Neuropsychological abnormalities in obsessive-compulsive disorder and their assessments

Abstract

Neuropsychological test performance of children, adolescents and adults with OCD was very variable. As a group, children and adolescents with OCD had persistent difficulties with executive functions, and show attentional and inhibitory deficits on a continuous performance test. As a group, adults with OCD showed consistent differences in allocation of attention, whether measured by evoked potential, eye movement or reaction time paradigms. They also showed inconsistent problems with visual perceptual discrimination, visual memory and working memory, as well as visuomotor tasks. However, these latter studies all failed to assess attentional capacity concurrently. Traditional measures of lateral prefrontal cortex-basal ganglia functioning tended to be depressed only in those subjects with comorbid depression, obsessional slowness, a large number of neurological soft signs, Tourette's syndrome, and/or lower IQ. Only tasks requiring inhibition of an automatic response correlated with severity of OCD symptoms; these are thought to be subserved by orbitofrontal-subcortical circuits.