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16 - Structural imaging of obsessive–compulsive disorder

from Section III - Anxiety Disorders

Published online by Cambridge University Press:  10 January 2011

By
Andrew R. Gilbert ,
Alison M. Gilbert ,
Jorge R. C. de Almeida  and
Philip R. Szeszko
Edited by
Martha E. Shenton  and
Bruce I. Turetsky
Andrew R. Gilbert
Affiliation:
Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh, PA, USA
Alison M. Gilbert
Affiliation:
Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh, PA, USA
Jorge R. C. de Almeida
Affiliation:
Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh, PA, USA
Philip R. Szeszko
Affiliation:
Department of Psychiatry The Zucker Hillside Hospital Glen Oaks, NY, USA and Albert Einstein College of Medicine Bronx, NY, USA
Martha E. Shenton
Affiliation:
VA Boston Healthcare System and Brigham and Women's Hospital, Harvard Medical School
Bruce I. Turetsky
Affiliation:
University of Pennsylvania
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Summary

Introduction

Obsessive–compulsive disorder (OCD) is a psychiatric disorder with a substantial prevalence in adulthood (2–3%) and in childhood and adolescence (1–2%), characterized by anxiety-producing obsessions (intrusive, unwanted thoughts or images) and anxiety-neutralizing compulsions (repetitive behaviors). OCD causes significant psychosocial impairment, and in 1996 was recognized by the World Health Organization as one of the top 10 leading causes of years lived with a disability (Murray and Lopez,1996). With approximately 40% of pediatric OCD patients reporting continued symptoms into adulthood, OCD has a substantial chronic course, contributing to social, academic, occupational and neurocognitive problems across the lifespan (Stewart et al., 2004).

In this chapter we present findings from structural neuroimaging studies of OCD in both pediatric and adult populations. We first briefly discuss neurobiological models of OCD, and next review the structural neuroimaging literature with a focus on regions strongly implicated in the pathophysiology of OCD, including the orbitofrontal cortex, anterior cingulate, basal ganglia, and thalamus. We also discuss the potential role of other brain regions in the pathogenesis of OCD. Neuroimaging evidence that OCD involves a disruption in the brain white matter is reviewed with emphasis placed on results from diffusion tensor imaging (DTI) studies. We finally discuss future directions in structural neuroimaging research in OCD.

Keywords

anterior cingulate cortexbasal gangliadiffusion tensor imagingstructural neuroimagingorbitofrontal cortexobsessive-compulsive disordermagnetic resonance imagingneurobiological modelsthalamus
Type
Chapter
Information
Understanding Neuropsychiatric Disorders
Insights from Neuroimaging
 , pp. 236 - 246
Publisher: Cambridge University Press
Print publication year: 2010

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