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Nuclear Neuroimaging and Psychosurgery in Obsessive-Compulsive Disorder

  • Jun Soo Kwon
  • Jung-Seok Choi
  • Myung Chul Lee
Chapter

Abstract

Nuclear neuroimaging techniques such as PET and SPECT have contributed enormously to the development of the neurobiological model of obsessive-compulsive disorder (OCD). Recently, studies using functional magnetic resonance imaging (fMRI) and magnetic resonance spectroscopy (MRS) in patients with OCD have been increasing in number, but these studies are not reviewed here. To date, based on the existing neuroimaging studies, many researchers have emphasized the role of the frontal cortex and the striatum in the pathophysiology of OCD. In the functional imaging studies, hypermetabolic rates or hyperactivity have been found in the OFC, anterior cingulate cortex, and/or basal ganglia with the patient in a resting state. Activation in similar brain regions has also been found in the case of OCD symptom provocation. Moreover, metabolic rates or blood flows were lowered after pharmacotherapy or behavioural therapy. In addition, surgical intervention disrupting the fronto-subcortical circuitry had an effect on the reduction of the hyperactivity in the components of this circuitry. So far, however, little consideration has been given to the involvement of the parieto-cerebellar dysfunction in the pathophysiology of OCD. Recently, some studies have suggested the involvement of the parieto-cerebellar dysfunction, as well as fronto-subcortical dysfunction in OCD. The parietal dysfunction may be related to visuo-spatial processing and visual memory deficits in some patients with OCD. Also, the cerebellum plays an important role in coordinating complex mental and non-motor higher cognitive functions, and dysfunctions may be related to some cognitive deficits in OCD. Further research will be needed to clarify the involvement of parieto-cerebellar dysfunction in the pathophysiology of OCD.

Keywords

Major Depressive Disorder Regional Cerebral Blood Flow Single Photon Emission Compute Tomography Study Orbital Gyrus Orbital Frontal Cortex 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • Jun Soo Kwon
    • 1
  • Jung-Seok Choi
    • 1
  • Myung Chul Lee
    • 2
  1. 1.Department of PsychiatrySeoul National University HospitalSeoulKorea
  2. 2.Seoul National University HospitalSeoulKorea

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