Neurobiological model of obsessive-compulsive disorder

Evidence from recent neuropsychological and neuroimaging findings

Tomohiro Nakao, Kayo Okada, Shigenobu Kanba

Research output: Contribution to journalReview article

62 Citations (Scopus)

Abstract

Obsessive-compulsive disorder (OCD) was previously considered refractory to most types of therapeutic intervention. There is now, however, ample evidence that selective serotonin reuptake inhibitors and behavior therapy are highly effective methods for treatment of OCD. Furthermore, recent neurobiological studies of OCD have found a close correlation between clinical symptoms, cognitive function, and brain function. A large number of previous neuroimaging studies using positron emission tomography, single-photon emission computed tomography or functional magnetic resonance imaging (fMRI) have identified abnormally high activities throughout the frontal cortex and subcortical structures in patients with OCD. Most studies reported excessive activation of these areas during symptom provocation. Furthermore, these hyperactivities were decreased after successful treatment using either selective serotonin reuptake inhibitors or behavioral therapy. Based on these findings, an orbitofronto-striatal model has been postulated as an abnormal neural circuit that mediates symptomatic expression of OCD. On the other hand, previous neuropsychological studies of OCD have reported cognitive dysfunction in executive function, attention, nonverbal memory, and visuospatial skills. Moreover, recent fMRI studies have revealed a correlation between neuropsychological dysfunction and clinical symptoms in OCD by using neuropsychological tasks during fMRI. The evidence from fMRI studies suggests that broader regions, including dorsolateral prefrontal and posterior regions, might be involved in the pathophysiology of OCD. Further, we should consider that OCD is heterogeneous and might have several different neural systems related to clinical factors, such as symptom dimensions. This review outlines recent neuropsychological and neuroimaging studies of OCD. We will also describe several neurobiological models that have been developed recently. Advanced findings in these fields will update the conventional biological model of OCD.

Original languageEnglish
Pages (from-to)587-605
Number of pages19
JournalPsychiatry and Clinical Neurosciences
Volume68
Issue number8
DOIs
Publication statusPublished - Jan 1 2014

Fingerprint

Obsessive-Compulsive Disorder
Neuroimaging
Magnetic Resonance Imaging
Serotonin Uptake Inhibitors
Corpus Striatum
Biological Models
Behavior Therapy
Executive Function
Frontal Lobe
Therapeutics
Single-Photon Emission-Computed Tomography
Positron-Emission Tomography
Cognition

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Neurobiological model of obsessive-compulsive disorder : Evidence from recent neuropsychological and neuroimaging findings. / Nakao, Tomohiro; Okada, Kayo; Kanba, Shigenobu.

In: Psychiatry and Clinical Neurosciences, Vol. 68, No. 8, 01.01.2014, p. 587-605.

Research output: Contribution to journalReview article

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