Obsessive, Compulsive, Spectrum Disorders Research

#Patients/Healthy

First Author

Study Date

Type

Age
Range

Comments

15

2006

18-FDG/PET/

Risperidone (n=9)

-

Results are consistent with a frontostriatal circuit change related to both dopaminergic and serotonergic systems and with the presence of psychopharmacological subtypes within OCD.

8

2006

PET/[(11)C]Rac/

Fluvoxamine

-

The modifications in D(2) receptor availability might be secondary to fluvoxamine effects on serotoninergic activity.

12 patients

12 matched healthy

2006

fMRI

-

Results replicate previous smaller studies showing aberrant hippocampal recruitment in OCD during SRT performance. Although findings of deficient striatal activation in OCD were not replicated, correlation results suggest that this inconsistency may be attributable to differences among OCD symptom dimensions.

6

2006

PET

-

Acute deep brain stimulation (DBS) at the ventral [anterior internal] capsule/ventral striatum (VC/VS) target is associated with activation of the circuitry implicated in OCD. Further studies will be necessary to replicate these findings and to determine the neural effects associated with chronic VC/VS DBS.

12 patients

12 matched healthy

2006

[(15)O]H(2)O/PET

-

The interaction between symptom provocation and WM occurring in the fronto-striatal system may hold the key to the neurobiology of OCD.

27 patients

38 healthy

2006

H(2) (15)O/PET

-

OCD may be characterized by a disruption in disgust processing, such that there is a decrease in appropriate disgust (such as that evoked by observing disgust in others) and an increase in inappropriate disgust (such as that evoked by contamination stimuli).

10

2006

[(123)I]beta-CIT/SPECT/

SSRI: Citalopram (n=5)

-

Higher occupancy of SERT by citalopram seems to be associated with better clinical response after 1 year of SSRI treatment of patients with OCD.

6 patients

20 healthy

2006

18-FDG/PET

-

Observations provide evidence that the subgenual anterior cingulate and ventral striatum have a key role in the neuronal circuitry involved in the pathophysiology of OCD with associated major depression and in the neuromodulatory mechanism of anterior capsular stimulation.

15 patients

15 healthy matched

2005

[(18)F]altanserin/PET/MRI

SSRI (n=11)

-

There was no correlation between the severity of OCD symptoms and 5-HT(2A )receptor binding. An increase in 5-HT(2A) receptor binding is found in the caudate nuclei of untreated patients with OCD. The up-regulation in 5-HT(2A) receptors might be compensatory for a lack of serotonin in the feedback loop between the thalamus and orbito-frontal cortex, the caudate nuclei, and the globus pallidus.

14

2005

SPECT

Children

(6-17)

There was no statistically significant difference in average ratios of rCBF before and after treatment. There were significant clinical correlations between current age and age of onset of OCD and rCBF in the bilateral superior frontal, and bilateral parietal cortical regions. Further investigations on abnormal neurodevelopment of cortical-subcortical circuits possibly involved in symptomatology of pediatric OCD are warranted.

8 patients

7 healthy

2005

Event-related fMRI

-

Error-processing abnormalities within the rostral anterior cingulate occur in the absence of symptom expression in patients with OCD.

37 BPD (borderline personality disorder) or

ASPD (anti-social personality disorder)

34 healthy

2005

SPECT

-

Patients with BPD and ASPD who showed impulsive behavior have diminished rCBF in areas of the right prefrontal and temporal cortex.

15 patients

10 controls

2005

[(123)I]beta-CIT/SPECT

-

Data provides evidence for imbalanced monoaminergic neurotransmitter modulation in OCD. Further studies with more selective DAT and SERT radiotracers are needed.

22

2005

HMPAO/SPECT/SSRI:

Fluvoxamine (n=15)

-

Study suggests that the thalamus plays a central role in the response to drug treatment.

14 patients

14 matched controls

2005

fMRI

-

Results suggest that correctly rejected, high-conflict trials that require response inhibition may provide a better model than error trials of compulsive behaviors in OCD.

24 patients

14 healthy

2005

fMRI

-

Both groups also showed similar activation pattern on fMRI. The patients, however, showed weaker activation than the normal controls in the anterior cingulate cortex (ACC) and the right caudate nucleus.

10 patients

2005

fMRI/SSRI:

Fluvoxamine (n=4)/

Behavior therapy (n=6)

-

After improvement of OCD with either fluvoxamine or behavioral therapy, hyperactivation of the frontal lobe related to a symptom-provocative state decreases, and posterior brain activity related to action-monitoring function increases.

-

2005

[(123)I]beta-CIT/SPECT

-

SERT availability decreased by a mean 36.5%, whereas DAT availability increased by about 40%. The data point at a citalopram induced modulation of both SERT and DAT activity and support the notion of functional interactions of mono- aminergic systems in the human brain.

16 patients

7 controls

2005

HMPAO/SPECT

-

Results indicating hypoperfusion in right basal ganglion in OCD patients support previous findings about dysfunction of frontal-subcortical circuits in this disorder.

22 patients

22 healthy

2005

Event-related fMRI

-

Findings support the hypothesis that decreased dorsal prefrontal-striatal responsiveness is associated with impaired planning capacity in OCD patients. Because the described frontal-striatal dysfunction in OCD is independent of state anxiety and disease symptom severity, we conclude that executive impairment is a core feature in OCD.

12

2005

Event-related fMRI

Young Adult

Higher regional activations suggest an abnormal amplification process in OCD subjects during the discrimination of repetitive visual stimuli. The regional distribution of functional changes may vary with the patients’ ability to resist obsessions.

10 patients

10 healthy

2004

fMRI

-

Contrary to findings in other anxiety disorders, there was no observed increase in amygdala responsivity to fearful versus neutral human faces in OCD as compared with healthy control subjects. Moreover, across all face conditions, amygdala responsivity was attenuated in OCD subjects relative to control subjects. Therefore, the present findings are consistent with abnormal amygdala function in OCD and are of a character that may distinguish OCD from other anxiety disorders.

- OCD

- PTSD(post-traumatic stress disorder)

- SAD (social anxiety disorder)

2004

HMPAO/SPECT/SSRI: Citalopram

-

Although each of the anxiety disorders may be mediated by different neurocircuits, there is some overlap in the functional neuro-anatomy of their response to SSRI treatment. The current data are consistent with previous work demonstrating the importance of limbic circuits in this spectrum of disorders. These play a crucial role in cognitive-affective processing, are innervated by serotonergic neurons, and changes in their activity during serotonergic pharmacotherapy seem crucial.

14

2004

HMPAO/SPECT/Inositol

-

Data are only partly consistent with previous functional imaging work on OCD. They may support the idea that inositol effects a clinical response through alternate neuronal circuitry to the SSRIs and may complement animal work proposing an overlapping but distinct mechanism of action.

10 patients

10 matched controls

2004

[(123)I]IBZM/SPECT

-

Study provides in vivo evidence for abnormalities in the binding potential of the dopamine D(2) receptor, which suggest the direct involvement of the dopaminergic system in the pathophysiology of OCD.

18 patients

12 controls

2004

HMPAO/SPECT/

SSRI: Paroxetine

Children

Findings on children are consistent with adult studies and support the theory of a cortical-striatal-thalamic-cortical loop disturbance in OCD.

16 patients

17 healthy

2004

fMRI

-

Findings suggest that different obsessive-compulsive symptom dimensions are mediated by relatively distinct components of frontostriato- thalamic circuits implicated in cognitive and emotion processing. OCD may be best conceptualized as a spectrum of multiple, potentially overlapping syndromes rather than a unitary nosologic entity.

1

2004

fMRI

-

The lack of activation of the orbito-fronto-striatothalamic circuits and at the same time the occurrence of the increased activation of the MFC and ACC reflects the cognitive avoidance strategies still triggered by the symptom provoking stimulus.

45 patients

17 healthy

2004

18-FDG/PET

Adult

OCD patients with compulsive hoarding syndrome had a different pattern of cerebral glucose metabolism than nonhoarding OCD patients and comparison subjects. Obsessive-compulsive hoarding may be a neurobiologically distinct subgroup or variant of OCD whose symptoms and poor response to anti-obsessional treatment are mediated by lower activity in the cingulate cortex.

10 patients

10 matched controls

2004

[(123)I]beta-CIT/SPECT

-

This in vivo finding of significant reduced serotonin transporter availability in midbrain/brainstem using [(123)I] beta-CIT SPECT further supports the serotonin deficit hypothesis of OCD.

11 patients

10 healthy

2004

H(2) (15)O/PET

-

Findings of the present study are consistent with the hypothesis of decreased frontal-striatal control of limbic structures, specifically the amygdala, resulting in an inadequate fear response in OCD patients with contamination fear.

15 patients

15 healthy

2004

[(123)I]beta-CIT/SPECT

Adult

The results of our study provide direct evidence for an involvement of the dopaminergic system in the pathophysiology of OCD.

2004

Abstract Link

2003

Abstract Link

30 patients

30 healthy

2003

HMPAO/SPECT

-

Results suggest a modification of the activating systems of basal ganglia functions in OCD compared with normal subjects.

26

2003

SPECT/SSRI: Sertraline

-

Findings suggest that obtaining functional brain imaging during specific symptom provocation emphasizes individual differences in brain reactivity. Thus can indicate prospective responders to symptom-related treatment in OCD and mark the relevant brain regions for effective response to treatment.

10

2003

18-FDG/PET

-

These results suggest a possibility that metabolic changes of frontal-subcortical and parietal-cerebellar circuit changes may underlie cognitive improvements in patients with OCD.

15 patients

19 healthy

2003

[123I]IPT/SPECT

Adult

Findings suggest that the dopaminergic neurotransmitter system of the basal ganglia in patients with OCD could be involved in the pathophysiology of OCD.

14 patients

14 healthy

2003

18-FDG/PET

-

These results suggest that patients with OCD have distinct features of brain metabolic activities for performing cognitive tasks as well as presenting obsessive-compulsive symptoms. In particular, the frontal-subcortical circuits might mediate not only symptomatic expression but also cognitive expression in patients with OCD.

16 Brazilian OCD patients

17 matched controls

2003

HMPAO/SPECT

-

Findings of this SPECT study conducted in Brazil are in agreement with prior studies and provide additional support for the involvement of prefrontal-subcortical circuits in the pathophysiology of OCD. Furthermore, the study suggests that similar brain mechanisms appear to be involved cross-culturally.

14 patients

14 healthy

2003

HMPAO/SPECT

9 unmedicated patients

10 healthy

2003

[(123)I]beta-CIT/SPECT

-

The study provides evidence of a serotonergic dysfunction in patients with OCD and suggests a serotonergic component in the pathophysiology of the disorder.

8 OCD w/ contamination preoccupation

8 healthy

2003

fMRI

-

This pilot study supports the relevance of disgust in the neurocircuitry of OCD with contamination-preoccupation symptoms; future studies looking at non-OCD individuals with high disgust ratings, non-contamination-preoccupied OCD individuals, and individuals with other anxiety disorders are needed.

11 patients

11 matched controls

2003

[(11)C]McN 5652/PET

-

OCD without comorbid depression, may not be associated with major changes in SERT availability in subcortical and limbic regions.

11 patients

13 matched controls

2003

fMRI

-

Findings suggest that as part of an overactive action-monitoring system, the ACC is more directly involved in the pathophysiology of OCD than previously thought.

1 OCD secondary to brain dysgerminoma

2002

FDG/PET/SSRI: Citalopram

Child

Patient responded to citalopram that had to be titrated gradually to 80 mg/day.

20

2002

18-FDG/PET/ SSRI: Paroxetine

-

Results support hypotheses regarding a malfunction of the cortico-striato-thalamic system in the pathophysiology of OCD and particularly point to the caudate nucleus playing an important role for the therapeutic action of paroxetine in the treatment of OCD.

9 contaminated-related OCD

2002

PET/SSRI: Fluvoxamine

-

Findings are consistent with prior studies of OCD, indicating that PET indices of brain activity within orbitofrontal cortex are inversely correlated with subsequent response to SRIs. In addition, similar to findings regarding cingulotomy for OCD, indices of activity within PCC appear to be positively correlated with response to fluvoxamine as well.

25 OCD

25 MDD

16 OCD + MDD

16 controls

2002

18-FDG/SPECT/SSRI: Paroxetine hydrochloride

-

Brain metabolic responses to SRIs are both disorder-specific and response-specific. They vary according to the underlying pathophysiology of the patient and the degree of symptomatic improvement.

9 Turkish OCD patients w/o depression

6 controls

2001

HMPAO/SPECT

-

Results of this cross-cultural study may support orbitofrontal and thalamic dysfunction in OCD in a sample of Turkish patients.

16 OCD patients w/ major depression

2001

HMPAO/SPECT/

SSRI: Sertraline (n=9)

TCA: Desipramine (n=7)

-

Higher prefrontal and subcortical activity was associated with better response to drug treatment. In addition, clinical change, but not the administration of medication as such, was associated with a decrease of prefrontal rCBF.

- patients

- healthy

2001

HMPAO/SPECT

-

Postoperative 99mTc-HMPAO SPECT findings implicate the medial frontal cortex, cingulate and striatum, which could be linked to limbic leukotomy that blocks the functional connection of corticolimbic loop.

11

2001

18-FDG/PET

-

A possible predictor of treatment response was identified for patients with OCD undergoing anterior cingulotomy. Further research, utilizing a prospective design, is indicated to determine the validity and reliability of this finding.

1 OCD treated w/ bilateral stereotactic lesions

2001

PET

Adult

This case supports some of the cortical-subcortical circuit dysfunction models of OCD and argues for the further evaluation of neurosurgery for the treatment of a severe and intractable disorder.

27 OCD

27 MDD (major depressive disorder)

17 OCD & MDD

17 healthy controls

2001

18-FDG/PET

-

Left hippocampal dysfunction associated with MDD episodes, regardless of primary diagnosis. Other cerebral metabolic abnormalities found in OCD and MDD occurring separately were not seen when the disorders coexisted. Depressive episodes occurring in OCD patients may be mediated by different basal ganglia-thalamic abnormalities than in primary MDD patients.

7

2000

fMRI

-

Results in unmedicated patients are consistent with those from previous studies with medicated patients and suggest that OCD symptomatology is mediated by multiple brain regions including the anterior cingulate as well as frontal and temporal brain regions.

13 early-onset OCD

13 late-onset OCD

22 controls

2000

SPECT

Adult

rCBF differences in frontal-subcortical circuits between early-onset and late-onset OCD subjects were found, both in location and direction of changes. These results provide preliminary evidence that brain mechanisms in OCD may differ depending on the age at which symptoms are first expressed.

26 patients

22 controls

2000

ECD/SPECT

-

Results implicate specific subregions of the orbitofrontal and anterior cingulate cortices in the pathophysiology of OCD, as well as suggesting the involvement of other areas not usually included in ROI-based imaging studies.

14 patients

14 matched controls

2000

fMRI

-

Study demonstrated a differential neural response to washer-relevant disgust in washers and checkers: only washers demonstrate a neural response to washer-relevant disgust associated with emotion perception rather than attention to non-emotive visual detail.

27 patients

16 healthy

1999

SPECT

-

Results are consistent with previous functional neuroimaging studies at rest that have widely involved the orbitofrontal cortex in the pathophysiology of the OCD. However, results do not support the idea that OCD patients with chronic tics may constitute a biological subgroup within the OCD.

1 OCD secondary to TBI (traumatic brain injury)

1999

SPECT

-

Demonstrated bilateral perfusion deficits in fronto-temporal regions, and asymmetric increased perfusion in the anterior striatum. Six months later, after clinical improvement, a second study demonstrated improvement of brain perfusion, mostly in the striatum.

6

1999

SPECT

Abnormal blood flow may be seen in a number of different brain regions in acquired OCD. It is unclear whether these changes reflect primary neurological lesions or secondary changes to compensate for such damage. However, increased frontal blood flow in OCD may be hypothesized to reflect a compensatory mechanism.

20 patients

20 controls

1999

fMRI

-

Results indicate that functional magnetic resonance imaging during cognitive challenge may be useful to reveal distinctive features of latent brain dysfunction in obsessive-compulsive disorder.

20

1999

18-FDG/PET

-

Results add to evidence indicating that orbitofrontal-subcortical circuit function mediates the symptomatic expression of OCD. Specific subregions of the OFC may be differentially involved in the pathophysiology of OCD and/or its response to pharmacotherapy.

14

1999

HMPAO/SPECT

-

It may be hypothesized that increased frontal activity in some patients with OCD is itself a compensatory mechanism. In patients with such compensatory hyperactivity, administration of a serotonin auto-receptor agonist results in decreased frontal activity and exacerbation of OCD symptoms. These patients may also be less likely to respond to treatment with a SSRI.

1999

Abstract Link

-

1998

18-FDG/PET

-

Results suggest that subjects with differing patterns of metabolism preferentially respond to behavioral therayp vs. medication.

7 patients

8 healthy controls

1998

HMPAO/mCPP/SPECT

-

The effect of mCPP (meta-chlorophenylpiperazine)on the reference regions in patients posed methodological problems in the normalization methods. A possible role of the cerebellum in OCD is discussed.

-

1998

PET/

tricyclic antidepressant: imipramine

-

Abnormal asymmetries found in unmedicated panic disorder patients and now in imipramine-treated panic disorder patients may reflect a trait abnormality. The orbital frontal rCMRglc differences between the imipramine-treated and unmedicated patients are similar to changes noted in OCD patients treated with clomipramine and may reflect direct or indirect effects of imipramine treatment in panic disorder patients.

64 patients

20 matched controls

1997

SPECT

Children

Findings indicate there may be an underlying biologic similarity between Oppositional Defiant Disorder and Obsessive-Compulsive Disorder. Implications for treatment include the potential usefulness of behavior therapy, EEG biofeedback and SSRI medication.

15 OCD

15 PA

(panic disorder with agoraphobia)

16 PTSD

- healthy controls

1997

SPECT

-

Functional rCBF differences in anxiety disorders could relate to repetitive, intrusive, distressing mental activity, prominent in both OCD and PTSD.

15 OCD

15 panic disorder

15 healthy matched controls

1997

HMPAO/SPECT

-

Data suggest functional involvement of the right caudate nucleus is present in OCD.

19 patients

19 healthy matched controls

1997

HMPAO/SPECT

-

The implications of these findings are discussed in the context of other studies which examine functional imaging and neuropsychology in OCD.

-

Abstract Link

1997

PET

-

Findings further implicate corticostriatal dysfunction in obsessive-compulsive disorder. Furthermore, when OCD patients are confronted with stimuli that call for recruitment of corticostriatal systems, they instead appear to access brain regions normally associated with explicit (conscious) information processing.

24 patients

21 matched controls

1996

Abstract Link

Adult

We did not observe evidence of a structural abnormality of the caudate nucleus in patients with OCD. Prior reports of a structural aberration of the caudate nucleus were mixed. We also did not find strong support for relative caudate metabolic or perfusion dysfunction in the literature, although increased function in the frontal cerebral cortex was identified. The heterogeneous nature of this disorder may account for inconsistencies between studies.

10 patients

5 healthy

1996

fMRI

-

Results of fMRI were consistent with past studies of obsessive-compulsive disorder that used other functional neuroimaging modalities. However, paralimbic and limbic activations were more prominent in the present study.

10 patients

10 matched controls

1996

PET/H2 15O

-

Study suggests specific abnormalities of information processing in the basal ganglia and temporal structures of compulsive checkers.

1996

Abstract Link

1

1995

18-FDG/PET

Adult

(female)

Clinical improvement in obsessive-compulsive disorder after stereotactic tractotomy seems to be associated with metabolic changes in the brain, in particular, in the orbital part of the frontal lobe.

30 patients

30 matched controls

1995

HMPAO/SPECT

-

rCBF differs significantly between resting OCD patients and healthy controls, and separate clinical dimensions are associated with functionally distinct rCBF patterns.

11 patients

15 age-matched controls

1995

18-FDG/PET

Adult

Findings indicate that OCD is associated with functional hyperactivity of a selected neuronal network and that treatment to reduce symptoms may have a selective neuromodulatory effect on cingulate cortex.

8 patients

8 matched controls

1995

HMPAO/Xe-133/SPECT/

Chlomipramine

Adult

(male)

Study provides additional support for the involvement of both the orbital frontal cortex and the caudate nuclei in the pathophysiology of OCD.

1

1995

SPECT

Adult

(male)

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.

12 OCD

12 Depression

- controls

1994

SPECT

Findings confirm that the functional topography of OCD implicates altered function in the basal ganglia.

4

1994

H2 15O/PET

-

It is hypothesised that the increases in rCBF in the orbitofrontal cortex, neostriatum, global pallidus and thalamus were related to urges to perform compulsive movements, while those in the hippocampus and posterior cingulate cortex corresponded to the anxiety that accompanied them.

8

1994

PET/C15O2

-

Findings are consistent with results of previous functional neuroimaging studies and contemporary neurocircuitry models of OCD. The data further implicate orbitofrontal cortex, caudate nucleus, and anterior cingulate cortex in the pathophysiology of OCD and in mediating OCD symptoms.

11

1993

HMPAO/SPECT

-

Eight of the 11 patients demonstrated asymmetric perfusion of the basal ganglia; the left side showed impaired perfusion in six patients.

10

1993

PET

-

Results suggest the conjunctive utility of this method to assess individual differences in rCMRglc during pharmacotherapy, and to explore the neurobiology of OCD.

10 patients

10 matched controls

1993

Xe-133/HMPAO/SPECT

Adult

(male)

Compared with their matched controls, the patients with OCD had significantly increased 99mTc-HMPAO uptake in the high dorsal parietal cortex bilaterally, in the left posterofrontal cortex, and in the orbital frontal cortex bilaterally.

13

1992

PET/

Clomipramine (n=8), Fluoxetine (n=2)

Adult

Among the treated patients, the decrease in right orbitofrontal metabolism was directly correlated with two measures of OCD improvement. Results extend previous PET findings of regional dysfunction in OCD and suggest involvement of the orbitofrontal regions in the pathophysiology of OCD.

6

1991

SPECT/SSRI: Fluoxetine

-

Treatment significantly reduced the patients’ hyperfrontality, as determined by the ratio between medial-frontal and whole cerebral cortex blood flow, and significantly lowered ratings of obsessive-compulsive and anxiety symptoms.

18 patients

18 matched controls

1991

18-FDG/PET

Adult

Results suggest that the correlation pattern in OCD is not characterized by an overall loss of functional integration but, rather, by functional reorganization.

10 patients

8 controls

1991

SPECT

-

The patients had a significantly higher ratio of medial-frontal to whole cortex blood flow; this w

as unrelated to symptom severity but was correlated negatively with anxiety. No differences in orbital-frontal blood flow were found.

6 OS (obsessional slowness)

1991

PET/[(15)O]/[18F]DOPA

-

Findings were of focal hypermetabolism in orbital frontal, premotor and midfrontal cortex, whilst dopa uptake into caudate, putamen and medial frontal cortex was normal.

1990

Abstract Link

7

1989

PET

-

PET studies suggest dysfunction of the prefrontal cortex as a result of damage to the lentiform nuclei. These clinical, anatomical and functional observations emphasize the role of the circuits linking the prefrontal associative cortex and some specific areas of the neostriatum, including the pallidum.

18

1989

18-FDG/PET

Adult

Results are consistent with the suggestion that OCD may result from a functional disturbance in the frontal-limbic-basal ganglia system.

14 patients

14 unipolar depression

14 healthy

1987

FDG/PET

-

OCD showed cerebral glucose metabolic patterns that differed from controls in both the symptomatic and recovered states.

6 OCD onset from neurological lesions

-

SPECT

-

Abnormal blood flow may be seen in a number of different brain regions in acquired OCD. It is unclear whether these changes reflect primary neurological lesions or secondary changes to compensate for such damage. However, increased frontal blood flow in OCD may be hypothesized to reflect a compensatory mechanism.

Total Patients

Total Studies

SPECT

Studies

PET

Studies

fMRI

Studies

2200

99