Cognitive deficits in obsessive-compulsive disorder on tests of frontal-striatal function

Background: although neuropsychological and neuroimaging studies of obsessive-compulsive disorder (OCD) have implicated the frontal cortex and subcortical structures in the pathophysiology of the disorder, few studies have examined cognitive function in patients with OCD on tasks validated in the assessment of frontal lobe and subcortical dysfunction. Methods: The accuracy and latency of executive and visual memory function was assessed in 23 nondepressed OCD patients and 23 normal healthy controls matched for age, sex, education, and estimated IQ. Results: The patients with OCD performed within the normal range on tasks of short-term memory capacity, delay dependent visual memory, pattern recognition, attentional shifting, and planning ability; however, specific cognitive deficits related to spatial working memory, spatial recognition, and motor initiation and execution were observed in the patient group. These deficits were not correlated with aspects of the patients' intellectual functioning or comorbid psychological symptoms, suggesting that the impairments were related to the specific clinical features of OCD. Conclusions: Patients with OCD showed specific cognitive deficits on tasks of executive and visual memory function. The pattern of impaired performance in these patients was qualitatively similar to the performance of patients with frontal lobe excisions and subcortical pathology on the same test battery, suggesting that the underlying pathophysiology of the disorder could best be conceptualized as reflecting dysfunction of frontal-striatal systems. (C) 1998 Society of Biological Psychiatry.