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Brain-behavior relationships in obsessive-compulsive disorder.
S Saxena1, R G Bota, A L Brody
1UCLA Obsessive-Compulsive Disorder Research Program, Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA, USA. ssaxena@mednet.ucla.edu
Seminars in Clinical Neuropsychiatry
|April 11, 2001
Summary
Neuroimaging reveals that obsessive-compulsive disorder (OCD) symptoms stem from overactive orbitofrontal-subcortical circuits. Serotonergic drugs may help by rebalancing these brain pathways.
Area of Science:
- Neuroscience
- Psychiatry
Background:
- Obsessive-compulsive disorder (OCD) is increasingly understood through brain-behavior relationships.
- Neuroimaging advances offer new insights into the neural underpinnings of OCD.
Purpose of the Study:
- To review and analyze structural and functional neuroimaging studies in OCD.
- To synthesize neuroimaging evidence and basic science literature to model brain mediation of OCD symptoms and treatment response.
Main Methods:
- Review of published structural and functional neuroimaging studies in OCD.
- Integration of basic science literature on cortico-basal ganglia-thalamo-cortical circuits.
- Development of a theoretical model for OCD brain mediation.
Main Results:
- OCD symptoms are associated with hyperactivity in orbitofrontal-subcortical circuits.
- This hyperactivity may result from an imbalance in striato-pallidal pathways.
- Serotonergic drugs appear to modulate this imbalance, reducing circuit activity.
Conclusions:
- Neuroimaging data support a model of OCD pathophysiology involving specific brain circuits.
- Understanding these circuits offers targets for therapeutic interventions.
- Modulation of cortico-basal ganglia-thalamo-cortical pathways is key to treating OCD.