Cognitive frontal lobe dysfunction in obsessive-compulsive disorder.
BACKGROUND
There is evidence that dysfunction within associative frontostriatal circuits represents a feature of obsessive-compulsive disorder (OCD). Previous neuropsychologic studies have yielded diverging results, which may in part be explained by differences in the selection of subjects and methods. The present study focused on the question of cognitive frontal lobe performance in OCD.


METHODS
Twenty-nine unmedicated OCD patients were compared to a double-size control group of normal subjects matched individually for age, sex, and intelligence. A series of 12 neuropsychologic tests was applied, most of which are thought to be sensitive to different aspects of cognitive frontal lobe function.


RESULTS
OCD patients were unimpaired at tests of abstraction, problem solving, set-shifting, response inhibition, active memory search, and choice reaction speed. Deficits of approximately one standard deviation were observed at timed tests of verbal and nonverbal fluency, attentional processing, and weight sorting.


CONCLUSIONS
OCD patients exhibited selective deficits in tasks involving controlled attentional processing and self-guided, spontaneous behavior. We discuss a link between this neuropsychologic profile and dysfunctioning within the anterior cingulate, but not the dorsolateral prefrontal circuit.
Schmidtke
K
K
Neurological Clinic, University of Freiburg, Germany.
Schorb
A
A
Winkelmann
G
G
Hohagen
F
F
D000293:Adolescent; D000328:Adult; D003071:Cognition / Q000502:physiology*; D003210:Concept Formation; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology* / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011930:Reaction Time / Q000502:physiology; D014705:Verbal Behavior / Q000502:physiology; D014706:Verbal Learning