Cognitive dysfunctions in the obsessive-compulsive disorder

The obsessive-compulsive disorder involves numerous cognitive dysfunctions, mainly of attention, spatial orientation, visual and motor coordination, movement initiation, memory (mainly spatial), as well as of frontal functions, such as working memory and executive functions, and hemispheric activation. These deficits reflect abnormalities of brain structures and their neural connections, which may occur in the early stages of brain development, as a result of noxious factors such as streptococcal infection (PANDAS). The results of current neuroimaging studies indicate that some psychopathological symptoms and cognitive dysfunctions are associated with the dysfunctions of neural circuits between orbitofrontal cerebral cortex and basal ganglia. Neuropsychological data show variable level of cognitive impairment in individual patients with obsessive-compulsive disorders: in some patients they have low, whereas in other – significant intensity. While in early stages of the illness the global cognitive disturbances are not present, the selective cognitive impairment can be observed. During the course of the illness, some cognitive disorders may increase. In the early phase of the illness the most conspicuous cognitive deficits occur in those patients who exhibit so called “soft” neurological symptoms which reflect structural and functional abnormalities of the brain. They may be associated with worse results of pharmacological and psychotherapeutic treatment.