Journal of Neural Transmission

, Volume 119, Issue 11, pp 1425–1448 | Cite as

Neuroimaging of cognitive brain function in paediatric obsessive compulsive disorder: a review of literature and preliminary meta-analysis

  • Silvia BremEmail author
  • Tobias U. Hauser
  • Reto Iannaccone
  • Daniel Brandeis
  • Renate Drechsler
  • Susanne Walitza
Biological Child and Adolescent Psychiatry - Review article


Obsessive compulsive disorder (OCD) is a frequent psychiatric disorder with a prevalence of 1–3 %, and it places an enormous burden on patients and their relatives. Up to 50 % of all cases suffer from onset in childhood or adolescence, and the disorder often takes a chronic course with a poor long-term prognosis. Paediatric OCD, with its high familiality, is often referred to as a distinct OCD subtype that coincides with a developmental period in which the prefrontal cortex exhibits extensive structural and functional maturation. In the present review, we included all studies examining cognitive brain activation in children and/or adolescents with OCD. We conducted extensive literature searches for relevant articles (Pubmed, ScienceDirect) and summarize, tabulate, and discuss their results. For the eight activation studies using functional magnetic resonance imaging, we also performed preliminary meta-analyses to assess the most consistent hypo- and hyperactivation in paediatric OCD patients during cognitive task performance. The review of literature as well as our preliminary meta-analyses of paediatric studies indicated altered functional activation in the same brain regions of affective and cognitive cortico-striatal-thalamic (CST) circuits as for adult OCD patients despite some variations in the direction of activation difference. The still small number of studies that examined brain activation in paediatric OCD patients thereby largely converged with previous findings in adult patients and with the established neurobiological models of CST circuit dysfunction in OCD.


Review Paediatric Obsessive compulsive disorder OCD Functional brain activation Functional magnetic resonance imaging (fMRI) Event-related potentials (ERP) Meta-analysis 



We thank the Swiss National Science Foundation, project No. 320030_130237 and the Hartmann-Müller foundation for medical research (project No. 1460), University of Zürich, for funding.

Conflict of interest

S. Walitza received speakers honoraria from Eli Lilly, Janssen-Cilag and AstraZeneca in the last five years. The other authors declare no competing financial interests.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Silvia Brem
    • 1
    Email author
  • Tobias U. Hauser
    • 1
  • Reto Iannaccone
    • 1
    • 2
  • Daniel Brandeis
    • 1
    • 3
    • 4
  • Renate Drechsler
    • 1
  • Susanne Walitza
    • 1
    • 3
  1. 1.Department of Child and Adolescent PsychiatryUniversity of ZurichZurichSwitzerland
  2. 2.PhD Program in Integrative Molecular Medicine (imMed)University of ZurichZurichSwitzerland
  3. 3.Zurich Center for Integrative Human PhysiologyUniversity of ZurichZurichSwitzerland
  4. 4.Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany

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