Brain Regions and Neuropsychological Deficits in Obsessive-Compulsive Disorder

Abstract

Neurobiological factors had been shown to play an important role in the emergence of obsessive-compulsive disorder by the information obtained from the methods developed over the years. According to the neuropsychological perspective, the defects had been detected mainly in executive functions, in attention, memory, visual-spatial functions; and abnormalities had been described in the frontal lobe, cingulate cortex, basal ganglia, and thalamus regions of the patients with obsessive-compulsive disorder. The main and the most repeated abnormalities in patients with obsessive-compulsive disorder are dysfunctions in executive function and visual memory. Dysfunctions of the inhibitory processes associated with the dominant frontal area lead to an insufficiency on the inhibition of verbal functions. Excessive activation of the orbitofrontal cortex that mediate the behavioral response suppression function in obsessive-compulsive disorder demonstrated by functional imaging techniques. Repeated-resistant behaviors (eg: compulsions) are composed by the deteriorations of the inhibitions of motor or cognitive programs in basal ganglions provided through cycles of frontal lobe. The findings of clinical observations in patients with obsessive-compulsive disorder could be considered as a reflection of excessive work in 'error detection system' which is the cause of the thoughts that something goes wrong and efforts to achieve perfection. As neurobiological, this finding is observed as excessive activity in orbitofrontal cortex and anterior cingulate cortex representing the ability of humans to provide and detect errors. İt is is expected to develop the vehicles that are more sensitive to the characteristics of cognitive deficits in obsessive-compulsive disorder. In addition to the neuropsychological tests, using electrophysiological and advanced functional imaging techniques will put forward a better underlying the physiopathology of this disorder in order to show the more distinctive structural and functional impairments.

Keywords

• Obsessive-compulsive disorder, neuropsychology, affected brain regions

Obsesif Kompulsif Bozuklukta Nöropsikolojik Defisitlerin Beyin Bölgeleri İle İlişkisi

Öz

Obsesif kompulsif bozukluğun ortaya çıkışında nörobiyolojik etkenlerin önemli rol oynadığı gösterilmiştir. Obsesif kompulsif bozukluğu olan hastalarda nöropsikolojik açıdan başlıca yürütücü işlevlerde olmak üzere dikkat, hafıza, görsel-mekansal işlevlerde kusurlar saptanmış, bu hastalarının frontal lob, singulat korteks, bazal ganglion ve talamus bölgelerinde anormallikler tanımlanmıştır. Obsesif kompulsif bozukluğu olan hastalarda başlıca ve en çok tekrarlanan anormallik yürütücü işlevler ve görsel bellekteki fonksiyon bozukluğudur. Obsesif kompulsif bozukluğu olan hastaların bir şeylerin yanlış gittiğine dair düşüncelerinin ve mükemmele ulaşma çabalarının nedeni 'hata saptama sisteminin' aşırı çalışmasının bir yansıması olabilir. Bu bulgunun nörobiyolojik karşılığı ise insanda hata saptama va sağlama yeteneğini temsil eden kortikal alanlar olan orbitofrontal korteks ve anterior singulat korteksteki aşırı aktivitenin varlığıdır. Yapısal ve fonksiyonel bozulmaların daha ayırt edici olarak gösterilebilmesi için nöropsikolojik testlere ek olarak elektrofizyolojik ve ileri fonksiyonel görüntüleme yöntemlerinin de kullanılması bu hastalığın altında yatan fizyopatolojinin daha iyi ortaya konulmasını sağlayacaktır.

Anahtar Kelimeler

• Obsesif kompulsif bozukluk, nöropsikoloji, beyin bölgeleri

Kaynakça

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42. Meneses A. Could the 5-HT1B receptor inverse agonism affect learning consolidation? Neurosci Biobehav Rev 2001; 25:193-201. Taner Öznur, Dr., Gülhane Askeri Tıp Fakültesi Psikiyatri A.D, Ankara; Murat Erdem, Doç. Dr., Gülhane Askeri Tıp Fakültesi Psikiyatri A.D, Ankara; Süleyman Akarsu, Dr., Gülhane Askeri Tıp Fakültesi Psikiyatri A.D,Ankara Yazışma Adresi/Correspondence: Taner Öznur, Gülhane Askeri Tıp Fakültesi Psikiyatri A.D, Ankara, Turkey. E-mail: [e-mail] Yazarlar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemişlerdir. The authors reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol5/no3/ Çevrimiçi yayım / Published online 07 Eylül/September 07, 2013; doi:10.5455/cap.20130523