Regional cerebral blood flow in obsessive-compulsive patients with and without a chronic tic disorder. A SPECT study.

Abstract

The main goal of the present study was to explore whether regional cerebral blood flow (rCBF) differs between obsessive-compulsive disorder (OCD) patients without chronic motor tic disorder and those OCD patients with a comorbid chronic tic disorder. Twenty-seven patients suffering from OCD (DSM-IV criteria), including 7 OCD patients who met DSM-IV criteria for simple chronic motor dic disorder, and 16 healthy volunteers were examined at rest using a high resolution SPECT. Seven regions of interest (ROIs) were manually traced and quantified as a percentage of the mean cerebellar uptake. Severity of obsessive-compulsive symptoms (OCS), anxiety and depressive symptoms and presence of motor tics were assessed with the Y-BOCS, HRS-A, HRS-D, MADRS, and Yale Global Tics Severity Scale, respectively. We found a significant relative decrease in rCBF in OCD patients without motor tics compared to healthy volunteers in the right orbitofrontal cortex (OCD without tics = 0.87; healthy volunteers = 0.94; p = 0.02). No significant differences in rCBF were seen when OCD patients with and without chronic tics were directly compared. A lower severity of OCS in OCD patients with chronic tics was found. These results are consistent with previous functional neuroimaging studies at rest that have widely involved the orbitofrontal cortex in the pathophysiology of the OCD. However, our results do not support the idea that OCD patients with chronic tics may constitute a biological subgroup within the OCD.

Functional Neuroimaging in Obsessive-Compulsive Disorder

“…This is consistent with differential neural patterns in MDD and OCD in frontal-striatal and paralimbic structures in this task. These findings are consistent with those of several previous structural, neuropsychological and functional studies suggesting that dysfunctions of the OFC [25,26,29,44,45,64,77] play a role in OCD symptomatology.…”

Positron Emission Tomography Imaging of Risperidone Augmentation in Serotonin Reuptake Inhibitor-Refractory Patients

“…Positron emission tomography with FDG showed increased metabolic rates in the orbitofrontal and cingulate gyrus region in patients with OCD [1][2][3][4] . SPECT studies have supported these patient hyperactivity findings in some [5,6] but not all studies [7,8] . The effect was more marked in more ventral areas than dorsal areas in one study that presented this dimension [9] and more marked in medial frontal cortex in one study [10] .…”

The neuropsychology of obsessive compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers

“…Multiple studies have identified such abnormalities in the basal ganglia (especially caudate), cingulate cortex, and orbitofrontal cortex (Edmonstone et al, 1994;Lucey et al, 1997;Crespo-Facorro et al, 1999;Busatto et al, 2000;Saxena et al, 2001aSaxena et al, , 2004Lacerda et al, 2003), and several of these studies included groups with different psychiatric disorders as well as healthy controls. Lucey et al (1997) utilised SPECT and identified reduced caudate rCBF in OCD not only when compared to healthy controls, but also when compared to controls with panic disorder.…”