Neuropsychological Findings in Obsessive-Compulsive Disorder and its Potential Implications for Treatment

Abstract

Neuropsychological studies have shed light on several important aspects of obsessive-compulsive disorder (OCD). Along with neuroimaging and information processing approaches, it has contributed to delineate some of the most instigating pathophysiological models of OCD and to strengthen its diagnostic validity. Lately, neuropsychological studies have also emerged as a potentially relevant research area for therapeutics. In this review, we described the nature of the executive dysfunctions associated with OCD and theorized how they may account for the characteristic memory and visuoconstructive/visuospatial impairments found in patients suffering from this disorder. We also examined the concepts of implicit memory, meta-memory, memory for actions, memory bias, reality monitoring, and the multiple ways these functions may be altered in patients with OCD. The role of cognitive dysfunctions as potential predictors of treatment response to either pharmacological approaches (e.g. serotonin reuptake inhibitors) or to cognitive-behavior therapies (i.e. exposure and response prevention) in patients with OCD was also discussed. Finally, we argued that cognition might be an area of particular vulnerability to the negative effects of the anti-obsessional drugs and of the neuroanatomically-based approaches (neurosurgery and deep-brain stimulation).

A critical review of the contribution of eye movement recordings to the neuropsychology of obsessive compulsive disorder

“…One of the most consistently described deficits is an impairment of non-verbal memory, in particular, visuospatial memory (11,13,18). One of the most consistently described deficits is an impairment of non-verbal memory, in particular, visuospatial memory (11,13,18).…”

“…Most studies suggest that patients with OCD perform as well as controls on a classical set-shifting task, the Wisconsin Card Sorting Test, which depends on the dorsolateral prefrontal cortex (DLPFC) (11,18). Most studies suggest that patients with OCD perform as well as controls on a classical set-shifting task, the Wisconsin Card Sorting Test, which depends on the dorsolateral prefrontal cortex (DLPFC) (11,18).…”

“…However, patients with OCD have been found to be impaired on other set-shifting tasks believed to be primarily sensitive to orbitofrontal dysfunction, such as the object alternation test or the delayed alternation test (20). Selective attention deficits have also been observed with the Stroop test (18). In particular, patients with OCD tend to allocate undue consideration to Considerations • The potential use of complex cognitive tasks to diagnose obsessive compulsive disorders is a farfetched, still speculative perspective.…”

“…Because abnormalities of prefrontal brain areas and executive functions impairment have also been found in patients with OCD (11,18), it was legitimate to think that OCD would be, like schizophrenia, associated with oculomotor dysfunction. Because abnormalities of prefrontal brain areas and executive functions impairment have also been found in patients with OCD (11,18), it was legitimate to think that OCD would be, like schizophrenia, associated with oculomotor dysfunction.…”

A neuropsychological evaluation of orthorexia nervosa

“…Previous studies of AN have identified impairments in attention, verbal long-term memory, visuospatial functioning, and executive functioning (e.g., working memory, response inhibition, and cognitive flexibility) [4,5]. Individuals with OCD have difficulty with cognitive flexibil-ity [6] and response inhibition [7]. The goal of this study is to determine whether orthorexic individuals experience the same cognitive problems using standardized neuropsychological tests sensitive to performance differences in these domains.…”