Obsessive–compulsive disorder as a visual processing impairment

Abstract

OCD has been hypothesized to involve the failures in both cognitive and behavioral inhibitory processes. There is evidence that the hyperactivation of cortical–subcortical pathways may be involved in the failure of these inhibitory systems associated with OCD. Despite this consensus on the role of frontal–subcortical pathways in OCD, recent studies have been showing that brain regions other than the frontal–subcortical loops may be needed to understand the different cognitive and emotional deficits in OCD. Some studies have been finding evidence for decreased metabolic activity in areas such as left inferior parietal and parieto- occipital junction suggesting the possible existence of visual processing deficits. While there has been inconsistent data regarding visual processing in OCD, recent studies have been claiming that these patients have abnormal patterns of visual processing social rich stimuli, particularly emotional arousing stimuli. Thus, in this article, we hypothesize that the fronto-subcortical activation consistently found in OCD may be due to a deactivation of occipital/parietal regions associated with visual-perceptual processing of incoming social rich stimuli. Additionally, this dissociation may be more evident as the emotional intensity of the social stimulus increases.