Case study: caudate glutamatergic changes with paroxetine therapy for pediatric obsessive-compulsive disorder

Neurobiological models for obsessive-compulsive disorder (OCD) have consistently implicated the caudate nucleus in the pathophysiology of this disorder. OCD symptoms improved markedly in a 9-year-old boy treated with paroxetine, a selective serotonin reuptake inhibitor, for whom pre/posttreatment proton magnetic resonance spectroscopic examinations were acquired to assess the relationship between neurochemical profile in the caudate nucleus, symptom severity, and treatment with paroxetine. Striking changes of the glutamate resonance in the caudate were observed after 12 weeks of paroxetine treatment. These data provide further support for glutamatergic-serotonin pathway involvement in the caudate nucleus of OCD patients.