Brain anatomy and chemistry may predict treatment response in paediatric obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a severe, highly prevalent and often chronically disabling illness with frequent onset in childhood and adolesc ence. This underscores the importance of studying the illness during childh ood near the onset of illness to minimize potential confounds of long-term illness duration and treatment intervention as well as to examine the devel opmental underpinnings of the illness. In this review, the authors focus on an integrated series of brain-imaging studies in paediatric OCD suggesting a reversible glutamatergically mediated thalamo-cortical-striatal dysfunct ion in OCD and their relevance for improved diagnosis and treatment of the condition. Developmental neurobiological models for OCD are presented and p articular attention is devoted to evaluating neuroimaging studies designed to test these models and how they may help predict treatment response in pa ediatric OCD.