Brain localization

The repetitive nature of trichotillomania as well as its similarity to tics and grooming behaviours implies a potential involvement of orbitofrontal-basal ganglia brain circuitry/1,4) Volumetric magnetic resonance imaging studies demonstrate a reduced left putamen volume but no caudate abnormalities. (1J> Baseline glucose hypermetabolism of the right superior parietal lobe, bilateral cerebellum, and whole brain, as well as a negative correlation between anterior cingulate and orbitofrontal metabolism and serotonin-reuptake inhibitor (clomipramine) treatment response, has been observed using positron emission tomography. (1.5> Studies of neurospsychological testing have been inconsistent, but they suggest a possible visuospatial dysfunction mediated by corticostriatal pathways. (1J The onset of trichotillomania in very young children has been observed to be associated with streptococcal infection, and has been hypothesized to occur when antistreptococcal antibodies crossreact with the basal ganglia.(9)

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