title: Neuropsychological performance and regional cerebral blood flow in obsessive-compulsive disorder.
abstract: Convergent findings from neuropsychological and neuroimaging studies have suggested that neural dysfunction in frontal-subcortical circuits may play a central role in the pathophysiology of obsessive-compulsive disorder (OCD). To further examine the relationship between these two sets of findings we investigated both neuropsychological functions and regional cerebral blood flow (rCBF) in a combined study. Fourteen unmedicated patients fulfilling DSM-IV criteria for OCD and 14 healthy controls matched for age, gender, handedness, and education were assessed on neuropsychological tests that included Trail Making Test (TMT), Rey Complex Figure Test (RCF) (copy and 5-min recall), Verbal Fluency Test (VFT), and Wisconsin Card Sorting Test (WCST). rCBF was studied with 99 mTc-hexamethyl-propyleneamine-oxime (HMPAO) single photon emission computed tomography (SPECT). Patients performed more poorly than controls (P<.05) on RCF (copy), VFT, and WCST (perseverative errors). Spearman's correlations indicated that severity of OCD correlated inversely with performance on the RCF (copy and recall scores) and positively with rCBF in the right thalamus. Positive correlations were observed between nonperseverative errors (WCST) and rCBF in frontal areas and anterior cingulate. Perseverative errors (WCST) correlated negatively with rCBF in the right thalamus. These findings are consistent with most previously published studies and suggest neural dysfunctions in the frontal-subcortical circuits probably more pronounced in the right hemisphere. They also extend the existing research, showing associations between deficits in cortical-subcortical circuitry and performance on neuropsychological tests of controlled attention and visuospatial functions.
authors.affiliation: Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Room 984, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. lacerdaal@msx.upmc.edu
authors.forename: Acioly L T
authors.initials: AL
authors.lastname: Lacerda
authors.forename: Paulo
authors.initials: P
authors.lastname: Dalgalarrondo
authors.forename: Dorgival
authors.initials: D
authors.lastname: Caetano
authors.forename: Gretchen L
authors.initials: GL
authors.lastname: Haas
authors.forename: Edwaldo E
authors.initials: EE
authors.lastname: Camargo
authors.forename: Matcheri S
authors.initials: MS
authors.lastname: Keshavan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001288:Attention; D002540:Cerebral Cortex / Q000098:blood supply* / Q000502:physiology; D003072:Cognition Disorders / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology*; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D013788:Thalamus / Q000098:blood supply / Q000502:physiology; D015899:Tomography, Emission-Computed, Single-Photon; D014796:Visual Perception