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Secondary obsessive-compulsive disorder related to diaschisis after pontine infarction, successfully treated with

Tokuzo Matsui1, Sanjaya Saxena, Joji Kawabe

  • 1Department of Neuropsychiatry, Graduate School of Medicine, Osaka City University, Osaka, Japan. qzg03064@nifty.ne.jp

Psychiatry and Clinical Neurosciences
|March 17, 2007
PubMed

Insights

Pontine infarction can lead to secondary obsessive-compulsive disorder (OCD) through diaschisis, a neurological condition affecting distant brain areas. This case highlights the link between brainstem lesions and temporal lobe dysfunction causing OCD symptoms.

Area of Science:

  • Neurology
  • Neuroscience
  • Psychiatry

Background:

  • Obsessive-compulsive disorder (OCD) is a mental health condition characterized by obsessions and compulsions.
  • Secondary OCD can arise from various neurological conditions.
  • Pontine infarction, a stroke affecting the pons in the brainstem, is a less common cause.

Observation:

  • A 71-year-old male presented with new-onset obsessive images following a pontine infarction.
  • Brain imaging revealed a lesion in the right pons (T1-weighted MRI) and reduced cerebral blood flow in the temporal lobe and pons (SPECT).

Findings:

  • The pontine infarction likely caused diaschisis, affecting the temporal lobe via neural pathways.
  • This temporal lobe dysfunction, secondary to the brainstem lesion, is hypothesized to have triggered OCD symptoms.

Implications:

  • This case suggests a potential mechanism linking brainstem infarction and secondary OCD.
  • It underscores the importance of considering cerebrovascular events in the differential diagnosis of secondary OCD.
  • Further research into diaschisis following brainstem strokes may elucidate other associated neuropsychiatric disorders.

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