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  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Scott L. Rauch, MD; Michael A. Jenike, MD; Nathaniel M. Alpert, PhD; Lee Baer, PhD; Hans C. R. Breiter, MD; Cary R. Savage, PhD; Alan J. Fischman, MD, PhD

Arch Gen Psychiatry. 1994;51(1):62-70.

Abstract
Background
The study was designed to determine the mediating neuroanatomy of obsessive-compulsive disorder (OCD).

Methods
The short half-life tracer oxygen 15—labeled carbon dioxide was used to allow for repeated positron emission tomographic determinations of regional cerebral blood flow on each of eight patients with OCD during a resting and a provoked (symptomatic) state.

Results
Individually tailored provocative stimuli were successful in provoking OCD symptoms, in comparison with paired innocuous stimuli, as measured by selfreport on OCD analogue scales (P=.002). Omnibus subtraction images demonstrated a statistically significant increase in relative regional cerebral blood flow during the OCD symptomatic state vs the resting state in right caudate nucleus (P<.006), left anterior cingulate cortex (P<.045), and bilateral orbitofrontal cortex (P<.008); increases in the left thalamus approached but did not reach statistical significance (P=.07).

Conclusions
These findings are consistent with results of previous functional neuroimaging studies and contemporary neurocircuitry models of OCD. The data further implicate orbitofrontal cortex, caudate nucleus, and anterior cigulate cortex in the pathophysiology of OCD and in mediating OCD symptoms.

Author Affiliations
From the Departments of Psychiatry (Drs Rauch, Jenike, Baer, Breiter, and Savage) and Radiology (Drs Rauch, Alpert, Breiter, and Fischman) and Division of Nuclear Medicine/Positron Emission Tomography Laboratory (Drs Rauch, Alpert, and Fischman), Massachusetts General Hospital and Harvard Medical School, Boston.

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  

Voxel-wise meta-analysis of grey matter changes in obsessive-compulsive disorder
Radua and Mataix-Cols
Br. J. Psychiatry 2009;195:393-402.
ABSTRACT | FULL TEXT  

Patterns of Brain Activation during Visually Evoked Sexual Arousal Differ between Homosexual and Heterosexual Men
Hu et al.
Am. J. Neuroradiol. 2008;29:1890-1896.
ABSTRACT | FULL TEXT  

A Psychological and Neuroanatomical Model of Obsessive-Compulsive Disorder
Huey et al.
J. Neuropsychiatry Clin. Neurosi. 2008;20:390-408.
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  

White Matter Abnormalities in Patients With Obsessive-Compulsive Disorder and Their First-Degree Relatives
Menzies et al.
Am. J. Psychiatry 2008;165:1308-1315.
ABSTRACT | FULL TEXT  

Reversal Learning as a Neuropsychological Indicator for the Neuropathology of Obsessive Compulsive Disorder? A Behavioral Study
Valerius et al.
J. Neuropsychiatry Clin. Neurosi. 2008;20:210-218.
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  

Neural correlates of cognitive inflexibility during task-switching in obsessive-compulsive disorder
Gu et al.
Brain 2008;131:155-164.
ABSTRACT | FULL TEXT  

Neurocognitive endophenotypes of obsessive-compulsive disorder
Menzies et al.
Brain 2007;130:3223-3236.
ABSTRACT | FULL TEXT  

High-Frequency Deep Brain Stimulation of the Nucleus Accumbens Region Suppresses Neuronal Activity and Selectively Modulates Afferent Drive in Rat Orbitofrontal Cortex In Vivo
McCracken and Grace
J. Neurosci. 2007;27:12601-12610.
ABSTRACT | FULL TEXT  

Functional and Biochemical Alterations of the Medial Frontal Cortex in Obsessive-Compulsive Disorder
Yucel et al.
Arch Gen Psychiatry 2007;64:946-955.
ABSTRACT | 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  

Reduced orbitofrontal-striatal activity on a reversal learning task in obsessive-compulsive disorder.
Remijnse et al.
Arch Gen Psychiatry 2006;63:1225-1236.
ABSTRACT | FULL TEXT  

Neural correlates of tic generation in Tourette syndrome: an event-related functional MRI study
Bohlhalter et al.
Brain 2006;129:2029-2037.
ABSTRACT | FULL TEXT  

Increased Medial Thalamic Creatine-Phosphocreatine Found by Proton Magnetic Resonance Spectroscopy in Children With Obsessive-Compulsive Disorder Versus Major Depression and Healthy Controls
Mirza et al.
J Child Neurol 2006;21:106-111.
ABSTRACT  

Rostral and dorsal anterior cingulate cortex make dissociable contributions during antisaccade error commission
Polli et al.
Proc. Natl. Acad. Sci. USA 2005;102:15700-15705.
ABSTRACT | FULL TEXT  

Disorder-Specific Neuroanatomical Correlates of Attentional Bias in Obsessive-compulsive Disorder, Panic Disorder, and Hypochondriasis
van den Heuvel et al.
Arch Gen Psychiatry 2005;62:922-933.
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  

Brain Serotonin Transporter Distribution in Subjects With Impulsive Aggressivity: A Positron Emission Study With [11C]McN 5652
Frankle et al.
Am. J. Psychiatry 2005;162:915-923.
ABSTRACT | FULL TEXT  

Functional Brain Imaging Alterations in Acne Patients Treated With Isotretinoin
Bremner et al.
Am. J. Psychiatry 2005;162:983-991.
ABSTRACT | FULL TEXT  

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  

Lateralization of Olfactory Processes
Royet and Plailly
Chem Senses 2004;29:731-745.
ABSTRACT | FULL TEXT  

Attenuation of the Neural Response to Sad Faces in Major Depression by Antidepressant Treatment: A Prospective, Event-Related Functional Magnetic Resonance Imaging Study
Fu et al.
Arch Gen Psychiatry 2004;61:877-889.
ABSTRACT | FULL TEXT  

Volumetric Investigation of the Frontal-Subcortical Circuitry in Patients With Obsessive-Compulsive Disorder
Kang et al.
J. Neuropsychiatry Clin. Neurosi. 2004;16:342-349.
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  

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

Brain Metabolic Changes During Cigarette Craving
Brody et al.
Arch Gen Psychiatry 2002;59:1162-1172.
ABSTRACT | FULL TEXT  

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

Book Review: Two Phylogenetic Specializations in the Human Brain
Allman et al.
Neuroscientist 2002;8:335-346.
ABSTRACT  

Anterior Cingulate: Single Neuronal Signals Related to Degree of Reward Expectancy
Shidara and Richmond
Science 2002;296:1709-1711.
ABSTRACT | FULL TEXT  

{micro}-Opioid receptors and limbic responses to aversive emotional stimuli
Liberzon et al.
Proc. Natl. Acad. Sci. USA 2002;99:7084-7089.
ABSTRACT | FULL TEXT  

Brain activation and sexual arousal in healthy, heterosexual males
Arnow et al.
Brain 2002;125:1014-1023.
ABSTRACT | FULL TEXT  

Grey matter abnormalities in obsessive--compulsive disorder: Statistical parametric mapping of segmented magnetic resonance images
KIM et al.
Br. J. Psychiatry 2001;179:330-334.
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  

Anterior Cingulate Cortex and Response Conflict: Effects of Response Modality and Processing Domain
Barch et al.
Cereb Cortex 2001;11:837-848.
ABSTRACT | FULL TEXT  

A 45-Year-Old Woman With Obsessive-Compulsive Disorder
Jenike
JAMA 2001;285:2121-2128.
FULL TEXT  

Prefrontal regions supporting spontaneous and directed application of verbal learning strategies: Evidence from PET
Savage et al.
Brain 2001;124:219-231.
ABSTRACT | FULL TEXT  

Neural Correlates of Imaginal Aggressive Behavior Assessed by Positron Emission Tomography in Healthy Subjects
Pietrini et al.
Am. J. Psychiatry 2000;157:1772-1781.
ABSTRACT | FULL TEXT  

Emotional Responses to Pleasant and Unpleasant Olfactory, Visual, and Auditory Stimuli: a Positron Emission Tomography Study
Royet et al.
J. Neurosci. 2000;20:7752-7759.
ABSTRACT | 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  

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  

Preliminary Findings of Antistreptococcal Antibody Titers and Basal Ganglia Volumes in Tic, Obsessive-compulsive, and Attention-Deficit/Hyperactivity Disorders
Peterson et al.
Arch Gen Psychiatry 2000;57:364-372.
ABSTRACT | FULL TEXT  

Orbitofrontal Cortex and Human Drug Abuse: Functional Imaging
London et al.
Cereb Cortex 2000;10:334-342.
ABSTRACT | 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  

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  

Neuropsychological Deficits in Obsessive-compulsive Disorder: A Comparison With Unipolar Depression, Panic Disorder, and Normal Controls
Purcell et al.
Arch Gen Psychiatry 1998;55:415-423.
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  

Frontostriatal Measurement in Treatment-Naive Children With Obsessive-Compulsive Disorder
Rosenberg et al.
Arch Gen Psychiatry 1997;54:824-830.
ABSTRACT  

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.
 

Effects of m-Chlorophenylpiperazine on Regional Brain Glucose Utilization: A Positron Emission Tomographic Comparison of Alcoholic and Control Subjects
Hommer et al.
J. Neurosci. 1997;17:2796-2806.
ABSTRACT | FULL TEXT  

Visual Imagery and Perception in Posttraumatic Stress Disorder: A Positron Emission Tomographic Investigation
Shin et al.
Arch Gen Psychiatry 1997;54:233-241.
ABSTRACT  

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

A Symptom Provocation Study of Posttraumatic Stress Disorder Using Positron Emission Tomography and Script-Driven Imagery
Rauch et al.
Arch Gen Psychiatry 1996;53:380-387.
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  

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  

Reciprocal Lateralization of Frontal Lobe Functions
Goldberg and Podell
Arch Gen Psychiatry 1995;52:159-159.
ABSTRACT  

Reciprocal Lateralization of Frontal Lobe Functions-Reply
Rauch et al.
Arch Gen Psychiatry 1995;52:159-160.
ABSTRACT  

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

Retrocallosal White Matter Abnormalities in Patients With Obsessive-compulsive Disorder
Breiter et al.
Arch Gen Psychiatry 1994;51:663-664.
ABSTRACT