###Human: My brother is on OCD treatment for 15 years without improvement. What is your opinion? ###Assistant: Hi. First of all what you mentioned over in the MRI report could be coincidental finding, and there is less to do with these changes if OCD (obsessive-compulsive disorder) is considered provided there is no family history of OCD or related psychiatric disorder. Now regarding the changes before searching anything, there is a definite need to see the reason behind the chronic ischemic changes. Although the most common causes are diabetes and high blood pressure, consistent hypotension (low blood pressure) can be another reason for ischemic changes. For further information consult a psychiatrist online -->