Functional brain imaging in obsessive-compulsive disorder secondary to neurological lesions

Obsessive-compulsive disorder (OCD) may result from a range of neurological lesions in frontal and basal ganglia areas. However, relatively few studie s have explored functional brain imaging in acquired OCD, Methods: Charts o f patients presenting to our Neuropsychiatry Unit where obsessive-compulsiv e symptoms appeared secondary to neurological lesions were reviewed. Demogr aphic information and clinical diagnoses were collated and brain SPECT scan s reviewed. Six patients with various neurological conditions presented with OCD, All d emonstrated decreased blood flow in the temporal lobes as well as cortical perfusion abnormalities in the frontal lobes (focal areas of decreased perf usion in one patient, focal areas of increased perfusion in two, and a comb ination of focal increased and decreased frontal perfusion in three eases). Abnormal blood flow may be seen in a number of different brain regions in a cquired OCD. It is unclear whether these changes reflect primary neurologic al lesions or secondary changes to compensate for such damage, However, inc reased frontal blood flow in OCD may be hypothesized to reflect a compensat ory mechanism, Depression and Anxiety (C) 1999 Wiley-Liss, Inc.