Purpose of review: This review examines emerging neuroimaging research in pediatric obsessive compulsive disorder (OCD) and explores the possibility that developmentally sensitive mechanisms may underlie OCD across the lifespan.
Recent findings: Diffusion tensor imaging (DTI) studies of pediatric OCD reveal abnormal structural connectivity within frontal-striato-thalamic circuity (FSTC). Resting-state functional magnetic resonance imaging (fMRI) studies further support atypical FSTC connectivity in young patients, but also suggest altered connectivity within cortical networks for task-control. Task-based fMRI studies show that hyper- and hypo-activation of task control networks may depend on task difficulty in pediatric patients similar to recent findings in adults.
Summary: This review suggests that atypical neurodevelopmental trajectories may underlie the emergence and early course of OCD. Abnormalities of structural and functional connectivity may vary with age, while functional engagement during task may vary with age and task complexity. Future research should combine DTI, resting-state fMRI and task-based fMRI methods and incorporate longitudinal designs to reveal developmentally sensitive targets for intervention.
Keywords: DTI; Pediatric OCD; executive function; fMRI; resting-state; task-control network.