New Clues to Obsessive Compulsive Disorder
In this month’s edition of the Journal of Neuroscience, a team from the University of Michigan has published a very interesting report. Every one of us has made a mistake at some stage in our lives, whether it is something trivial like dropping the groceries, or something more serious, like deleting a crucial computer file. What the researchers did was use functional MRI (fMRI) to peer inside the brain at the instant of making a mistake. While in the scanner, people were forced into making an error that carries consequences – for instance, losing money. When that happened, a particular part of the brain called the rostral anterior cingulate cortex, or rACC, became much more active when the person realized that he or she had erred and there was a penalty attached to the mistake. This part of the brain is involved in deciding what kinds of emotional responses are appropriate.
What is so interesting about this work is that in a previous study on a small group of people with obsessive compulsive disorder (OCD), the same team has shown that the rACC region of the brain became much more active in response to a no-penalty error in the brains of OCD patients, compared to people without the condition. One of the characteristics of OCD is fear and anxiety about errors or failures in certain aspects of everyday life. As a result, many begin repetitive patterns of behavior to ward off or to prevent such events.
So it looks as if people struggling with OCD have a hyperactive response to making errors, after which they begin to get more and more worried that they may have made a mistake. OCD can be a terribly incapacitating condition. We think of mild cases like Melvin Udall in As Good as it Gets, or Adrian Monk, but in reality it can cause much suffering.
I was once asked to see a seventy five year old man who had suffered from a bizarre case of OCD since the age of fourteen. He had traveled the country trying to get help, and it was an extraordinary tribute to him that despite his problem he had built a successful business and family life. He came to see me for acupuncture, but left with a prescription for a medicine that was at the time relatively new. His improvement over the next few months, as we used medication, psychological and social work and then some energetic techniques was just extraordinary.
Research like that from the University of Michigan may well bear important fruit in the future.
Technorati tags: OCD, neurobiology, anxiety, psychiatry