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Revisualization During Pharmacotherapy

Susan E. Swedo, MD; Pietro Pietrini, MD; Henrietta L. Leonard, MD; Mark B. Schapiro, MD; David C. Rettew; Erica L. Goldberger; Stanley I. Rapoport, MD; Judith L. Rapoport, MD; Cheryl L. Grady, PhD

Arch Gen Psychiatry. 1992;49(9):690-694.

Abstract
• 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.

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.

Footnotes
Accepted for publication February 3, 1992.

Reprint requests to Child Psychiatry, National Institute of Mental Health, Bldg 10, Room 6N240, 9000 Rockville Pike, Bethesda, MD 20892 (Dr Swedo)

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