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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Autism is a developmental disorder that manifests itself in early childhood and affects the functioning of the brain, primarily in the areas of social interaction and communication. Children with autism look like other children but do not play or behave like other children. They must struggle daily to cope and connect with the world around them.