Obsessive-compulsive disorder and executive deficits in two patients with primary dystonia.

In spite of the high prevalence of behavioral and cognitive disturbances found in most basal ganglia disorders and attributed to fronto-striatal dysfunction, the existence of psychiatric and cognitive symptoms in patients with primary dystonia remains controversial. We present a 42-year-old female with primary writer's cramp and obsessive-compulsive disorder (OCD) and a 59-year-old male with Meigs syndrome, idiopathic torticollis and OCD. Both patients had mild executive dysfunction. The coexistence of psychiatric, cognitive and motor symptoms of different intensity may be explained by variable dysfunction on different frontal-striatal loops, as proposed by the open interconnected model of fronto-striatal circuits.