurochemistry findings collectively implicating cortico-striato-thalamo-cortical (CSTC) circuits in OCD pathophysiology [40][41][42][43] . This evidence is described in detail below.…”