A 2004 study looked at a group patients who had 'focal brain lesions' very specific injuries to small areas, in particular those who displayed 'abnormal collecting behaviour'.
Using high-resolution, three-dimensional magnetic resonance imaging they compared the study group with normal images and found that damage to a part of the frontal lobes of the cortex, particularly on the right side, was shared by the individuals with abnormal behaviour. This means that there is a particular spot in the brain that put the brakes on hoarding.
Another study from 2008 has shown that compulsive hoarders have a unique pattern of brain activity, distinct from that seen non-hoarding OCD patients or normal control subjects. It suggests that hoarding is associated with impaired decision making. When hoarders wrestled with decisions about their personal items MRI scans show much more activity in the areas of the brain that control decision making, attention and controlling emotions.
This area of the brain is known as the 'bilateral anterior ventromedial prefrontal cortex' or VMPFC. The prefrontal cortex is the the most 'advanced' area of the brain, only mammals have it and it is most developed in humans.
It seems that the although the regions are missing in the brain lesion patients and over-active in the OCD hoarding patients, it that they share the same functional unit of the central nervous system.
Put simply, this means that hoarders think differently. This may explain why traditional treatments for OCD sufferers with hoarding are less successful for those without hoarding. These findings are at a very early age of discovery.
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