Neuropsychiatry and SPECT of an Acute Obsessive–Compulsive Syndrome Patient

Simpson, Steve; Baldwin, Bob

doi:10.1192/bjp.166.3.390

Cited by 45 publications

(24 citation statements)

References 8 publications

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“…Taken together, these findings are consistent with those of a number of earlier structural, neuropsychological and functional studies suggesting that dysfunction of the temporal cortex [78,95] , in particular of the anterior temporal cortex [96,97] and of superior regions of the temporal cortex [26] , is involved in OCD symptomatology.…”

Section: Dysfunctions Of the Frontal Parietal And Temporal Corticessupporting

confidence: 80%

Functional Neuroimaging in Obsessive-Compulsive Disorder

Casale

Kotzalidis²,

Rapinesi³

et al. 2011

Neuropsychobiology

181

111

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Background and Aim: Obsessive-compulsive disorder (OCD) is a severe, highly prevalent and chronically disabling psychiatric disorder that usually emerges during childhood or adolescence. This paper aims to review the literature on functional neuroimaging in OCD, analysing the reported dysfunctional connectivity in the corticostriatothalamocortical circuitry. Method: This study included papers published in peer-reviewed journals dealing with functional imaging in OCD. Results: Striatal dysfunction, mainly of the caudate nucleus, leads to inefficient thalamic gating, resulting in hyperactivity within the orbitofrontal cortex (intrusive thoughts) and the anterior cingulate cortex (non-specific anxiety). Compulsions consist of ritualistic behaviours performed to recruit the inefficient striatum and neutralise unwanted thoughts and anxiety. Functional neuroimaging findings are discussed against the background of specific cognitive impairments, mainly regarding visuospatial processing, executive functioning and motor speed. Cognitive deficits are partial and specific, matching imaging data. Conclusions: Several studies have targeted brain regions hypothesised to be involved in the pathogenesis of OCD, showing the existence of dysfunctional connectivity in the corticostriatothalamocortical circuitry. Improvements in spatial resolution of neuroimaging techniques may contribute to a better understanding of the neurocircuitry of OCD and other anxiety disorders.

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Section: Dysfunctions Of the Frontal Parietal And Temporal Corticessupporting

confidence: 80%

Functional Neuroimaging in Obsessive-Compulsive Disorder

Casale

Kotzalidis²,

Rapinesi³

et al. 2011

Neuropsychobiology

181

111

View full text Add to dashboard Cite

show abstract

“…Certain symptom presentations, such as obsessions and compulsions related to fear of forgetting names [Jenike, 1991] or ego-syntonic scrupulosity [Fallon et al, 1990], have been noted in this age group. However, cognitive decline can exacerbate or mimic symptoms of OCD [Markovitz, 1993] and medical difficulties that are more prevalent in the elderly, such as cerebrovascular accidents, have been noted to produce OCD symptoms in previously healthy patients [Simpson and Baldwin, 1995].…”

Section: Introductionmentioning

confidence: 99%

Treatment of late-onset OCD following basal ganglia infarct

et al. 2002

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Current consensus on the treatment of obsessive-compulsive disorder (OCD) includes cognitive behavior therapy (CBT) in the form of exposure and response prevention (ERP). However, the generalizability of these methods to elderly populations remains largely undocumented. This clinical case study examines the effectiveness of medications and intensive, inpatient ERP in an elderly patient with onset of OCD following basal ganglia infarcts. There was a dramatic reduction from baseline to follow-up in both obsessions and compulsions with Yale-Brown Obsessive-Compulsive Scale [YBOCS; Goodman et al., 1989] total scores decreasing by over 20 points. These gains were maintained up to 1 year post-treatment. Age-specific issues and the application of standard therapeutic methods to elderly clients are discussed.

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“…However, Simpson and Baldwin [30] described a patient with no previous psychiatric history who developed an obsessive-compulsive disorder associated with a right inferior parietal infarct and decreased regional cerebral blood flow revealed by SPECT in the right basal ganglia and temporal areas.…”

Section: Discussionmentioning

confidence: 99%

Affective and Behavioural Dysfunctions in Patients with Subcortical Stroke

Cabello¹,

Gómez-Ruiz²,

Alonso³

et al. 2012

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Objective: To investigate the association of ischaemic and haemorrhagic strokes with the site of subcortical focal cerebrovascular injuries with affective, behavioural and cognitive dysfunctions in the acute phase and after three months. Sample: 58 patients with focal cerebrovascular injuries; mean age 61.5 ± 13.5, 72.4% male. Control group: 20 healthy subjects, mean age 67.1 ± 7.6, 50% male. Results: Significant differences were observed (p = 0.006) between the acute phase and three months later on the apathy items of the Neuropsychiatric Inventory (NPI) in patients with subcortical stroke. Significant differences were also observed on the affective scale of the BRMS (p = 0.004), the behaviour scale of the Maudsley Obsessive-Compulsive Inventory (MOCI) (p = 0.000), and on the Mini Mental State Examination (MMSE) (p = 0.006). No significant differences were observed on the Hamilton Rating Scale-Depression (HRSM) (p = 0.101). Significant differences were found according to the infarct type: patients with haemorrhagic lesions had higher raw scores on the HRS-D than those with ischaemic lesions (p = 0.024). Conclusions: The performance of patients with subcortical stroke on affective, behavioural and cognitive scales improves after three months. Patients with haemorrhagic lesions are more likely to be depressive than those with ischaemic lesions.

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Neuropsychiatry and SPECT of an Acute Obsessive–Compulsive Syndrome Patient

Abstract: SPECT is effective in the diagnosis of neuropsychiatric disorders such as OCD, and the pathological changes in brain metabolism detected by SPECT may be reversed by both drug therapy and psychotherapy.

Cited by 45 publications

References 8 publications

Functional Neuroimaging in Obsessive-Compulsive Disorder

Functional Neuroimaging in Obsessive-Compulsive Disorder

Treatment of late-onset OCD following basal ganglia infarct

Affective and Behavioural Dysfunctions in Patients with Subcortical Stroke

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