Cerebral Glucose Metabolism in Childhood-Onset Obsessive-Compulsive Disorder

TLDR

The study aimed to assess the impact of pharmacotherapy on childhood‑onset OCD. Repeated positron emission tomography scans were performed after at least one year of treatment in 13 adults with OCD, including those on clomipramine, fluoxetine, or no medication. Patients exhibited significant improvements in OCD and anxiety scores, alongside a bilateral reduction in orbitofrontal glucose metabolism, with right orbitofrontal decreases correlating with symptom improvement, underscoring orbitofrontal involvement in OCD.

Abstract

To investigate the effects of drug treatment in childhood-onset 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.