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A Neuroanatomy of Obsessive-Compulsive Disorder

Stephen Fleck, MD
Arch Gen Psychiatry. 1993;50(6):501. doi:10.1001/archpsyc.1993.01820180103018.
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The extensive and scholarly comment by Insel1 discusses the accumulation of data from state-of-the-art metabolic and hemodynamic exploration of brain function. The findings do not point toward a neuroanatomy of various disorders such as obsessive-compulsive disorder but to functional neuroanatomy. These findings concern vascular and metabolic aberrations, and the important discoveries in recent years point to physiochemical and metabolic aberration in what might be epitomized as the continuing plasticity of the brain throughout life.

That metabolic rate changes in the brain can be changed with either pharmacotherapy or behavioral treatments is the key finding and issue in the studies cited. The term anatomy, suggesting a static state, should be avoided, much as Adolph Meyer once pointed out to Walter B. Cannon that his notion of homeostasis was wrong because it should be homeodynamics, considering the continuous shift and rebalancing of life-sustaining forces and phenomena.


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