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Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder

Published online by Cambridge University Press:  06 August 2018

S. Saxena ,
A. L. Brody ,
J. M. Schwartz  and
L. R. Baxter
S. Saxena
Affiliation:
UCLA Department of Psychiatry and Biobehavioral Sciences, UCLA Neuropsychiatric Institute, Los Angeles
A. L. Brody
Affiliation:
UCLA Department of Psychiatry and Biobehavioral Sciences, UCLA Neuropsychiatric Institute, Los Angeles
J. M. Schwartz
Affiliation:
UCLA Department of Psychiatry and Biobehavioral Sciences, UCLA Neuropsychiatric Institute, Los Angeles
L. R. Baxter
Affiliation:
UCLA Department of Psychiatry and Biobehavioral Sciences, UCLA Neuropsychiatric Institute, and Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham AL, USA
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Abstract

Background Neuroimaging studies provide strong evidence that the pathophysiology of obsessive-compulsive disorder (OCD) involves abnormal functioning along specific frontal-subcortical brain circuits.

Method A literature search was carried out for all brain imaging studies of patients with OCD. We also reviewed the basic science literature on the functional neuroanatomy of cortico-basal ganglia circuits, and integrated this information with neuroimaging data in OCD to formulate a theoretical model of brain mediation of OCD symptoms and response to treatment.

Results At least a subgroup of patients with OCD may have abnormal basal ganglia development. Functional neuroimaging studies indicate that OCD symptoms are associated with increased activity in orbitofrontal cortex, caudate nucleus, thalamus and anterior cingulate gyrus.

Conclusions OCD symptoms are mediated by hyperactivity in orbitofrontal-subcortical circuits, perhaps due to an imbalance of tone between direct and indirect striatopallidal pathways. We present a model which describes how frontal-subcortical brain circuitry may mediate OCD symptomatology, and suggest a hypothesis for how successful treatments may ameliorate symptoms, via their effects on circuit activity.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 173 , Issue S35: New perspectives in research and treatment of obsessive-compulsive disorder , August 1998 , pp. 26 - 37
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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