Repeated Cortico-Striatal Stimulation Generates Persistent OCD-Like Behavior

Although cortico-striato-thalamo-cortical (CSTC) circuit dysregulation is correlated with obsessive compulsive disorder (OCD), causation cannot be tested in humans. We used optogenetics in mice to simulate CSTC hyperactivation observed in OCD patients. Whereas acute orbitofrontal cortex (OFC)–ventromedial striatum (VMS) stimulation did not produce repetitive behaviors, repeated hyperactivation over multiple days generated a progressive increase in grooming, a mouse behavior related to OCD. Increased grooming persisted for 2 weeks after stimulation cessation. The grooming increase was temporally coupled with a progressive increase in light-evoked firing of postsynaptic VMS cells. Both increased grooming and evoked firing were reversed by chronic fluoxetine, a first-line OCD treatment. Brief but repeated episodes of abnormal circuit activity may thus set the stage for the development of persistent psychopathology.

Download Full-text

The Orbitofrontal Cortex

10.1093/oso/9780198845997.001.0001 ◽

2019 ◽

Cited By ~ 12

Author(s):

Edmund T. Rolls

Keyword(s):

Bipolar Disorder ◽

Human Brain ◽

Obsessive Compulsive Disorder ◽

Orbitofrontal Cortex ◽

Multidisciplinary Approach ◽

Animal Behaviour ◽

Obsessive Compulsive ◽

Undergraduate Level ◽

Compulsive Disorder

The book will be valuable for those in the fields of neuroscience, neurology, psychology, psychiatry, biology, animal behaviour, economics, and philosophy, from the undergraduate level upwards. The book is unique in providing a coherent multidisciplinary approach to understanding the functions of one of the most interesting regions of the human brain, in both health and in disease, including depression, bipolar disorder, autism, and obsessive-compulsive disorder. There is no competing book published in the last 10 years.

Download Full-text

Recurrent hyperperfusion in the right orbitofrontal cortex in obsessive–compulsive disorder

Progress in Neuro-Psychopharmacology and Biological Psychiatry ◽

10.1016/j.pnpbp.2008.02.006 ◽

2008 ◽

Vol 32 (4) ◽

pp. 1082-1084 ◽

Cited By ~ 2

Author(s):

Ryohei Matsumoto ◽

Takashi Nakamae ◽

Takafumi Yoshida ◽

Yurinosuke Kitabayashi ◽

Yo Ushijima ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Orbitofrontal Cortex ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

The Right

Download Full-text

Relapse of obsessive–compulsive disorder after cerebral venous sinus thrombosis: a case report

Neuropsychiatrie ◽

10.1007/s40211-019-00327-8 ◽

2019 ◽

Vol 34 (1) ◽

pp. 27-29

Author(s):

Vid Velikić ◽

Andreas Wippel ◽

Marion Freidl

Keyword(s):

Obsessive Compulsive Disorder ◽

Sinus Thrombosis ◽

Cerebral Venous Sinus Thrombosis ◽

Tricyclic Antidepressant ◽

Repetitive Behaviors ◽

Venous Sinus ◽

Obsessive Compulsive ◽

Venous Sinus Thrombosis ◽

Compulsive Disorder ◽

Sagittal Sinus

SummaryObsessive–compulsive disorder (OCD) is characterized by repetitive, persistent and unwanted thoughts and ritualistic, repetitive behaviors. The pathophysiology of OCD involves many distinct cortical and subcortical regions and it has been reported that OCD may occur as a consequence of traumatic brain injury, infections and tumors as well as cerebrovascular insult such as cerebral venous sinus thrombosis (CVST). We here describe the case of a 36-year-old woman who developed OCD at the age of 13 with almost complete remission of the symptoms after a 1 year-long treatment. Interestingly, after suffering CVST at the superior sagittal sinus at the age of 33, she experienced a relapse of OCD. The patient was successfully treated with Sertraline and Clomipramine. Previous studies revealed cases of OCD following different cerebrovascular accidents, i.e. predominantly arterial stroke. However, the present case is the first to describe OCD after venous thrombosis. Based on our clinical experience, the most effective treatment of OCD after CVST represents the combination of the selective serotonin reuptake inhibitor Sertraline and the tricyclic antidepressant Clomipramine.

Download Full-text

Agomelatine Augmentation of Escitalopram Therapy in Treatment-Resistant Obsessive-Compulsive Disorder: A Case Report

Case Reports in Psychiatry ◽

10.1155/2012/642752 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Domenico De Berardis ◽

Nicola Serroni ◽

Stefano Marini ◽

Giovanni Martinotti ◽

Francesca Ferri ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Chronic Condition ◽

Selective Serotonin Reuptake Inhibitors ◽

Atypical Antipsychotics ◽

Young Female ◽

Treatment Resistant ◽

First Line ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Augmentation Strategies

Obsessive-compulsive disorder (OCD) is a chronic condition characterized by obsessions or compulsions that cause distress or interfere with functioning. Selective serotonin reuptake inhibitors are the first-line strategy in the treatment of OCD, but approximately 40% to 60% of patients with OCD fail to respond to them. Several augmentation strategies have been proposed, including the use of atypical antipsychotics and antidepressant combinations. In the present paper we describe the case of a young female patient suffering from severe treatment-resistant OCD who remitted as a result of agomelatine augmentation of escitalopram therapy.

Download Full-text

Layer-specific reduced neuronal density in the orbitofrontal cortex of older adults with obsessive–compulsive disorder

Brain Structure and Function ◽

10.1007/s00429-018-1752-8 ◽

2018 ◽

Vol 224 (1) ◽

pp. 191-203 ◽

Cited By ~ 4

Author(s):

Katia Cristina de Oliveira ◽

Lea Tenenholz Grinberg ◽

Marcelo Queiroz Hoexter ◽

Helena Brentani ◽

Claudia Kimie Suemoto ◽

...

Keyword(s):

Older Adults ◽

Obsessive Compulsive Disorder ◽

Orbitofrontal Cortex ◽

Obsessive Compulsive ◽

Neuronal Density ◽

Compulsive Disorder

Download Full-text

Treatments for Obsessive-Compulsive Disorder

10.1093/med:psych/9780199342211.003.0017 ◽

2015 ◽

Cited By ~ 2

Author(s):

Darin D. Dougherty ◽

Scott L. Rauch ◽

Michael A. Jenike

Keyword(s):

Obsessive Compulsive Disorder ◽

Behavior Therapy ◽

First Line ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

First Line Therapy ◽

Line Therapy ◽

Augmentation Strategies ◽

Overwhelming Evidence ◽

Limited Support

There is overwhelming evidence of the most rigorous type supporting the efficacy of serotonin reuptake inhibitors (SRIs) in the treatment of obsessive-compulsive disorder (OCD). Along with SRIs, behavior therapy must be considered a viable first-line therapy. The best available data suggest that behavior therapy, and perhaps cognitive therapy, is at least as effective as medication in some instances and may be superior with respect to risks, costs, and enduring benefits. A variety of second-line medication treatments for OCD have been studied in a controlled or systematic fashion. Augmentation of SRIs with antipsychotics, buspirone, or clonazepam is provisionally recommended based on the available data. Other monotherapies and augmentation strategies find very limited support at present.

Download Full-text

Mapping Alterations of the Functional Structure of the Cerebral Cortex in Obsessive–Compulsive Disorder

Cerebral Cortex ◽

10.1093/cercor/bhz008 ◽

2019 ◽

Vol 29 (11) ◽

pp. 4753-4762 ◽

Cited By ~ 4

Author(s):

Jesus Pujol ◽

Laura Blanco-Hinojo ◽

Dídac Maciá ◽

Pino Alonso ◽

Ben J Harrison ◽

...

Keyword(s):

Cerebral Cortex ◽

Obsessive Compulsive Disorder ◽

Neural Activity ◽

Orbitofrontal Cortex ◽

Inhibitory Neuron ◽

Functional Structure ◽

Neuron Activity ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Neurophysiological Studies

AbstractWe mapped alterations of the functional structure of the cerebral cortex using a novel imaging approach in a sample of 160 obsessive–compulsive disorder (OCD) patients. Whole-brain functional connectivity maps were generated using multidistance measures of intracortical neural activity coupling defined within isodistant local areas. OCD patients demonstrated neural activity desynchronization within the orbitofrontal cortex and in primary somatosensory, auditory, visual, gustatory, and olfactory areas. Symptom severity was significantly associated with the degree of functional structure alteration in OCD-relevant brain regions. By means of a novel imaging perspective, we once again identified brain alterations in the orbitofrontal cortex, involving areas purportedly implicated in the pathophysiology of OCD. However, our results also indicated that weaker intracortical activity coupling is also present in each primary sensory area. On the basis of previous neurophysiological studies, such cortical activity desynchronization may best be interpreted as reflecting deficient inhibitory neuron activity and altered sensory filtering.

Download Full-text

Adequacy of Pharmacotherapy Among Medicaid-Enrolled Patients Newly Diagnosed with Obsessive-Compulsive Disorder

CNS Spectrums ◽

10.1017/s1092852900023956 ◽

2009 ◽

Vol 14 (12) ◽

pp. 695-703 ◽

Cited By ~ 2

Author(s):

Cheryl S. Hankin ◽

Lorrin M. Koran ◽

Amy Bronstone ◽

Donald W. Black ◽

David V. Sheehan ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Patient Adherence ◽

Standards Of Care ◽

Newly Diagnosed ◽

Claims Analysis ◽

First Line ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Physician Awareness

ABSTRACTObjective: To determine the adequacy of pharmacotherapy received by patients with newly-diagnosed obsessive-compulsive disorder (OCD), based on current practice guidelines.Methods: A 9 year (1997–2006) retrospective claims analysis of adults enrolled in Florida Medicaid for at least 3 continuous years was conducted to determine the percentage who received both a minimally effective duration (≥ 8 continuous weeks) and dose of first-line OCD pharmacotherapy during the year following their first (“index”) OCD diagnosis.Results: Among 2,960,421 adult (≥ 18 years of age) enrollees, 2,921 (0.1%) were diagnosed with OCD. Among the 2,825 OCD patients without comorbid Asperger syndrome or autism, 843 had newly-diagnosed OCD and at least 12 months of follow-up data after their index diagnosis. Among these 843 patients, 588 (69.7%) received first-line OCD pharmacotherapy but only 323 (38.3%) received a minimally effective pharmacotherapy trial in the year following their index diagnosis.Conclusions: Among clinically-diagnosed persons with OCD (<10% of those with the disorder), a minority of newly-diagnosed patients receive a minimally effective pharmacotherapy trial consistent with current standards of care. Reasons such as limited patient adherence and/or physician awareness of guidelines must be identified and redressed to ameliorate the patient, healthcare system, and economic burdens associated with OCD.

Download Full-text