Damage to the dorsolateral prefrontal cortex is associated with repetitive compulsive behaviors in patients with penetrating brain injury

Rachel Fremont; Jordan Dworkin; Masood Manoochehri; Frank Krueger; Edward Huey; Jordan Grafman

doi:10.1136/bmjno-2021-000229

Damage to the dorsolateral prefrontal cortex is associated with repetitive compulsive behaviors in patients with penetrating brain injury

BMJ Neurol Open. 2022 Apr 18;4(1):e000229. doi: 10.1136/bmjno-2021-000229. eCollection 2022.

Authors

Rachel Fremont¹, Jordan Dworkin^{1

2}, Masood Manoochehri³, Frank Krueger^{4

5}, Edward Huey^{1

6}, Jordan Grafman⁷

Affiliations

¹ Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.
² Department of Psychiatry, New York State Psychiatric Institute, New York, New York, USA.
³ Taub Insitute, Columbia University Medical Center, New York, New York, USA.
⁴ Molecular Neuroscience Department, George Mason University, Fairfax, Virginia, USA.
⁵ Department of Psychology, George Mason University, Fairfax, Virginia, USA.
⁶ Department of Neurology, Columbia University, New York, New York, USA.
⁷ Brain Injury Research, Rehabilitation Institute of Chicago, Chicago, Illinois, USA.

Abstract

Background: Damage to cortico-striato-thalamo-cortical (CSTC) circuits is associated with the development of repetitive behaviours in animals and humans. However, the types of repetitive behaviours that are developed after injury to these structures are poorly defined. This study examines the effect of damage to separate elements of CSTC circuits sustained by veterans of the Vietnam War on obsessions, compulsions, and tics.

Methods: We performed partial correlations (correcting for cognition, age, education, and global brain damage) between volume loss from traumatic brain injury in specific elements of CSTC circuits (lateral and medial orbitofrontal and dorsolateral prefrontal cortices, anterior cingulate cortex, thalamus, and basal ganglia) and scores on a modified version of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist and the Yale Global Tic Severity Scale in 83 Vietnam war veterans with penetrating brain injuries at different sites throughout the brain.

Results: We found that volume loss in the left dorsolateral prefrontal cortex was associated with the development of compulsive behaviours (r=0.32, padj<0.05) whereas volume loss in the basal ganglia was associated with the development of tics (r=0.33, padj<0.05).

Conclusion: Our findings indicate that damage to specific CSTC elements can be associated with the development of compulsive behaviours and tics that are not necessarily accompanied by obsessions.

Keywords: NEUROPSYCHIATRY; TRAUMATIC BRAIN INJURY.

Abstract

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