Late-onset obsessive-compulsive disorder as the initial manifestation of possible behavioural variant Alzheimer’s disease

ABSTRACT

Introduction

A late-onset obsessive-compulsive disorder (OCD) might be a challenging diagnostic issue because of the overlapping with the dementia conditions more related to frontal lobe pathology. We aim to describe and investigate how this condition might represent the isolated long-lasting symptomatology of a frontal Alzheimer’s disease (AD).

Methods

An elderly woman with normal cognitive status showed a subacute onset of OCD with contamination obsession and washing compulsion. We conducted neuropsychological assessments and neuroimaging examinations at the onset and at 3-years follow-up.

Results

At 3-years follow-up, the patient developed cognitive deterioration, frontal behavioural disorders and improvement of OCD. Cognitive assessment showed impairments of executive functions, episodic memory, and constructional apraxia, according to the involvement of fronto-mesial, temporal and parietal regions at neuroimaging. A clinical diagnosis of possible behavioural variant AD was assigned.

Conclusion

A typical OCD might be the long-lasting initial manifestation of a possible behavioural variant AD due to dysfunctions of the anterior cingulate network.

KEYWORDS:

• Obsessive-compulsive disorder
• fronto-temporal dementia
• Alzheimer’s disease

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Massimiliano Ruggeri

Massimiliano Ruggeri is a psychologists specialists in Neuropsychology, and colleagues at the Unit for Cognitive Disorders and Dementia of the San Camillo - Forlanini Hospital in Rome. They are involved as well in research in the field of clinical neuropsychology and neuropsychiatry, authors of many publications, Lecturers in several courses of Master and PhD at Sapienza and LUMSA universities in Rome, and they work in neuropsychological rehabilitation in private practice and rehabilitation centers.

Monica Ricci

Monica Ricci is a psychologists specialists in Neuropsychology, and colleagues at the Unit for Cognitive Disorders and Dementia of the San Camillo - Forlanini Hospital in Rome. They are involved as well in research in the field of clinical neuropsychology and neuropsychiatry, authors of many publications, Lecturers in several courses of Master and PhD at Sapienza and LUMSA universities in Rome, and they work in neuropsychological rehabilitation in private practice and rehabilitation centers.

Carmela Gerace

Carmela Gerace is a neurologist MD, specialized in cognitive and behavioral neurology, and Chief of Department of the Unit for Cognitive Disorders and Dementia of the San Camillo - Forlanini Hospital in Rome, author of many publications, and Lecturer at Tor Vergata University of Rome.

Carlo Blundo

Carlo Blundo is a neurologist MC, specialized in cognitive and behavioral neurology, the ex- chief of the same department, research supervisor, Head of a Master at the LUMSA University in Rome, author and editor of the book “Neuroscienze cliniche del comportamento”, published by Elsvier, and author of many publications.