Simpson S, Baldwin B
Manchester Royal Infirmary.
Br J Psychiatry. 1995 Mar;166(3):390-2. doi: 10.1192/bjp.166.3.390.
A 71-year-old man with no previous psychiatric history presented with an acute onset of obsessive-compulsive disorder (OCD) symptoms associated with a right inferior parietal infarct. There were no abnormal neurological signs. There were no noteworthy abnormalities on neuropsychological testing.
Whereas a computerised tomography scan showed only a right inferior parietal infarct, a single photon emission computerised tomography (SPECT) scan revealed that in addition to the infarct there was decreased regional cerebral blood flow in the right basal ganglia and temporal areas. There was higher activity in the right orbitofrontal area than in the left.
The patient improved with standard drug therapy and psychotherapy.
SPECT is effective in the diagnosis of neuropsychiatric disorders such as OCD, and the pathological changes in brain metabolism detected by SPECT may be reversed by both drug therapy and psychotherapy.
一名71岁男性，既往无精神病史，因右顶叶下部梗死出现急性起病的强迫症（OCD）症状。无异常神经体征。神经心理学测试未发现明显异常。
计算机断层扫描仅显示右顶叶下部梗死，而单光子发射计算机断层扫描（SPECT）显示，除梗死灶外，右侧基底节和颞叶区域脑血流量减少。右侧眶额区活动高于左侧。
患者经标准药物治疗和心理治疗后病情改善。
SPECT对OCD等神经精神疾病的诊断有效，药物治疗和心理治疗均可逆转SPECT检测到的脑代谢病理变化。
