title: Brain circuitry of compulsivity.
abstract: Compulsivity is associated with alterations in the structure and the function of parallel and interacting brain circuits involved in emotional processing (involving both the reward and the fear circuits), cognitive control, and motor functioning. These brain circuits develop during the pre-natal period and early childhood under strong genetic and environmental influences. In this review we bring together literature on cognitive, emotional, and behavioral processes in compulsivity, based mainly on studies in patients with obsessive-compulsive disorder and addiction. Disease symptoms normally change over time. Goal-directed behaviors, in response to reward or anxiety, often become more habitual over time. During the course of compulsive disorders the mental processes and repetitive behaviors themselves contribute to the neuroplastic changes in the involved circuits, mainly in case of chronicity. On the other hand, successful treatment is able to normalize altered circuit functioning or to induce compensatory mechanisms. We conclude that insight in the neurobiological characteristics of the individual symptom profile and disease course, including the potential targets for neuroplasticity is an unmet need to advance the field.
authors.affiliation: Department of Psychiatry, VU University Medical Center (VUmc), Amsterdam, The Netherlands; Department of Anatomy & Neurosciences, VUmc, Amsterdam, The Netherlands; The Obsessive-Compulsive Disorder Team, Haukeland University Hospital, Bergen, Norway. Electronic address: oa.vandenheuvel@vumc.nl.
authors.forename: Odile A
authors.initials: OA
authors.lastname: van den Heuvel
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Guido
authors.initials: G
authors.lastname: van Wingen
authors.affiliation: OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge University Hospital; Bellvitge Biomedical Research Institute (IDIBELL), and CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Barcelona, Spain; Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Soriano-Mas
authors.affiliation: OCD Clinical and Research Unit, Department of Psychiatry, Bellvitge University Hospital; Bellvitge Biomedical Research Institute (IDIBELL), and CIBERSAM (Centro de Investigación en Red de Salud Mental), Carlos III Health Institute, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain.
authors.forename: Pino
authors.initials: P
authors.lastname: Alonso
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom; Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge, United Kingdom.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Chamberlain
authors.affiliation: Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamae
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
authors.affiliation: Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands; Arkin Mental Health and Jellinek Addiction Treatment, Amsterdam, The Netherlands.
authors.forename: Anna E
authors.initials: AE
authors.lastname: Goudriaan
authors.affiliation: Department of Psychiatry, VU University Medical Center (VUmc), Amsterdam, The Netherlands.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Veltman
mesh_terms: D000818:Animals; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use; D001007:Anxiety / Q000503:physiopathology / Q000628:therapy; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D003071:Cognition / Q000187:drug effects; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003192:Compulsive Behavior / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy; D003193:Compulsive Personality Disorder / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D008032:Limbic System / Q000187:drug effects / Q000503:physiopathology; D008959:Models, Neurological; D009415:Nerve Net / Q000187:drug effects / Q000503:physiopathology*; D055495:Neurogenesis / Q000187:drug effects; D009473:Neuronal Plasticity / Q000187:drug effects; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy
chemical_list: D014150:Antipsychotic Agents
keywords: Anxiety; Compulsivity; Cortico-striato-thalamico-cortical circuits; Limbic; Neuroimaging