Journal of the American Academy of Child & Adolescent Psychiatry
Volume 47, Issue 11 , Pages 1262-1272, November 2008

Brain Imaging in Pediatric Obsessive-Compulsive Disorder

Drs. MacMaster and Rosenberg are with the Department of Psychiatry and Behavioral Neurosciences, Wayne State University. Dr. O'Neill is with the Division of Child and Adolescent Psychiatry, University of California, Los Angeles Semel Institute for Neurosciences

Accepted 15 May 2008.

Disclosure: Dr. Rosenberg serves as a consultant for Gerson Lehrman and is on the speakers' bureau of Jazz Pharmaceuticals. The other authors report no conflicts of interest.

Abstract 

Objective

To review progress in understanding pediatric obsessive-compulsive disorder (OCD). The focus is on the frontal-striatal-thalamic model of OCD, neurobiological and genetic studies of the disorder, and their influence on recent advances in treatment.

Method

Computerized literature searches were conducted with the key words Bobsessive-compulsive disorder” in conjunction with “pediatric,” “genetics,” and “imaging.”

Results

Neuroimaging studies find evidence to support the frontal-striatal-thalamic model. Genetic and neurochemical studies also implicate glutamate in the pathological finding of OCD. This has led to the application of glutamate-modulating agents to treat OCD.

Conclusions

Studies of pediatric OCD have led to a refined frontal-striatal-thalamic model of pathogenesis and are having an evidence-based impact on treatment. Despite this progress, fully explanatory models are still needed that would allow for accurate prognosis and the development of targeted and efficacious treatments.

Key Words:  glutamate , gene , obsessive-compulsive disorder , pediatric, striatum

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 This research was supported in part by the State of Michigan Joe F. Young Sr. Psychiatric Research and Training Program, the Miriam L. Hamburger Endowed Chair of Child Psychiatry at Children's Hospital of Michigan, and Wayne State University, and grants from the National Institute of Mental Health (R01MH59299, R01MH65122, K24MH02037) and the Mental Illness Research Association.Portions of this article were presented at the 2007 research forum The Future of Neuroimaging: Relevance for Child Psychiatry, American Academy of Child and Adolescent Psychiatry, Boston, MA, October 2007.This article is the subject of an editorial by Dr. Ellen Leibenluft in this issue.

PII: S0890-8567(08)60118-5

doi:10.1097/CHI.0b013e318185d2be

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 47, Issue 11 , Pages 1262-1272, November 2008

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