FRONTAL ABNORMALITIES IN A PATIENT WITH OBSESSIVE-COMPULSIVE DISORDER- THE ROLE OF STRUCTURAL LESIONS IN OBSESSIVE-COMPULSIVE BEHAVIOR

A man with onset of obsessive-compulsive disorder (OCD) at age 62 had a large right posterior frontal infarct and occlusion of the ipsilater al internal carotid artery. We review additional cases from the litera ture with obsessive or compulsive behaviors and structural lesions. OC D may have a structural correlate, and this should be searched for in instances where onset occurs after age 60, is atypical, or is associat ed with other neurologic signs or symptoms. Rational therapy for OCD w ill depend on a detailed understanding of the neuronal circuitry and p hysiologic mechanisms underlying such behaviors, and additional data f rom thoroughly evaluated patients may be revealing.