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Obsessive-compulsive Symptoms in Dementia : Scooping Review of Neurobiological and Cognitive Underpinnings

Published online by Cambridge University Press:  01 September 2022

F. Martinho ,
T. Ferreira ,
D. Magalhães ,
R. Felício  and
F. Godinho
F. Martinho
Affiliation:
Hospital Prof Doutor Fernando Fonseca, Mental Health Department, Amadora, Portugal
T. Ferreira*
Affiliation:
Hospital Prof Doutor Fernando Fonseca, Mental Health Department, Amadora, Portugal
D. Magalhães
Affiliation:
Hospital Prof Doutor Fernando Fonseca, Mental Health Department, Amadora, Portugal
R. Felício
Affiliation:
Hospital Prof Doutor Fernando Fonseca, Mental Health Department, Amadora, Portugal
F. Godinho
Affiliation:
Hospital Prof Doutor Fernando Fonseca, Mental Health Department, Amadora, Portugal
*
*Corresponding author.

Abstract

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Introduction

Obsessive-compulsive symptoms (OCS) have been described in many neurological disorders, including dementia. A meta-analysis by the authors (2021) reported a prevalence of OCS in dementia of approx. 35.8%, and a higher percentage in frontotemporal dementia (FTD) (46.7%). The literature also points that obsessive-compulsive disorder with late-life onset is rare, but those cases are frequently associated with neurologic injury, and some authors suggest a role of cognitive disfunction.

Objectives

Our main goal was to describe the neurobiologic and cognitive underpinnings of OCS in patients with dementia.

Methods

MEDLINE, CENTRAL and PsycNet databases were searched for articles about obsessive-compulsive symptoms in dementia. Search terms included “obsessive”, “compulsive”, “OCD”, “cognitive decline”, “cognitive dysfunction” and “dementia”. Titles, abstracts and full texts were screened independently by 2 reviewers.

Results

Correlations between dysfunction / lesions in various circuits in the context of dementia and OCS were found, such as (1) frontal regions (specially the orbitofrontal cortex) and anterior cingulate cortex (2) fronto-striatal-thalamic circuits (3) temporal structures; (4) cerebellar structures; (5) serotoninergic, dopaminergic, and cholinergic neurotransmission. A high proportion of studies concerned FTD. Regarding cognitive mechanisms, there is a focus on the importance subjective concerns about cognitive functioning, which could exacerbate obsessional beliefs and maladaptive responses to intrusions.

Conclusions

The main brain circuits implicated in dementia, specially FTD, and OCS are those involving frontal regions and the fronto-striatal-thalamic circuits, with areas such as the temporal and cerebellar structures algo being studied. The correlation between dysfunctional circuits in dementia and OCS could give us new hints about OCD and its treatment.

Disclosure

No significant relationships.

Keywords

frontotemporal dementiaobsessive-compulsive disorderObsessive-compulsive symptomsDementia
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S78
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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