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Obsessive-Compulsive Symptoms in Dementia: Scoping Review of Pathological Changes
Filipe P Martinho1, Tiago F Ferreira1, Daniela Magalhães1
1Psychiatry and Mental Health Department, Hospital Professor Doutor Fernando Fonseca, EPE, Lisboa, Portugal.
The Primary Care Companion for CNS Disorders
|June 21, 2024
Summary
Neurobiological research reveals that dementia with obsessive-compulsive symptoms (OCS) involves frontal and temporal lobe changes. Serotonergic agents show promise for OCS in dementia, but further studies are needed.
Area of Science:
- Neurobiology
- Geriatric Psychiatry
- Neurology
Background:
- Obsessive-compulsive symptoms (OCS) can manifest in individuals with dementia.
- Understanding the neurobiological underpinnings of OCS in dementia is crucial for developing effective treatments.
Purpose of the Study:
- To conduct a literature review on the neurobiological mechanisms associated with obsessive-compulsive symptoms in patients with dementia.
Main Methods:
- A comprehensive literature search was performed across MEDLINE/PubMed, CENTRAL, and PsycNet databases up to March 2023.
- Included original studies of any methodology investigating the neurobiology of OCS in dementia patients.
- Search terms included variations of 'obsessive-compulsive' and 'dementia' or 'cognitive dysfunction'.
Main Results:
- Patients with dementia and OCS exhibited atrophy and hypoperfusion in frontal, temporal, striatal, and limbic regions.
- Serotonergic agents demonstrated potential efficacy in reducing OCS, though one trial showed no effect.
- Microglial dysfunction and microtubule-associated protein τ mutations were implicated; dopaminergic evidence was insufficient.
Conclusions:
- Observed frontal hypometabolism and temporal lobe atrophy/hypometabolism in dementia with OCS are contrary to prior obsessive-compulsive disorder research.
- While case reports suggest efficacy, further research is required to validate the use of serotonergic agents for OCS in dementia.
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