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...But cerebral secrets persist.

Despite these intriguing new findings, the causes of OCD remain largely mysterious, cautions NIMH psychiatrist Thomas R. Insel in a commentary accompanying the two PET scan reports.

Brain imaging studies have yet to demonstrate that a specific biological abnormality sparks OCD symptoms, he notes. Changes in metabolic activity linked with symptom improvement vary in PET studies conducted by Baxter, Swedo, and others, Insel points out. To make matters more complex, OCD patients undoubtedly display individual differences in their bioligical response to treatment, he asserts.

Moreover, in some brain diseases, areas of intense metabolic activity compensate for regions of sluggish activity that go undetected on PET scans. Thus, brain regions that chew up gobs of energy and light up PET scans are not necessarily the prime biological culprits behind OCD, Insel argues.

Increased orbital cortex metabolism among OCD sufferers, as measured by Swedo's group, may reflect mental attempts to resist disturbing urges and thoughts, Insel suggests; declines in orbital cortex activity with treatment may signal the reduced effort needed to control obsessive thoughts.

Future studies should obtain brain scans while people with OCD perform their rituals -- such as washing their hands or rechecking a lock for hours at a time -- or during behavior therapy as they attempt to resist inner urges, Insel says.
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Title Annotation:research suggests patients of obsessive-compulsive disorder should be scanned while they carry out their rituals
Publication:Science News
Article Type:Brief Article
Date:Sep 26, 1992
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