The delayed-maturation theory of obsessive–compulsive disorder suggests that obsessive–compulsive disorder (OCD) can be caused by delayed maturation of the frontal striatal circuitry or parts of the brain that make up the frontal cortex, striatum, or integrating circuits. Some researchers suspect that variations in the volume of specific brain structures can be observed in children that have OCD (Lambert, K.G; Kinsley, C.H., 2011). It has not been determined if delayed-maturation of this frontal circuitry contributes to the development of OCD or if OCD is the ailment that inhibits normal growth of structures in the frontal striatal, frontal cortex, or striatum. However, the use of neuroimaging has equipped researchers with evidence of some brain structures that are consistently less adequate and less matured in patients diagnosed with OCD in comparison to brains without OCD. More specifically, structures such as the caudate nucleus, volumes of gray matter, white matter, and the cingulate have been identified as being less developed in people with OCD in comparison to individuals that do not have OCD (Lambert, K.G.; Kinsley, C.H.). However, the cortex volume of the operculum (brain) is larger and OCD patients are also reported to have larger temporal lobe volumes; which has been identified in some women patients with OCD (Jenike, M.; Breiter, H.; at el, 1996). Further research is needed to determine the effect of these structural size differences on the onset and degree of OCD and the maturation of specific brain structures.
History
Origins of obsessive-compulsive disorder
The first record of obsessive-compulsive disorder dates back to the 14th century in Europe. It was believed that people who had OCD were possessed by the devil, and treatment included a series of performed exorcisms. In the 1910s, Sigmund Freud, a neurologist from Austria described Obsessive Compulsive Disorder to a case of touching phobia. This phobia is said to start in early childhood and happens when a person has a strong desire to touch. However, the opposite can also develop where the person develops what is called external prohibition. This happens when someone has the fear of a form of touching sensation. There are some circumstances where this disorder can be delayed. The earliest signs of OCD can start showing up in as little as six months. The brain becomes even more hyperactive around 54 months, and it is easier to notice obsessive-compulsive behavior at this time. Although there is no exact date as to when OCD begins to develop in later stages of life; different environments or events in a person's life can quickly become the catalyst to the development of this disorder.
Origins of obsessive-compulsive disorder and neuroimaging
Research for psychiatric neuroimaging began in 1994 at Massachusetts General Hospital, in Boston, by Dr. Scott Rauch. The group was developed into an entire program in 2003. They discovered close collaborations between several other different disorders and the brain stem. Since the research first began, there has been a significant amount of development in regards to OCD. Studies done, via neuroimaging, show that the pathophysiology of obsessive-compulsive disorder involve abnormal functioning along specific frontal-sub-cortical brain circuits.
The use of fMRI imaging to predict and follow individual's responses is a new approach. The goal is to be able to increase the understanding of the neurology of OCD. This specific study focuses on OCD patients with different refractory time. The timeline for the type of scan is a total of about three and a half months. These individuals undergo fMRI scanning one day prior to starting treatment, plus an additional four days following the treatment.
The results of this test show the baseline brain pattern compared to the first scan they took. The first scan provides data about the activation in the frontal-striatal neural circuit, which is the area involving OCD. The difference in the brain patterns depict information regarding biological mechanisms, which underlie heterogeneity in OCD.