OCD Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

What is the concordance rate for OCD?

A

33% for MZ twins and 7% for DZ twins

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2
Q

What other disease is OCD linked to?

A

Tourette’s Syndrome, it’s thought to share the same genotype.
Not clear why in some cases Tourette’s manifest in childhood and OCD in adults.

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3
Q

Tell me the link between Pediatric Autoimmune Neuropsychiatric Disorder Associated w/ Steptococcus (PANDAS) and OCD…

A

PANDAS is a disease caused by an autoimmune reaction that damages the basal ganglia (caudate in particular) and OCD and/or TICS can develop following the strep infection.

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4
Q

What do fMRI images show of brain activity in ppl w/ OCD?

A

Increased activation of orbitofrontal lobe and caudate

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5
Q

What has OCD surgical studies involving electrodes implanted in the caudate shown?

A

Increased activity in patients having obsessive thoughts during surgery and lower rate of activity in patients without obsessive thoughts.

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6
Q

Improvement in OCD symptoms is associated with…

A

Decreased activity of caudate and orbitofrontal area; durgs and beh therapy both produce this effect.

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7
Q

In severe cases of OCD, what does CINGULOTOMY do in psychosurgery?

A

Severs the cingulum, which connects the orbitofrontal and cingulate w/ limbic temporal lobe (hippocampus+amygdala)

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8
Q

In severe cases of OCD, what does CAPSULOTOMY do in psychosurgery?

A

Severs section of internal capsule connections between caudate and medial prefrontal.

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9
Q

When is psychosurgery for OCD performed and what’s the outcome?

A

Only in SEVERE cases when it can’t be treated any other way and 54% show definitely or probably improvement.

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10
Q

In psychosurgery w/ OCD, what happens to personality?

A

Negative personality changes are “very unlikely” w/ precision of modern surgery techniques. However, executive functioning deficits reported for some patients (planning, apathy, social disinhibition).
*man shot himself with a 22

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11
Q

How is deep brain stimulation used for OCD tx?

A

Electrode implanted in subthalamic nucleus & internal capsule associated w/ reduction in OCD symptoms in some treatment refractory patients

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12
Q

Whats the order for Brain Dysfunction in OCD (theory)?

A

1) The CAUDATE (learning and exec func)+PUTAMEN (regulate movmt and influence learning) receive input from entire cortex.

2) output thru 2 pathways to the THALAMUS (sleep & alertness) and FRONTAL LOBE (including prefrontal).
* Direct is excitatory
* indirect is inhibitory

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13
Q

What’s the theory for OCD in the output pathways (thalamus and frontal lobe pathways)?

A

The imbalance btwn these two pathways results in OVERACTIVATION of direct excitatory path.

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14
Q

Basal ganglia mediates what?

remember that cuaduate & putamen are in the Basal, motor fx

A

Execution of well-learned actions that are automatic so they can be executed rapidly.

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15
Q

Orbitofrontal area recognizes what?

A

Situations of personal significance and can activate the pathway and the behavior it controls (brain dysfunction OCD pathway)

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16
Q

The inhibitory indirect path does what?

A

Suppresses the automatic responses so you can switch to a different more adaptive response when needed.

17
Q

What happens when DIRECT pathway is activated?

A

It is excitatory and can’t switch to a diff response. That’s why OCD may result from direct path overactivation, where it can’t be suppressed by indirect path inhibition.

18
Q

The 3 drugs most effective for OCD are all ….

A

SSRI’S

19
Q

Which part of the brain receives the INHIBITORY input from SERATONIN neurons?

A

Orbitofrontal and Basal Ganglia

20
Q

DCS- the NMDA agonist w/ CBT results in what?

A

GREATER decrease in OCD symptoms after rx ends.