This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (611)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Lewis R. Baxter, Jr, MD; Jeffrey M. Schwartz, MD; Kenneth S. Bergman, MD; Martin P. Szuba, MD; Barry H. Guze, MD; John C. Mazziotta, MD, PhD; Adina Alazraki; Carl E. Selin, MS; Huan-Kwang Ferng, MD; Paul Munford, PhD; Michael E. Phelps, PhD

Arch Gen Psychiatry. 1992;49(9):681-689.

Abstract
• We used positron emission tomography to investigate local cerebral metabolic rates for glucose (LCMRG1c) in patients with obsessive-compulsive disorder before and after treatment with either fluoxetine hydrochloride or behavior therapy. After treatment, LCMRG1c in the head of the right caudate nucleus, divided by that in the ipsilateral hemisphere (Cd/hem), was decreased significantly compared with pretreatment values in responders to both drug and behavior therapy. These decreases in responders were also significantly greater than right Cd/hem changes in nonresponders and normal controls, in both of whom values did not change from baseline. Percentage change in obsessivecompulsive disorder symptom ratings correlated significantly with the percent of right Cd/hem change with drug therapy and there was a trend to significance for this same correlation with behavior therapy. By lumping all responders to either treatment, right orbital cortex/hem was significantly correlated with ipsilateral Cd/hem and thalamus/ hem before treatment but not after, and the differences before and after treatment were significant. A similar pattern was noted in the left hemisphere. A brain circuit involving these brain regions may mediate obsessivecompulsive disorder symptoms.

Author Affiliations
From the Departments of Psychiatry (Drs Baxter, Schwartz, Bergman, Szuba, Guze, Ferng, and Munford), Radiological Sciences (Drs Baxter, Guze, Mazziotta, and Phelps, Ms Alazraki, and Mr Selin), and Neurology (Dr Mazziotta and Ms Alazraki) and the Laboratory of Nuclear Medicine (Drs Baxter, Guze, Mazziotta, and Phelps, Ms Alazraki, and Mr Selin), UCLA School of Medicine. Dr Bergman is now at the University of Washington School of Medicine, Seattle; Ms Alazraki is now at Emory University School of Medicine, Atlanta, Ga; and Dr Ferng is now at National Defense Medical Center, Taipei, Republic of China.

Footnotes
Accepted for publication February 8, 1992.

Reprint requests to the Department of Psychiatry, UCLA/NPI, 760 Westwood Plaza, Los Angeles, CA 90024 (Dr Baxter).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Altered Corticostriatal Functional Connectivity in Obsessive-compulsive Disorder
Harrison et al.
Arch Gen Psychiatry 2009;66:1189-1200.
ABSTRACT | FULL TEXT  

Preventing Excessive Weight Gain in Adolescents: Interpersonal Psychotherapy for Binge Eating
Tanofsky-Kraff et al.
Focus 2009;7:502-511.
ABSTRACT | FULL TEXT  

Does Cognitive Behavioral Therapy Change the Brain? A Systematic Review of Neuroimaging in Anxiety Disorders
Porto et al.
J. Neuropsychiatry Clin. Neurosi. 2009;21:114-125.
ABSTRACT | FULL TEXT  

Gray Matter Structural Alterations in Psychotropic Drug-Naive Pediatric Obsessive-Compulsive Disorder: An Optimized Voxel-Based Morphometry Study
Szeszko et al.
Am. J. Psychiatry 2008;165:1299-1307.
ABSTRACT | FULL TEXT  

Treatment for Late-Onset Obsessive-Compulsive Disorder with Parkinsonism
Agarwal et al.
J. Neuropsychiatry Clin. Neurosi. 2008;20:331-336.
ABSTRACT | FULL TEXT  

Corpus Callosum in Patients with Obsessive-Compulsive Disorder: Diffusion-Tensor Imaging Study
Saito et al.
Radiology 2008;246:536-542.
ABSTRACT | FULL TEXT  

Mindfulness training and neural integration: differentiation of distinct streams of awareness and the cultivation of well-being
Siegel
Soc Cogn Affect Neurosci 2007;2:259-263.
FULL TEXT  

Physiologic Responses to Loud Tones in Individuals With Obsessive-Compulsive Disorder
Buhlmann et al.
Psychosom. Med. 2007;69:166-172.
ABSTRACT | FULL TEXT  

Obsessive-Compulsive Disorder
Greist and Jefferson
Focus 2007;5:283-298.
ABSTRACT | FULL TEXT  

Obsessive-Compulsive Disorder: An Update for the Clinician
Koran
Focus 2007;5:299-313.
FULL TEXT  

Bibliography for Obsessive-Compulsive Disorder
Focus 2007;5:328-329.
FULL TEXT  

A Neuropsychiatric Model of Biological and Psychological Processes in the Remission of Delusions and Auditory Hallucinations
van der Gaag
Schizophr Bull 2006;32:S113-S122.
ABSTRACT | FULL TEXT  

A Proton MRSI Study of Brain N-Acetylaspartate Level After 12 Weeks of Citalopram Treatment in Drug-Naive Patients With Obsessive-Compulsive Disorder
Jang et al.
Am. J. Psychiatry 2006;163:1202-1207.
ABSTRACT | FULL TEXT  

Neurological Soft Signs as Predictors of Treatment Response to Selective Serotonin Reuptake Inhibitors in Obsessive-Compulsive Disorder
Hollander et al.
J. Neuropsychiatry Clin. Neurosi. 2005;17:472-477.
ABSTRACT | FULL TEXT  

White Matter Abnormalities in Obsessive-compulsive Disorder: A Diffusion Tensor Imaging Study
Szeszko et al.
Arch Gen Psychiatry 2005;62:782-790.
ABSTRACT | FULL TEXT  

Does Executive Dysfunction Affect Treatment Outcome in Late-Life Mood and Anxiety Disorders?
Mohlman
J Geriatr Psychiatry Neurol 2005;18:97-108.
ABSTRACT  

Toward a Neurobiology of Psychotherapy: Basic Science and Clinical Applications
Etkin et al.
J. Neuropsychiatry Clin. Neurosi. 2005;17:145-158.
ABSTRACT | FULL TEXT  

Frontal-Striatal Dysfunction During Planning in Obsessive-Compulsive Disorder
van den Heuvel et al.
Arch Gen Psychiatry 2005;62:301-309.
ABSTRACT | FULL TEXT  

Gilles de la Tourette's syndrome and its impact in the UK
Stern et al.
Postgrad. Med. J. 2005;81:12-19.
ABSTRACT | FULL TEXT  

Mapping Structural Brain Alterations in Obsessive-Compulsive Disorder
Pujol et al.
Arch Gen Psychiatry 2004;61:720-730.
ABSTRACT | FULL TEXT  

Cerebral Glucose Metabolism in Obsessive-Compulsive Hoarding
Saxena et al.
Am. J. Psychiatry 2004;161:1038-1048.
ABSTRACT | FULL TEXT  

Brain Structural Abnormalities in Psychotropic Drug-Naive Pediatric Patients With Obsessive-Compulsive Disorder
Szeszko et al.
Am. J. Psychiatry 2004;161:1049-1056.
ABSTRACT | FULL TEXT  

Distinct Neural Correlates of Washing, Checking, and Hoarding Symptom Dimensions in Obsessive-compulsive Disorder
Mataix-Cols et al.
Arch Gen Psychiatry 2004;61:564-576.
ABSTRACT | FULL TEXT  

Modulation of Cortical-Limbic Pathways in Major Depression: Treatment-Specific Effects of Cognitive Behavior Therapy
Goldapple et al.
Arch Gen Psychiatry 2004;61:34-41.
ABSTRACT | FULL TEXT  

The Emerging Dialogue Between Psychoanalysis and Neuroscience: Neuroimaging Perspectives
Beutel et al.
J Am Psychoanal Assoc 2003;51:773-801.
ABSTRACT  

Mental Health
Vaillant
Am. J. Psychiatry 2003;160:1373-1384.
ABSTRACT | FULL TEXT  

Motor Performance and Anatomic Magnetic Resonance Imaging (MRI) of the Basal Ganglia in Autism
Hardan et al.
J Child Neurol 2003;18:317-324.
ABSTRACT  

Differential Brain Metabolic Predictors of Response to Paroxetine in Obsessive-Compulsive Disorder Versus Major Depression
Saxena et al.
Am. J. Psychiatry 2003;160:522-532.
ABSTRACT | FULL TEXT  

The behavioral spectrum of tic disorders: A community-based study
Kurlan et al.
Neurology 2002;59:414-420.
ABSTRACT | FULL TEXT  

Nonreductive Physicalism and Soul: Finding Resonance Between Theology and Neuroscience
BROWN
American Behavioral Scientist 2002;45:1812-1821.
ABSTRACT  

Common Changes in Cerebral Blood Flow in Patients With Social Phobia Treated With Citalopram or Cognitive-Behavioral Therapy
Furmark et al.
Arch Gen Psychiatry 2002;59:425-433.
ABSTRACT | FULL TEXT  

Whither Child Psychiatry in the 21st Century?
Hertzig and Shapiro
Arch Gen Psychiatry 2002;59:477-480.
FULL TEXT  

Differential Cerebral Metabolic Changes With Paroxetine Treatment of Obsessive-Compulsive Disorder vs Major Depression
Saxena et al.
Arch Gen Psychiatry 2002;59:250-261.
ABSTRACT | FULL TEXT  

The Fate of Integrated Treatment: Whatever Happened to the Biopsychosocial Psychiatrist?
Gabbard and Kay
Am. J. Psychiatry 2001;158:1956-1963.
ABSTRACT | FULL TEXT  

Prevalence of tics in schoolchildren and association with placement in special education
Kurlan et al.
Neurology 2001;57:1383-1388.
ABSTRACT | FULL TEXT  

Increased Medial Thalamic Choline in Pediatric Obsessive-Compulsive Disorder as Detected by Quantitative in Vivo Spectroscopic Imaging
Rosenberg et al.
J Child Neurol 2001;16:636-641.
ABSTRACT  

Regional Brain Metabolic Changes in Patients With Major Depression Treated With Either Paroxetine or Interpersonal Therapy: Preliminary Findings
Brody et al.
Arch Gen Psychiatry 2001;58:631-640.
ABSTRACT | FULL TEXT  

Empirical Evidence and Psychotherapy: A Growing Scientific Base
GABBARD
Am. J. Psychiatry 2001;158:1-3.
FULL TEXT  

Decrease in Thalamic Volumes of Pediatric Patients With Obsessive-compulsive Disorder Who Are Taking Paroxetine
Gilbert et al.
Arch Gen Psychiatry 2000;57:449-456.
ABSTRACT | FULL TEXT  

The Role of the Cerebellum in Cognition and Behavior: A Selective Review
Rapoport et al.
J. Neuropsychiatry Clin. Neurosi. 2000;12:193-198.
ABSTRACT | FULL TEXT  

Late-Onset Obsessive-Compulsive Disorder: A Case Series
Weiss and Jenike
J. Neuropsychiatry Clin. Neurosi. 2000;12:265-268.
ABSTRACT | FULL TEXT  

Acquired Obsessive-Compulsive Disorder Associated With Basal Ganglia Lesions
Chacko et al.
J. Neuropsychiatry Clin. Neurosi. 2000;12:269-272.
ABSTRACT | FULL TEXT  

Neurology and psychiatry: Closing the great divide
Price et al.
Neurology 2000;54:8-8.
FULL TEXT  

Altered cortical excitability in obsessive-compulsive disorder
Greenberg et al.
Neurology 2000;54:142-142.
ABSTRACT | FULL TEXT  

Peeking Through the Door to the 21st Century
Frank and Kupfer
Arch Gen Psychiatry 2000;57:83-85.
FULL TEXT  

Is psychiatry more mindful or brainier than it was a decade ago?
EISENBERG
Br. J. Psychiatry 2000;176:1-5.
FULL TEXT  

Orbital Frontal and Amygdala Volume Reductions in Obsessive-compulsive Disorder
Szeszko et al.
Arch Gen Psychiatry 1999;56:913-919.
ABSTRACT | FULL TEXT  

Braincutting for Psychiatrists: The Time Is Ripe
Green et al.
J. Neuropsychiatry Clin. Neurosi. 1999;11:301-306.
ABSTRACT | FULL TEXT  

Some Neurobiological Aspects of Psychotherapy: A Review
Liggan and Kay
J. Psychother. Pract. Res. 1999;8:103-114.
ABSTRACT | FULL TEXT  

Nature, Niche, and Nurture: The Role of Social Experience in Transforming Genotype Into Phenotype
Eisenberg
Acad. Psychiatry 1998;22:213-222.
ABSTRACT | FULL TEXT  

A Short Echo 1H Spectroscopy and Volumetric MRI Study of the Corpus Striatum in Patients With Obsessive- Compulsive Disorder and Comparison Subjects
Bartha et al.
Am. J. Psychiatry 1998;155:1584-1591.
ABSTRACT | FULL TEXT  

A Functional Magnetic Resonance Imaging Study of Tic Suppression in Tourette Syndrome
Peterson et al.
Arch Gen Psychiatry 1998;55:326-333.
ABSTRACT | FULL TEXT  

Obsessive-Compulsive Disorder and Ventromedial Frontal Lesions: Clinical and Neuropsychological Findings
Irle et al.
Am. J. Psychiatry 1998;155:255-263.
ABSTRACT | FULL TEXT  

Electroencephalographic Sleep Profiles Before and After Cognitive Behavior Therapy of Depression
Thase et al.
Arch Gen Psychiatry 1998;55:138-144.
ABSTRACT | FULL TEXT  

Oculomotor Response Inhibition Abnormalities in Pediatric Obsessive-Compulsive Disorder
Rosenberg et al.
Arch Gen Psychiatry 1997;54:831-838.
ABSTRACT  

The Neurobiology of Obsessive-Compulsive Disorder
Glod and Cawley
J Am Psychiatr Nurses Assoc 1997;3:120-122.
 

Pattern of Interictal Hypometabolism in PET Scans With Fludeoxyglucose F 18 Reflects Prior Seizure Types in Patients With Mesial Temporal Lobe Seizures
Savic et al.
Arch Neurol 1997;54:129-136.
ABSTRACT  

Olfactory Bedside Test: A Simple Approach to Identify Temporo-orbitofrontal Dysfunction
Savic et al.
Arch Neurol 1997;54:162-168.
ABSTRACT  

The frontal lobes and neurosurgery for psychiatric disorders
Malizia
J Psychopharmacol 1997;11:179-187.
ABSTRACT  

The Neurobiology of Obsessive-Compulsive Disorder
Stein
Neuroscientist 1996;2:300-305.
ABSTRACT  

Normal Caudate Nucleus in Obsessive-compulsive Disorder Assessed by Quantitative Neuroimaging
Aylward et al.
Arch Gen Psychiatry 1996;53:577-584.
ABSTRACT  

Functional Magnetic Resonance Imaging of Symptom Provocation in Obsessive-compulsive Disorder
Breiter et al.
Arch Gen Psychiatry 1996;53:595-606.
ABSTRACT  

Cerebral Structural Abnormalities in Obsessive-compulsive Disorder: A Quantitative Morphometric Magnetic Resonance Imaging Study
Jenike et al.
Arch Gen Psychiatry 1996;53:625-632.
ABSTRACT  

Systematic Changes in Cerebral Glucose Metabolic Rate After Successful Behavior Modification Treatment of Obsessive-Compulsive Disorder
Schwartz et al.
Arch Gen Psychiatry 1996;53:109-113.
ABSTRACT  

Friday the 13th and obsessive compulsive disorder
Veale
BMJ 1995;311:963-964.
FULL TEXT  

Recent Advances: Psychiatry
Ramsay and Fahy
BMJ 1995;311:167-170.
FULL TEXT  

Cingulotomy for Intractable Obsessive-compulsive Disorder: Prospective Long-term Follow-up of 18 Patients
Baer et al.
Arch Gen Psychiatry 1995;52:384-392.
ABSTRACT  

A Positron Emission Tomographic Study of Simple Phobic Symptom Provocation
Rauch et al.
Arch Gen Psychiatry 1995;52:20-28.
ABSTRACT  

The basal ganglia and adaptive motor control
Graybiel et al.
Science 1994;265:1826-1831.
ABSTRACT  

A Multicenter Investigation of Fixed-Dose Fluoxetine in the Treatment of Obsessive-compulsive Disorder
Tollefson et al.
Arch Gen Psychiatry 1994;51:559-567.
ABSTRACT  

Tryptophan Depletion in Patients With Obsessive-Compulsive Disorder Who Respond to Serotonin Reuptake Inhibitors
Barr et al.
Arch Gen Psychiatry 1994;51:309-317.
ABSTRACT  

Regional Cerebral Blood Flow Measured During Symptom Provocation in Obsessive-Compulsive Disorder Using Oxygen 15--Labeled Carbon Dioxide and Positron Emission Tomography
Rauch et al.
Arch Gen Psychiatry 1994;51:62-70.
ABSTRACT  

Psychiatry
Freedman and Stahl
JAMA 1993;270:252-254.
ABSTRACT  

A Double-blind Comparison of Clomipramine, Desipramine, and Placebo in the Treatment of Autistic Disorder
Gordon et al.
Arch Gen Psychiatry 1993;50:441-447.
ABSTRACT  

Toward a Neuroanatomy of Obsessive-Compulsive Disorder
Insel
Arch Gen Psychiatry 1992;49:739-744.
ABSTRACT