OCD is a Brain Disorder which presents with intrusive, unwanted thoughts known as obsessions and some behaviour or counter thoughts to neutralize the obsessions. These countering thoughts or behaviours are known as compulsions.
Let us see the kind of brain dysfunction and changes occur with OCD.
There are several cortical and subcortical circuits in the brain.
There is a relationship between OCD and basal Ganglia.
Basal Ganglia structures were traditionally thought to be involved in regulating movement (that is prevent unwanted movements and encourage wanted movements). Hence Basal Ganglia has been implicated in movement disorders such as Tourette Syndrome, Huntington’s chorea, Sydenham’s chorea and Parkinson’s disease. Interestingly studies have shown that OCD is increased in people presenting with these disorders (Alex S. S. Freire Maia,1999)
Let us understand what is Basal Ganglia. Basal Ganglia are a group of structures in the base of the brain.
The structures that make up the basal Ganglia are Caudate, putamen, globus pallidus (Cerebrum), Substantia Nigra (Midbrain) and subthalamic nucleus (diencephalon).
Apart from movement and motor functions we now know that the basal ganglia have several other functions related to cognition, learning, behaviours, emotions, executive functions and so forth.
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Apart from the loops with the cortex, basal ganglia have loops with the prefrontal cortex. Prefrontal cortex is involved in attention, impulse control, memory and cognitive flexibility.
When there is a dysfunction in this loop between the basal ganglia and pre frontal cortex, the ability to supress unwanted thoughts is lost which may be implicated in unwanted, intrusive thoughts not within one’s control.
OCD comes with dysfunction in a neuronal loop running from the orbital frontal cortex (which is part of the prefrontal cortex) to the cingulate gyrus, striatum (caudate nucleus and putamen), globus pallidus, thalamus and back to the frontal cortex.
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credit: Buckyball Design, Melissa Thomas Baum Source: International OCD foundation
In OCD, a maladaptive brain circuitry is implicated (Grant E Joe et al 2020). There is a loss of top-down control over inhibitions.
There is evidence of reduced grey matter (substance and cells in the brain) in the cortical region and increased grey matter in the subcortical region in OCD.
The good news is that these changes are reversible with medications, Cognitive Behaviour Therapy and mindfulness.
In Chennai Minds we offer exclusive treatment for OCD and have developed packages which incorporates diet, psychoeducation, CBT, yoga and mindfulness. Chennai minds , the Best Psychiatrist in Chennai now also offering Telepsychiatry including Online Counselling for Depression and OCD as well.