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Neuropsychiatry and SPECT of an Acute Obsessive–Compulsive Syndrome Patient

Published online by Cambridge University Press:  02 January 2018

Steve Simpson*
Affiliation:
York House, Manchester Royal Infirmary, Oxford Road, Manchester
Bob Baldwin
Affiliation:
York House, Manchester Royal Infirmary, Oxford Road, Manchester
*
Dr Simpson, York House, Manchester Royal Infirmary, Oxford Road, Manchester M13 9BX

Abstract

Background

A 71-year-old man with no previous psychiatric history presented with an acute onset of obsessive–compulsive disorder (OCD) symptoms associated with a right inferior parietal infarct. There were no abnormal neurological signs. There were no noteworthy abnormalities on neuropsychological testing.

Method

Whereas a computerised tomography scan showed only a right inferior parietal infarct, a single photon emission computerised tomography (SPECT) scan revealed that in addition to the infarct there was decreased regional cerebral blood flow in the right basal ganglia and temporal areas. There was higher activity in the right orbitofrontal area than in the left.

Results

The patient improved with standard drug therapy and psychotherapy.

Conclusions

SPECT is effective in the diagnosis of neuropsychiatric disorders such as OCD, and the pathological changes in brain metabolism detected by SPECT may be reversed by both drug therapy and psychotherapy.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

Alexander, G., DeLong, M. & Strick, P. (1986) Parallel organisation of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neuroscience, 9, 357381.Google Scholar
Baxter, L., Schwartz, J., Bergman, K., et al (1992) Caudate glucose metabolic rate changes with both drug and behaviour therapy for obsessive compulsive disorder. Archives of General Psychiatry, 49, 681689.Google Scholar
Hamlin, C. L., Swayne, L. C., Liebowitz, M. R., et al (1989) Striatal IMP-SPECT decrease in obsessive compulsive disorder, normalized by pharmacotherapy. Neuropsychiatry, Neuropsychology and Behavioural Neurology, 2, 290300.Google Scholar
Hollander, E., Schiffman, E., Cohen, B., et al (1990) Signs of central nervous system dysfunction in obsessive compulsive disorder. Archives of General Psychiatry, 47, 2732.CrossRefGoogle ScholarPubMed
Insel, T. (1992) Towards a neuroanatomy of obsessive–compulsive disorder. Archives of General Psychiatry, 49, 739745.Google Scholar
Kellner, C. H., Jolley, R., Holgate, R. C., et al (1991) Brain MRI in obsessive compulsive disorder. Psychiatric Research, 36, 4549.Google Scholar
Machlin, S. R., Harris, G. J., Pearlson, G. D., et al (1991) Elevated medial frontal cerebral blood flow in obsessive compulsive patients. American Journal of Psychiatry, 148, 12401242.Google Scholar
Rubin, R. T., Villanueva-Meyer, J., Ananth, J., et al (1992) Regional xenon 133 cerebral blood flow and technetium TC 99m-HMPAO uptake in unmedicated OCD and matched normal controls: determination using high resolution single photon emission computed tomography. Archives of General Psychiatry, 49, 695702.Google Scholar
Schilder, R. (1938) The organic background of obsessions and compulsions. American Journal of Psychiatry, 94, 13971414.CrossRefGoogle Scholar
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