Brain imaging studies

The use of positron emission tomography has demonstrated the presence of increased activity (i.e. metabolism and blood flow) in the frontal lobes, the basal ganglia (especially the caudate nucleus), and the cingulum of patients with OCD. (36> Pharmacological and behavioural treatments reportedly reverse those abnormalities.(37) The data from functional imaging studies are consistent with the data from structural brain imaging studies. Both CT and magnetic resonance imaging studies have found decreased sizes of caudates bilaterally. Both functional and structural imaging procedures are also consistent with the observation that neurological procedures involving the cingulum are sometimes effective in the treatment of patients with OCD.

Overall, the brain imaging research suggests a role for the prefrontal cortex-basal ganglia thalamic circuitry. Dysfunction of these circuits can be explored by neuropsychological testing and recording evoked potentials. A recent study of patients with OCD showed that they are slower in performing tasks involving frontocortical systems, suggesting alterations at this level. (38> An evoked potential study showed enhanced processing negativity in the frontal cortex consistent with the prefrontal hyperactivity shown in brain imaging studies. (3.9>

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