September 1992

Cerebral Glucose Metabolism in Childhood-Onset Obsessive-Compulsive DisorderRevisualization During Pharmacotherapy

Author Affiliations

From the Child Psychiatry Branch, National Institute of Mental Health (Drs Swedo, Leonard, and J. Rapoport, Mr Rettew, and Ms Goldberger), and Laboratory of Neurosciences, National Institute on Aging (Drs Pietrini, Schapiro, S. Rapoport, and Grady), Bethesda, Md.

Arch Gen Psychiatry. 1992;49(9):690-694. doi:10.1001/archpsyc.1992.01820090018003

• To investigate the effects of drug treatment in childhoodonset obsessive-compulsive disorder (OCD), we repeated positron emission tomographic scans in 13 adults with OCD (eight taking clomipramine, two taking fluoxetine, and three taking no drug) after at least 1 year of pharmacotherapy. As a group, the patients had a significant improvement on all OCD and anxiety ratings. Positron emission tomography revealed a significant decrease in normalized orbitofrontal regional cerebral glucose metabolism (relative to global metabolism) bilaterally. Among the treated patients, the decrease in right orbitofrontal metabolism was directly correlated with two measures of OCD improvement. These results extend previous positron emission tomographic findings of regional dysfunction in OCD and suggest involvement of the orbitofrontal regions in the pathophysiology of OCD.