Paediatric obsessive-compulsive disorder, a neurodevelopmental disorder? Evidence from neuroimaging.
OBJECTIVE
To present an overview of neuroimaging data on paediatric obsessive-compulsive disorder (OCD) and discuss implications for further research.


METHODS
Medline PsycINFO databases and reference lists were searched for relevant articles. All neuroimaging studies up to October 1, 2008 involving children and adolescents with obsessive-compulsive disorder were included.


RESULTS
Twenty-eight neuroimaging studies using various neuroimaging techniques (CT (2) MRI (15) MRS (8) and SPECT (2) fMRI (2) but no PET or DTI) including a total of 462 paediatric patients were identified. A number of findings indicate a dysfunction of the prefrontal-striatal-thalamic circuit with the involvement of other basal ganglia structures (putamen globus pallidus) and the thalamus in contrast to adult studies which report mainly involvement of the caudate nucleus and orbitofrontal cortex. Several findings point at an aberrant development of the brain in paediatric OCD, patients when compared with healthy controls.


CONCLUSIONS
Neuroimaging studies have contributed to our understanding of the neurobiological basis of paediatric OCD. This review provides an agenda for further theory driven research in particular aimed at identifying a critical window of abnormal maturation of prefrontal-striatal-thalamic and limbic circuitry in paediatric OCD patients.
De Bascule Academic Centre for Child and Adolescent Psychiatry, Duivendrecht, The Netherlands. c.huyser@debascule.com
Chaim
C
Huyser
Dick J
DJ
Veltman
Else
E
de Haan
Frits
F
Boer
D000293:Adolescent; D041923:Adolescent Development; D001921:Brain / Q000254:growth & development* / Q000503:physiopathology*; D001923:Brain Chemistry; D002648:Child; D002657:Child Development; D003952:Diagnostic Imaging; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology*; D055815:Young Adult