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Compulsions without obsession following stroke

Contributors

Genetti Gatfield, Melanie; Peron, Julie Anne; Medlin, Friedrich; Annoni, Jean-Marie; Accolla, Ettore A.

Published in

Neuropsychologia, vol. 162, 108050

Publication date

2021-11

Abstract

Background: Obsessive-compulsive disorder (OCD) is characterized by intrusive and irrational thoughts as well as repetitive behaviours. OCD-like behaviours have been described in a wide range of neurological disorders. In cerebrovascular accidents, the semiology arises mostly from lesions to the basal ganglia – though cortical regions may also be involved. In the past few years, the mechanisms underlying OCD in psychiatric patients have been re- examined, in particular the functional relationship between anxiety, obsessions and compulsions. Traditionally, obsessions are viewed as a trigger for compulsive behaviour that represents an attempt to reduce anxiety. By contrast, other models place compulsions – as a manifestation of an imbalance between goal-directed action and automatic habits that leads to maladaptive habit learning – at the core of OCD. CASE: We show neurological evidence of pure compulsions without obsession in a patient following stroke in the left subcortical regions. Furthermore, we present comprehensive neuropsychological findings that identify specific alterations across executive and emotional domains. Finally, MRI analyses reveal that the subcortical stroke had resulted in a strong decrease of connectivity suggestive of large network alterations. CONCLUSIONS: Our case provides direct information on how brain structure and function relate in an OCD patient, highlighting the central role of compulsions in the pathology.

Keywords

  • Cognition
  • Compulsion
  • Obsessive-compulsive disorder
  • Stroke

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

GENETTI GATFIELD, Melanie et al. Compulsions without obsession following stroke. In: Neuropsychologia, 2021, vol. 162, p. 108050. doi: 10.1016/j.neuropsychologia.2021.108050

Main files (1)

Article (Published version)
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Identifiers

Additional URL for this publication

https://linkinghub.elsevier.com/retrieve/pii/S0028393221003031

Journal ISSN

0028-3932
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673downloads

Technical informations

Creation

06/01/2022 20:28:00

First validation

06/01/2022 20:28:00

Update

30/06/2023 10:24:09

Status update

30/06/2023 10:24:09

Last indexation

01/11/2024 00:36:51
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