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The Journal of Nuclear Medicine Vol. 36 No. 12 2234-2238
© 1995 by Society of Nuclear Medicine
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Drug Therapy and Cerebral Perfusion in Obsessive-Compulsive Disorder

V. Molina, R. Montz, M. Martín-Loeches, A. Jiménez-Vicioso, J.L. Carreras and F.J. Rubia

Department of Psychiatry, San Juan de Dios Hospital, Ciempozuelos, Madrid
Brain Mapping Unit, Pluridisciplinar Institute and Department of Nuclear Medicine, Complutense University of Madrid, Spain

Correspondence: For correspondence reprints or contact: V. Molina, MD, PhD, Instituto Pluridisciplinar, Universidad Complutense de Madrid, P??? Juan XXIII, 1, 28040 Madrid, Spain.

ABSTRACT

Cerebral perfusion in a previously untreated patient with obsessive-compulsive disorder was studied qualitatively and semiquantitatively with SPECT before, during and 6 wk after treatment with clomipramine. The patient's symptoms disappeared while on medication and relapsed after drug withdrawal. At baseline, there was an increased perfusion ratio in the bilateral orbitofrontal, anterior cingular, frontotemporal and right caudate regions. These alterations disappeared during drug therapy. After treatment discontinuation and symptomatic relapse, the same pattern of hyperactivity was found. Semiquantitative measurements after treatment withdrawal showed a return to perfusion values similar to those observed before treatment in subcortical structures. In cortical areas, this level was not completely achieved. Subtraction SPECT images showed perfusion changes at the orbito frontal, caudate and thalamic levels.

Key Words: obsessive-compulsive disorder • single-photon emission computed tomography • clomipramine • neuroimaging






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Copyright © 1995 by the Society of Nuclear Medicine.