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Harika-Germaneau G, Heit D, Drapier D, Sauvaget A, Bation R, Chatard A, Doolub D, Wassouf I, Langbour N, Jaafari N. Treating refractory obsessive compulsive disorder with cathodal transcranial direct current stimulation over the supplementary motor area: a large multisite randomized sham-controlled double-blind study. Front Psychiatry 2024; 15:1338594. [PMID: 38827437 PMCID: PMC11140596 DOI: 10.3389/fpsyt.2024.1338594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/29/2024] [Indexed: 06/04/2024] Open
Abstract
Background The present study evaluated the therapeutic efficacy and tolerability of 10 transcranial direct current stimulation (tDCS) sessions in treatment-resistance obsessive-compulsive disorder (OCD) patients using a multisite double-blind sham-controlled design. Methods Eighty treatment-resistance outpatients suffering from obsessive-compulsive disorder were randomized to receive either active or sham transcranial direct current stimulation. The cathode was positioned over the supplementary motor area and the anode over the right supraorbital area. Patients were evaluated at baseline, end of treatment (day 14), one-month follow-up (day 45), and three-month follow-up (day 105) on the Yale-Brown Obsessive Compulsive Scale. Results Although a significant interaction between time and treatment was observed, the primary endpoint-measuring the change in Yale-Brown obsessive compulsive scale scores after two weeks-was not achieved. Conversely, the secondary endpoint, which concerned the change in Yale-Brown obsessive compulsive scale scores after three months, was successfully met. It is important to note, however, that there were no significant differences in the percentage of responders and remitters at any of the post-treatment assessments. This suggests that the treatment may not have had a clinically relevant impact. Patients well received the transcranial direct current stimulation treatment, indicating its good tolerability. Conclusion This is the largest controlled trial using transcranial direct current stimulation in treatment-resistance obsessive-compulsive disorder patients. Our results indicate the importance of studying the placebo effect in transcranial direct current stimulation and the necessity to consider a long follow-up time to best evaluate the effects of the intervention. Clinical trial registration ClinicalTrials.gov, identifier NCT03304600.
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Affiliation(s)
- Ghina Harika-Germaneau
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France
- Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
- HUGOPSY Network, Rennes, France
| | - Damien Heit
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France
| | - Dominique Drapier
- HUGOPSY Network, Rennes, France
- Adult Psychiatry Department, Guillaume-Régnier Hospital, University of Rennes 1, Centre d’investigation Clinique (CIC) Inserm 1414, Rennes University Hospital, Rennes, France
| | - Anne Sauvaget
- HUGOPSY Network, Rennes, France
- Nantes Université, CHU Nantes, Mouvement, Interactions, Performance, MIP, UR 4334, Nantes, France
| | - Remy Bation
- Université Lyon 1, Lyon University, Villeurbanne, France
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Lyon, France
- Psychiatric Unit, Wertheimer Neurologic Hospital, Bron, France
| | - Armand Chatard
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France
- Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
| | - Damien Doolub
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France
- Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
| | - Issa Wassouf
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France
- Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
- Centre Hospitalier Nord Deux-Sèvres, Service de Psychiatrie Adulte, Thouars, France
| | - Nicolas Langbour
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France
- Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
- HUGOPSY Network, Rennes, France
| | - Nematollah Jaafari
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale du Centre Hospitalier Henri Laborit, Poitiers, France
- Université de Poitiers, Poitiers, France
- Centre de Recherches sur la Cognition et l’Apprentissage, Centre National de la Recherche Scientifique (CNRS 7295), Université de Poitiers, Poitiers, France
- HUGOPSY Network, Rennes, France
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Wang J, Huang C, Luo G, Xiao Y, Guo G, Quan D, Zheng H. Reduced sleep quality defines a subtype of obsessive-compulsive disorder with lower Glx levels in the resting thalamus and worse response inhibition. J Psychiatr Res 2024; 173:14-24. [PMID: 38461674 DOI: 10.1016/j.jpsychires.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND The aim of this study was to investigate the differences between resting and active thalamic neurometabolite levels and inhibitory function in obsessive compulsive disorder (OCD) patients with poor sleep quality (PSQ was defined as Pittsburgh Sleep Quality Index >5 and sleep efficiency ≤85%) compared to OCD patients with good sleep quality (GSQ) and healthy controls (HCs), as well as the relationship of these indices to obsessive compulsive symptoms. METHODS Functional magnetic resonance spectroscopy (fMRS) was used to measure resting and active thalamic neurometabolite levels in 72 subjects (20 HCs and 38 OCD patients included in study analysis). Response inhibition function was measured by the Go-Nogo task before and during MRS recording. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The symptoms of OCD, anxiety and depression were evaluated using relevant clinical scales. RESULTS OCD patients exhibited significantly reduced Glx/Cr levels in the resting thalamus. The levels of resting thalamic Glu/Cr and Glx/Cr in OCD patients with PSQ were significantly lowest. OCD patients had significantly lower correct rates on Go tasks, higher error rates on Nogo tasks, and longer error average response times (EART) to the Nogo task. OCD patients with PSQ demonstrated the highest Nogo task error rate and the longest EART to Nogo task. Furthermore, PSQI scores exhibited negative correlations with Glu/Cr and Glx/Cr in the resting thalamus. CONCLUSION OCD patients with PSQ demonstrated reduced levels of thalamic resting Glx and more pronounced response inhibitory function impairment. Aberrant neurometabolite levels in critical brain regions, coupled with heightened response inhibition function deficits, may be a neurobiological basis for the PSQ that OCD patients generally exhibit.
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Affiliation(s)
- Jian Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China; School of Medicine, South China University of Technology, Guangzhou, 510006, China
| | - Cigui Huang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China; The Second Clinical School of Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Guowei Luo
- Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518052, China
| | - Yuqing Xiao
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China; The Second Clinical School of Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Guangquan Guo
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China
| | - Dongming Quan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China
| | - Huirong Zheng
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510180, China; School of Medicine, South China University of Technology, Guangzhou, 510006, China; The Second Clinical School of Medicine, Southern Medical University, Guangzhou, 510515, China.
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Öztel T, Balcı F. Metric error monitoring as a component of metacognitive processing. Eur J Neurosci 2024; 59:807-821. [PMID: 37941152 DOI: 10.1111/ejn.16182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/12/2023] [Accepted: 10/16/2023] [Indexed: 11/10/2023]
Abstract
Metacognitive processing constitutes one of the contemporary target domains in consciousness research. Error monitoring (the ability to correctly report one's own errors without feedback) is considered one of the functional outcomes of metacognitive processing. Error monitoring is traditionally investigated as part of categorical decisions where choice accuracy is a binary construct (choice is either correct or incorrect). However, recent studies revealed that this ability is characterized by metric features (i.e., direction and magnitude) in temporal, spatial, and numerical domains. Here, we discuss methodological approaches to investigating metric error monitoring in both humans and non-human animals and review their findings. The potential neural substrates of metric error monitoring measures are also discussed. This new scope of metacognitive processing can help improve our current understanding of conscious processing from a new perspective. Thus, by summarizing and discussing the perspectives, findings, and common applications in the metric error monitoring literature, this paper aims to provide a guideline for future research.
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Affiliation(s)
- Tutku Öztel
- Psychology Department, Koç University, Istanbul, Turkey
| | - Fuat Balcı
- Psychology Department, Koç University, Istanbul, Turkey
- Department of Biological Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Zhao G, Yu L, Chen P, Zhu K, Yang L, Lin W, Luo Y, Dou Z, Xu H, Zhang P, Zhu T, Yu S. Neural mechanisms of attentional bias to emotional faces in patients with chronic insomnia disorder. J Psychiatr Res 2024; 169:49-57. [PMID: 38000184 DOI: 10.1016/j.jpsychires.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/27/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
OBJECTIVE This study used event-related potential (ERP) and resting-state functional connectivity (rs-FC) approaches to investigate the neural mechanisms underlying the emotional attention bias in patients with chronic insomnia disorder (CID). METHODS Twenty-five patients with CID and thirty-three demographically matched healthy controls (HCs) completed clinical questionnaires and underwent electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) scans. EEG analysis examined the group differences in terms of reaction times, P3 amplitudes, event-related spectral perturbations, and inter-trial phase synchrony. Subsequently, seed-based rs-FC analysis of the amygdala nuclei (including the central-medial amygdala [CMA] and basolateral amygdala [BLA]) was performed. The relationship between P3 amplitude, rs-FC and clinical symptom severity in patients with CID was further investigated by correlation analysis. RESULTS CID patients exhibited shorter reaction times than HCs in both standard and deviant stimuli, with the abnormalities becoming more pronounced as attention allocation increased. Compared to HCs, ERP analysis revealed increased P3 amplitude, theta wave power, and inter-trial synchrony in CID patients. The rs-FC analysis showed increased connectivity of the BLA-occipital pole, CMA-precuneus, and CMA-angular gyrus and decreased connectivity of the CMA-thalamus in CID patients. Notably, correlation analysis of the EEG and fMRI measurements showed a significant positive correlation between the P3 amplitude and the rs-FC of the CMA-PCU. CONCLUSION This study confirms an emotional attention bias in CID, specifically in the neural mechanisms of attention processing that vary depending on the allocation of attentional resources. Abnormal connectivity in the emotion-cognition networks may constitute the neural basis of the abnormal scalp activation pattern.
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Affiliation(s)
- Guangli Zhao
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liyong Yu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peixin Chen
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Keli Zhu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lu Yang
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wenting Lin
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yucai Luo
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zeyang Dou
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hao Xu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Center of Interventional Medicine, Affiliated Hospital of North Sichuan Medical College, North Sichuan Medical College, Nanchong, China
| | - Pan Zhang
- Nervous System Disease Treatment Center, Traditional Chinese Medicine Hospital of Meishan, Meishan, China.
| | - Tianmin Zhu
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Siyi Yu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China; Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Li Z, Tong G, Wang Y, Ruan H, Zheng Z, Cheng J, Wang Z. Task fMRI studies investigating inhibitory control in patients with obsessive-compulsive disorder and eating disorders: A comparative meta-analysis. World J Biol Psychiatry 2024; 25:26-42. [PMID: 37640027 DOI: 10.1080/15622975.2023.2251057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/04/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) and eating disorders (EDs) share similarities in terms of clinical characteristics and deficits in inhibitory control. OBJECTIVE To investigate whether inhibitory control could serve as a common behavioural phenotype between OCD and EDs and whether it might be underpinned by shared and/or distinct neural signatures. METHOD We performed a quantitative meta-analysis of brain function abnormalities during the inhibitory control task-based functional Magnetic Resonance Imaging (fMRI) scan across patients with OCD and EDs using seed-based d mapping (SDM). RESULTS The meta-analysis included sixteen OCD fMRI studies and ten EDs fMRI studies. And findings revealed that patients with OCD showed hypoactivation relative to healthy controls and patients with EDs in the anterior cingulate cortex, while compared to healthy controls and patients with OCD, patients with EDs showed hypoactivation in the right insula. CONCLUSIONS Patients with OCD and EDs are inclined to exhibit impaired inhibitory control, which may be attributed to different abnormal patterns of neural activation.
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Affiliation(s)
- Zheqin Li
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Geya Tong
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yang Wang
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hanyang Ruan
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zifeng Zheng
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jiayue Cheng
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhen Wang
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
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Liu W, Li G, Huang Z, Jiang W, Luo X, Xu X. Enhancing generalized anxiety disorder diagnosis precision: MSTCNN model utilizing high-frequency EEG signals. Front Psychiatry 2023; 14:1310323. [PMID: 38179243 PMCID: PMC10764566 DOI: 10.3389/fpsyt.2023.1310323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/01/2023] [Indexed: 01/06/2024] Open
Abstract
Generalized Anxiety Disorder (GAD) is a prevalent mental disorder on the rise in modern society. It is crucial to achieve precise diagnosis of GAD for improving the treatments and averting exacerbation. Although a growing number of researchers beginning to explore the deep learning algorithms for detecting mental disorders, there is a dearth of reports concerning precise GAD diagnosis. This study proposes a multi-scale spatial-temporal local sequential and global parallel convolutional model, named MSTCNN, which designed to achieve highly accurate GAD diagnosis using high-frequency electroencephalogram (EEG) signals. To this end, 10-min resting EEG data were collected from 45 GAD patients and 36 healthy controls (HC). Various frequency bands were extracted from the EEG data as the inputs of the MSTCNN. The results demonstrate that the proposed MSTCNN, combined with the attention mechanism of Squeeze-and-Excitation Networks, achieves outstanding classification performance for GAD detection, with an accuracy of 99.48% within the 4-30 Hz EEG data, which is competitively related to state-of-art methods in terms of GAD classification. Furthermore, our research unveils an intriguing revelation regarding the pivotal role of high-frequency band in GAD diagnosis. As the frequency band increases, diagnostic accuracy improves. Notably, high-frequency EEG data ranging from 10-30 Hz exhibited an accuracy rate of 99.47%, paralleling the performance of the broader 4-30 Hz band. In summary, these findings move a step forward towards the practical application of automatic diagnosis of GAD and provide basic theory and technical support for the development of future clinical diagnosis system.
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Affiliation(s)
- Wei Liu
- College of Computer Science and Technology, Zhejiang Normal University, Jinhua, China
| | - Gang Li
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua, China
| | - Ziyi Huang
- School of Advanced Technology, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | - Weixiong Jiang
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua, China
| | | | - Xingjuan Xu
- College of Mathematical Medicine, Zhejiang Normal University, Jinhua, China
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Perera MPN, Mallawaarachchi S, Bailey NW, Murphy OW, Fitzgerald PB. Obsessive-compulsive disorder (OCD) is associated with increased engagement of frontal brain regions across multiple event-related potentials. Psychol Med 2023; 53:7287-7299. [PMID: 37092862 PMCID: PMC10719690 DOI: 10.1017/s0033291723000843] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/09/2023] [Accepted: 03/15/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a psychiatric condition leading to significant distress and poor quality of life. Successful treatment of OCD is restricted by the limited knowledge about its pathophysiology. This study aimed to investigate the pathophysiology of OCD using electroencephalographic (EEG) event-related potentials (ERPs), elicited from multiple tasks to characterise disorder-related differences in underlying brain activity across multiple neural processes. METHODS ERP data were obtained from 25 OCD patients and 27 age- and sex-matched healthy controls (HCs) by recording EEG during flanker and go/nogo tasks. Error-related negativity (ERN) was elicited by the flanker task, while N200 and P300 were generated using the go/nogo task. Primary comparisons of the neural response amplitudes and the topographical distribution of neural activity were conducted using scalp field differences across all time points and electrodes. RESULTS Compared to HCs, the OCD group showed altered ERP distributions. Contrasting with the previous literature on ERN and N200 topographies in OCD where fronto-central negative voltages were reported, we detected positive voltages. Additionally, the P300 was found to be less negative in the frontal regions. None of these ERP findings were associated with OCD symptom severity. CONCLUSIONS These results indicate that individuals with OCD show altered frontal neural activity across multiple executive function-related processes, supporting the frontal dysfunction theory of OCD. Furthermore, due to the lack of association between altered ERPs and OCD symptom severity, they may be considered potential candidate endophenotypes for OCD.
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Affiliation(s)
- M. Prabhavi N. Perera
- Central Clinical School, Monash University, Wellington Road, Clayton, VIC 3800, Australia
| | | | - Neil W. Bailey
- Central Clinical School, Monash University, Wellington Road, Clayton, VIC 3800, Australia
- Monarch Research Institute, Monarch Mental Health Group, Sydney, NSW, Australia
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2600, Australia
| | - Oscar W. Murphy
- Central Clinical School, Monash University, Wellington Road, Clayton, VIC 3800, Australia
- Bionics Institute, East Melbourne, VIC 3002, Australia
| | - Paul B. Fitzgerald
- School of Medicine and Psychology, Australian National University, Canberra, ACT 2600, Australia
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Riesel A, Härpfer K, Thoma L, Kathmann N, Klawohn J. Associations of neural error-processing with symptoms and traits in a dimensional sample recruited across the obsessive-compulsive spectrum. Psychophysiology 2023; 60:e14164. [PMID: 36030541 DOI: 10.1111/psyp.14164] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 06/24/2022] [Accepted: 07/21/2022] [Indexed: 01/04/2023]
Abstract
The error-related negativity (ERN), a neural response to errors, has been associated with several forms of psychopathology and assumed to represent a neural risk marker for obsessive-compulsive disorder (OCD) and anxiety disorders. Yet, it is still unknown which specific symptoms or traits best explain ERN variation. This study investigated performance-monitoring in participants (N = 100) recruited across a spectrum of obsessive-compulsive characteristics (n = 26 patients with OCD; n = 74 healthy participants including n = 24 with low, n = 24 with medium, and n = 26 with high OC-characteristics). Several compulsivity- and anxiety-associated characteristics were assessed and submitted to exploratory principal axis factor analysis. Associations of raw measures and derived factors with ERN and correct-related negativity (CRN) were examined. Patients with OCD showed increased ERN amplitudes compared to healthy participants. The ERN was associated with a variety of traits related to anxiety and negative affect. Factor analysis results revealed a most prominent association of the ERN with a composite measure of anxiety and neuroticism, whereas the CRN was specifically associated with compulsivity. Results support differential associations for the ERN and CRN and demonstrate that a dimensional recruitment approach and use of composite measures can improve our understanding of characteristics underlying variation in neural performance monitoring.
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Affiliation(s)
- Anja Riesel
- Department of Psychology, Universität Hamburg, Hamburg, Germany
| | - Kai Härpfer
- Department of Psychology, Universität Hamburg, Hamburg, Germany
| | - Lars Thoma
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Julia Klawohn
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Medicine, MSB Medical School Berlin, Berlin, Germany
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Fang L, Andrzejewski JA, Carlson JM. The gray matter morphology associated with the electrophysiological response to errors in individuals with high trait anxiety. Int J Psychophysiol 2023; 184:76-83. [PMID: 36581044 PMCID: PMC10125723 DOI: 10.1016/j.ijpsycho.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
Enhanced error monitoring has been associated with higher levels of anxiety. This has been consistently demonstrated in its most reliable electrophysiological index, the error-related negativity (ERN), such that increased ERN is related with elevated anxiety symptomology. However, it is still unclear whether the structural properties of the brain are associated with individual differences in ERN amplitude. Moreover, the relationship between ERN and anxiety has recently been suggested to be moderated by sex, but the degree to which sex moderates the association between brain structure and ERN amplitude is unknown. The present study investigated the association between gray matter volume (GMV) and ERN amplitude in individuals with high trait anxiety (N = 98) as well as the role of sex in moderating this association. The ERN was elicited from a flanker task, whereas structural MRI images were obtained from whole brain structural T1-weighted MRI scans. The results of voxel-based morphometry analyses showed that the relationship between ERN difference scores and GMV was moderated by sex in the dorsal anterior cingulate cortex (dACC). This sex difference was derived from a negative correlation between ERN difference scores and dACC GMV in females and a positive correlation in males. Our findings are in accordance with the critical role of the dACC serving as a neural substrate of error monitoring. It also provides further evidence for sex-specific associations with brain structures related to error monitoring.
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Affiliation(s)
- Lin Fang
- Department of Psychological Science, Northern Michigan University, Marquette, MI, USA.
| | - Jeremy A Andrzejewski
- Department of Psychological Science, Northern Michigan University, Marquette, MI, USA
| | - Joshua M Carlson
- Department of Psychological Science, Northern Michigan University, Marquette, MI, USA
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Grützmann R, Kathmann N, Heinzel S. Effects of a three-week executive control training on adaptation to task difficulty and emotional interference. PLoS One 2022; 17:e0276994. [PMID: 36413545 PMCID: PMC9681094 DOI: 10.1371/journal.pone.0276994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/29/2022] [Indexed: 11/23/2022] Open
Abstract
Intact executive functions are characterized by flexible adaptation to task requirements, while these effects are reduced in internalizing disorders. Furthermore, as executive functions play an important role in emotion regulation, deficits in executive functions may contribute to symptom generation in psychological disorders through increased emotional interference. Thus, the present study investigated transfer effects of a three-week executive control training on adaptation to task difficulty and emotional interference in healthy participants (n = 24) to further explore the training's suitability for clinical application. To assess the adaptation to task difficulty, the proportion congruency effect on behavioral data (response times, error rates) and ERP measures (N2, CRN) was assessed in a flanker task with varying frequency of incompatible trials (25%, 75%). To quantify emotional interference, flanker stimuli were superimposed on neutral or negative pictures. Replicating previous results, the training increased interference control as indexed by decreased response times and errors rates, increased N2 amplitude and decreased CRN amplitude in incompatible trials after training. Proportion congruency effects were weaker than expected and not affected by the training intervention. The training lead to a shift in the time-point of emotional interference: before training negative pictures lead to a reduction in CRN amplitude, while after training this reduction was observed for the N2. This pattern illustrates that the training leads to a change in task processing mode from predominant response-related cognitive control to predominant stimulus-related cognitive control (N2), indicating a proactive processing mode.
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Affiliation(s)
- Rosa Grützmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- * E-mail:
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephan Heinzel
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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Grützmann R, Klawohn J, Elsner B, Reuter B, Kaufmann C, Riesel A, Bey K, Heinzel S, Kathmann N. Error-related activity of the sensorimotor network contributes to the prediction of response to cognitive-behavioral therapy in obsessive-compulsive disorder. Neuroimage Clin 2022; 36:103216. [PMID: 36208547 PMCID: PMC9668595 DOI: 10.1016/j.nicl.2022.103216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although cognitive behavioral therapy is a highly effective treatment for obsessive-compulsive disorder (OCD), yielding large symptom reductions on the group level, individual treatment response varies considerably. Identification of treatment response predictors may provide important information for maximizing individual treatment response and thus achieving efficient treatment resource allocation. Here, we investigated the predictive value of previously identified biomarkers of OCD, namely the error-related activity of the supplementary motor area (SMA) and the sensorimotor network (SMN, postcentral gyrus/precuneus). METHODS Seventy-two participants with a primary diagnosis of OCD underwent functional magnetic resonance imaging (fMRI) scanning while performing a flanker task prior to receiving routine-care CBT. RESULTS Error-related BOLD response of the SMN significantly contributed to the prediction of treatment response beyond the variance accounted for by clinical and sociodemographic variables. Stronger error-related SMN activity at baseline was associated with a higher likelihood of treatment response. CONCLUSIONS The present results illustrate that the inclusion of error-related SMN activity can significantly increase treatment response prediction quality in OCD. Stronger error-related activity of the SMN may reflect the ability to activate symptom-relevant processing networks and may thus facilitate response to exposure-based CBT interventions.
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Affiliation(s)
- Rosa Grützmann
- Humboldt-Universität zu Berlin, Department of Psychology, Germany; MSB Medical School Berlin, Department of Psychology, Germany.
| | - Julia Klawohn
- Humboldt-Universität zu Berlin, Department of Psychology, Germany; MSB Medical School Berlin, Department of Medicine, Germany
| | - Björn Elsner
- Humboldt-Universität zu Berlin, Department of Psychology, Germany
| | - Benedikt Reuter
- Humboldt-Universität zu Berlin, Department of Psychology, Germany; MSB Medical School Berlin, Department of Medicine, Germany
| | | | - Anja Riesel
- Humboldt-Universität zu Berlin, Department of Psychology, Germany; Universität Hamburg, Department of Psychology, Germany
| | - Katharina Bey
- University Hospital Bonn, Department of Psychiatry and Psychotherapy, Germany
| | - Stephan Heinzel
- Humboldt-Universität zu Berlin, Department of Psychology, Germany; Freie Universität Berlin, Department of Education and Psychology, Germany
| | - Norbert Kathmann
- Humboldt-Universität zu Berlin, Department of Psychology, Germany
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12
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Rueppel M, Mannella KA, Fitzgerald KD, Schroder HS. Post-error slowing in anxiety and obsessive-compulsive disorders. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2022; 22:610-624. [PMID: 34966981 DOI: 10.3758/s13415-021-00976-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
Altered brain response to errors in anxiety and obsessive-compulsive disorders (OCD) suggests cognitive control abnormalities across both types of illness, but behavioral metrics of cognitive control function have yet to be compared in patients selected from these different diagnostic categories. Thus, we examined post-error slowing (PES), a behavioral adjustment that typically occurs after a mistake, in children and adolescents with and without a primary anxiety disorder (N = 103 anxiety and N = 28 healthy controls) and adolescents and adults with and without OCD (N = 118 OCD and N = 60 healthy controls) using a go/no-go task. Primary analyses tested for differences in PES between diagnostic groups (anxiety, OCD, healthy), controlling for age, overall reaction time, and overall accuracy. Results indicated that patients with anxiety disorders exhibited more post-error slowing than both patients with OCD and healthy volunteers. In contrast, participants with OCD did not differ from healthy volunteers in post-error slowing. In subgroup analyses restricted to adolescent participants (ages 13-17 years), more post-error slowing was observed in the anxiety disorders group compared with either the OCD or healthy groups. These data suggest that excessive post-error slowing, an index of behavioral adjustment following errors, may uniquely characterize patients with anxiety disorders relative to healthy individuals and those with OCD.
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Affiliation(s)
- Meryl Rueppel
- Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA
| | - Kristin A Mannella
- Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA
| | - Kate D Fitzgerald
- Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA
| | - Hans S Schroder
- Department of Psychiatry, University of Michigan Medical School, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA.
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13
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Balzus L, Klawohn J, Elsner B, Schmidt S, Brandt SA, Kathmann N. Non-invasive brain stimulation modulates neural correlates of performance monitoring in patients with obsessive-compulsive disorder. NEUROIMAGE: CLINICAL 2022; 35:103113. [PMID: 35870380 PMCID: PMC9421486 DOI: 10.1016/j.nicl.2022.103113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/18/2022] [Accepted: 07/10/2022] [Indexed: 12/02/2022] Open
Abstract
Effects of tDCS on performance monitoring examined in OCD and healthy individuals. A preregistered, randomized, sham-controlled tDCS–EEG study was conducted. Cathodal tDCS over the pre-SMA reduced the error-related negativity (ERN). Correct-response negativity was enhanced, error positivity reduced by cathodal tDCS. The findings substantiate the role of the ERN as a target for new interventions.
Overactive performance monitoring, as reflected by enhanced neural responses to errors (the error-related negativity, ERN), is considered a biomarker for obsessive-compulsive disorder (OCD) and may be a promising target for novel treatment approaches. Prior research suggests that non-invasive brain stimulation with transcranial direct current stimulation (tDCS) may reduce the ERN in healthy individuals, yet no study has investigated its efficacy in attenuating the ERN in OCD. In this preregistered, randomized, sham-controlled, crossover study, we investigated effects of tDCS on performance monitoring in patients with OCD (n = 28) and healthy individuals (n = 28). Cathodal and sham tDCS was applied over the presupplementary motor area (pre-SMA) in two sessions, each followed by electroencephalogram recording during a flanker task. Cathodal tDCS reduced the ERN amplitude compared to sham tDCS, albeit this effect was only marginally significant (p = .052; mean difference: 0.86 μV). Additionally, cathodal tDCS reduced the correct-response negativity and increased the error positivity. These neural modulations were not accompanied by behavioral changes. Moreover, we found no evidence that the tDCS effect was more pronounced in the patient group. In summary, our findings indicate that tDCS over the pre-SMA modulates neural correlates of performance monitoring across groups. Therefore, this study represents a valuable starting point for future research to determine whether repeated tDCS application induces a more pronounced ERN attenuation and normalizes aberrant performance monitoring in the long term, thereby potentially alleviating obsessive-compulsive symptoms and providing a psychophysiological intervention strategy for individuals who do not benefit sufficiently from existing interventions.
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14
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Yacou MA, Chowdury A, Easter P, Hanna GL, Rosenberg DR, Diwadkar VA. Sustained attention induces altered effective connectivity of the ascending thalamo-cortical relay in obsessive-compulsive disorder. Front Psychiatry 2022; 13:869106. [PMID: 36032258 PMCID: PMC9402224 DOI: 10.3389/fpsyt.2022.869106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Abnormal function of the thalamo-cortical relay is considered a hallmark of obsessive-compulsive disorder (OCD) and aberrant network interactions may underpin many of the clinical and cognitive symptoms that characterize the disorder. Several statistical approaches have been applied to in vivo fMRI data to support the general loss of thalamo-cortical connectivity in OCD. However, (a) few studies have assessed the contextual constraints under which abnormal network interactions arise or (b) have used methods of effective connectivity to understand abnormal network interactions. Effective connectivity is a particularly valuable method as it describes the putative causal influences that brain regions exert over each other, as opposed to the largely statistical consistencies captured in functional connectivity techniques. Here, using dynamic causal modeling (DCM), we evaluated how attention demand induced inter-group differences (HC ≠ OCD) in effective connectivity within a motivated thalamo-cortical network. Of interest was whether these effects were observed on the ascending thalamo-cortical relay, essential for the sensory innervation of the cortex. fMRI time series data from sixty-two participants (OCD, 30; HC, 32) collected using an established sustained attention task were submitted to a space of 162 competing models. Across the space, models distinguished between competing hypotheses of thalamo-cortical interactions. Bayesian model selection (BMS) identified marginally differing likely generative model architectures in OCD and HC groups. Bayesian model averaging (BMA), was used to weight connectivity parameter estimates across all models, with each parameter weighted by each model's posterior probability, thus providing more stable estimates of effective connectivity. Inferential statistical analyses of estimated parameters revealed two principal results: (1) Significantly reduced intrinsic connectivity of the V1 → SPC pathway in OCD, suggested connective weakness in the early constituents of the dorsal visual pathway; (2) More pertinent with the discovery possibilities afforded by DCM, sustained attention in OCD patients induced significantly reduced contextual modulation of the ascending relay from the thalamus to the prefrontal cortex. These results form an important complement to our understanding of the contextual bases of thalamo-cortical network deficits in OCD, emphasizing vulnerability of the ascending relay.
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Affiliation(s)
- Mario A Yacou
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Asadur Chowdury
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Philip Easter
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - David R Rosenberg
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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15
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Error-Related Brain Activity in Patients With Obsessive-Compulsive Disorder and Unaffected First-Degree Relatives: Evidence for Protective Patterns. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022; 2:79-87. [PMID: 36324601 PMCID: PMC9616249 DOI: 10.1016/j.bpsgos.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background Indicators of increased error monitoring are associated with obsessive-compulsive disorder (OCD), as shown in electroencephalography and functional magnetic resonance imaging studies. As most studies used strictly controlled samples (excluding comorbidity and medication), it remains open whether these findings extend to naturalistic settings. Thus, we assessed error-related brain activity in a large, naturalistic OCD sample. We also explored which activity patterns might qualify as vulnerability endophenotypes or protective factors for the disorder. To this aim, a sample of unaffected first-degree relatives of patients with OCD was also included. Methods Participants (84 patients with OCD, 99 healthy control participants, and 37 unaffected first-degree relatives of patients with OCD) completed a flanker task while blood oxygen level–dependent responses were measured with functional magnetic resonance imaging. Aberrant error-related brain activity in patients and relatives was identified. Results Patients with OCD showed increased error-related activity in the supplementary motor area and within the default mode network, specifically in the precuneus and postcentral gyrus. Unaffected first-degree relatives showed increased error-related activity in the bilateral inferior frontal gyrus. Conclusions Increased supplementary motor area and default mode network activity in patients with OCD replicates previous studies and might indicate excessive error signals and increased self-referential error processing. Increased activity of the inferior frontal gyrus in relatives may reflect increased inhibition. Impaired response inhibition in OCD has been demonstrated in several studies and might contribute to impairments in suppressing compulsive actions. Thus, increased inferior frontal gyrus activity in the unaffected relatives of patients with OCD may have contributed to protection from symptom development.
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16
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Ahmari SE, Rauch SL. The prefrontal cortex and OCD. Neuropsychopharmacology 2022; 47:211-224. [PMID: 34400778 PMCID: PMC8617188 DOI: 10.1038/s41386-021-01130-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 01/03/2023]
Abstract
Obsessive Compulsive Disorder (OCD) is a highly prevalent and severe neuropsychiatric disorder, with an incidence of 1.5-3% worldwide. However, despite the clear public health burden of OCD and relatively well-defined symptom criteria, effective treatments are still limited, spotlighting the need for investigation of the neural substrates of the disorder. Human neuroimaging studies have consistently highlighted abnormal activity patterns in prefrontal cortex (PFC) regions and connected circuits in OCD during both symptom provocation and performance of neurocognitive tasks. Because of recent technical advances, these findings can now be leveraged to develop novel targeted interventions. Here we will highlight current theories regarding the role of the prefrontal cortex in the generation of OCD symptoms, discuss ways in which this knowledge can be used to improve treatments for this often disabling illness, and lay out challenges in the field for future study.
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Affiliation(s)
- Susanne E Ahmari
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA.
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA, USA.
| | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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17
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Grützmann R, Kathmann N, Heinzel S. Cognitive control is quickly adapted to actual task requirements despite misleading context cues-Evidence from the N2, CRN, and ERN. Psychophysiology 2021; 59:e13961. [PMID: 34713905 DOI: 10.1111/psyp.13961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 09/13/2021] [Accepted: 10/14/2021] [Indexed: 11/29/2022]
Abstract
Cognitive control is flexibly adapted to task requirements in healthy individuals. Medio-frontal negativities in the event-related potential of the electroencephalogram can serve as indicators of cognitive control. With increasing conflict frequency, stimulus-locked control, as indexed by the N2, is increased and response-locked control, as indexed by the correct-related negativity, is reduced. On the behavioral level, this shift is associated with improved conflict resolution as evident in reduced response times and error rates in incompatible trials and a reduced response time congruency effect. Cognitive control adaptation might be implemented through experience-based task sets specifying advantageous processing strategies. Here, we investigated whether the cognitive control task set will be sustained when coupled with a contextual cue, even when the initial task requirements are no longer present. A flanker task with two conflict frequency conditions (25% incompatible and 75% incompatible trials) was presented. In the training phase, the conflict frequency conditions were paired with a distinct context cue (i.e., background color). In the test phase, the previously associated cues were again presented, but conflict frequency was identical in both conditions (50% incompatible trials). Although typical cognitive control adaptation was observed in the training phase on the behavioral and event-related potentials level, this pattern was not sustained in the test phase. Thus, the present study provides further evidence that cognitive control is flexibly adapted to task requirements even in the presence of misleading cues.
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Affiliation(s)
- Rosa Grützmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephan Heinzel
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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18
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Bellato A, Norman L, Idrees I, Ogawa CY, Waitt A, Zuccolo PF, Tye C, Radua J, Groom MJ, Shephard E. A systematic review and meta-analysis of altered electrophysiological markers of performance monitoring in Obsessive-Compulsive Disorder (OCD), Gilles de la Tourette Syndrome (GTS), Attention-Deficit/Hyperactivity disorder (ADHD) and Autism. Neurosci Biobehav Rev 2021; 131:964-987. [PMID: 34687698 DOI: 10.1016/j.neubiorev.2021.10.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 12/15/2022]
Abstract
Altered performance monitoring is implicated in obsessive-compulsive disorder (OCD), Gilles de la Tourette syndrome (GTS), attention-deficit/hyperactivity disorder (ADHD) and autism. We conducted a systematic review and meta-analysis of electrophysiological correlates of performance monitoring (error-related negativity, ERN; error positivity, Pe; feedback-related negativity, FRN; feedback-P3) in individuals with OCD, GTS, ADHD or autism compared to control participants, or associations between correlates and symptoms/traits of these conditions. Meta-analyses on 97 studies (5890 participants) showed increased ERN in OCD (Hedge's g = 0.54[CIs:0.44,0.65]) and GTS (g = 0.99[CIs:0.05,1.93]). OCD also showed increased Pe (g = 0.51[CIs:0.21,0.81]) and FRN (g = 0.50[CIs:0.26,0.73]). ADHD and autism showed reduced ERN (ADHD: g=-0.47[CIs:-0.67,-0.26]; autism: g=-0.61[CIs:-1.10,-0.13]). ADHD also showed reduced Pe (g=-0.50[CIs:-0.69,-0.32]). These findings suggest overlap in electrophysiological markers of performance monitoring alterations in four common neurodevelopmental conditions, with increased amplitudes of the markers in OCD and GTS and decreased amplitudes in ADHD and autism. Implications of these findings in terms of shared and distinct performance monitoring alterations across these neurodevelopmental conditions are discussed. PROSPERO pre-registration code: CRD42019134612.
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Affiliation(s)
- Alessio Bellato
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK; Academic Unit of Mental Health & Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Luke Norman
- Section on Neurobehavioral and Clinical Research, Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Iman Idrees
- Academic Unit of Mental Health & Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Carolina Y Ogawa
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Alice Waitt
- Academic Unit of Mental Health & Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Pedro F Zuccolo
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Charlotte Tye
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Joaquim Radua
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain; Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Madeleine J Groom
- Academic Unit of Mental Health & Clinical Neurosciences, School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Elizabeth Shephard
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK; Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
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19
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Qing X, Gu L, Li D. Abnormalities of Localized Connectivity in Obsessive-Compulsive Disorder: A Voxel-Wise Meta-Analysis. Front Hum Neurosci 2021; 15:739175. [PMID: 34602998 PMCID: PMC8481585 DOI: 10.3389/fnhum.2021.739175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 08/26/2021] [Indexed: 01/20/2023] Open
Abstract
Background: A large amount of resting-state functional magnetic resonance imaging (rs-fMRI) studies have revealed abnormalities of regional homogeneity (ReHo, an index of localized intraregional connectivity) in the obsessive-compulsive disorder (OCD) in the past few decades, However, the findings of these ReHo studies have remained inconsistent. Hence, we performed a meta-analysis to investigate the concurrence across ReHo studies for clarifying the most consistent localized connectivity underpinning this disorder. Methods: A systematic review of online databases was conducted for whole-brain rs-fMRI studies comparing ReHo between OCD patients and healthy control subjects (HCS). Anisotropic effect size version of the seed-based d mapping, a voxel-wise meta-analytic approach, was adopted to explore regions of abnormal ReHo alterations in OCD patients relative to HCS. Additionally, meta-regression analyses were conducted to explore the potential effects of clinical features on the reported ReHo abnormalities. Results: Ten datasets comprising 359 OCD patients and 361 HCS were included. Compared with HCS, patients with OCD showed higher ReHo in the bilateral inferior frontal gyri and orbitofrontal cortex (OFC). Meanwhile, lower ReHo was identified in the supplementary motor area (SMA) and bilateral cerebellum in OCD patients. Meta-regression analysis demonstrated that the ReHo in the OFC was negatively correlated with illness duration in OCD patients. Conclusions: Our meta-analysis gave a quantitative overview of ReHo findings in OCD and demonstrated that the most consistent localized connectivity abnormalities in individuals with OCD are in the prefrontal cortex. Meanwhile, our findings provided evidence that the hypo-activation of SMA and cerebellum might be associated with the pathophysiology of OCD.
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Affiliation(s)
- Xiuli Qing
- Department of Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children in Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Li Gu
- Department of Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children in Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Dehua Li
- Nursing Department, West China Second University Hospital, Sichuan University, Chengdu, China
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20
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Altered corticostriatal synchronization associated with compulsive-like behavior in APP/PS1 mice. Exp Neurol 2021; 344:113805. [PMID: 34242631 DOI: 10.1016/j.expneurol.2021.113805] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/17/2021] [Accepted: 07/02/2021] [Indexed: 11/22/2022]
Abstract
Mild behavioral impairment (MBI), which can include compulsive behavior, is an early sign of Alzheimer's disease (AD), but its underlying neural mechanisms remain unclear. Here, we show that 3-5-month-old APP/PS1 mice display obsessive-compulsive disorder (OCD)-like behavior. The number of parvalbumin-positive (PV) interneurons and level of high gamma (γhigh) oscillation are significantly decreased in the striatum of AD mice. This is accompanied by enhanced β-γhigh coupling and firing rates of putative striatal projection neurons (SPNs), indicating decorrelation between PV interneurons and SPNs. Local field potentials (LFPs) simultaneously recorded in prefrontal cortex (PFC) and striatum (Str) demonstrate a decrease in γhigh-band coherent activity and spike-field coherence in corticostriatal circuits of APP/PS1 mice. Furthermore, levels of GABAB receptor (GABABR), but not GABAA receptor (GABAAR), and glutamatergic receptors, were markedly reduced, in line with presymptomatic AD-related behavioral changes. These findings suggest that MBI occurs as early as 3-5 months in APP/PS1 mice and that altered corticostriatal synchronization may play a role in mediating the behavioral phenotypes observed.
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21
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Shephard E, Batistuzzo MC, Hoexter MQ, Stern ER, Zuccolo PF, Ogawa CY, Silva RM, Brunoni AR, Costa DL, Doretto V, Saraiva L, Cappi C, Shavitt RG, Simpson HB, van den Heuvel OA, Miguel EC. Neurocircuit models of obsessive-compulsive disorder: limitations and future directions for research. REVISTA BRASILEIRA DE PSIQUIATRIA 2021; 44:187-200. [PMID: 35617698 PMCID: PMC9041967 DOI: 10.1590/1516-4446-2020-1709] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/05/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Elizabeth Shephard
- Universidade de São Paulo (USP), Brazil; Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, UK
| | - Marcelo C. Batistuzzo
- Universidade de São Paulo (USP), Brazil; Pontifícia Universidade Católica de São Paulo, Brazil
| | | | - Emily R. Stern
- The New York University School of Medicine, USA; Orangeburg, USA
| | | | | | | | | | | | | | | | - Carolina Cappi
- Universidade de São Paulo (USP), Brazil; Icahn School of Medicine at Mount Sinai, USA
| | | | - H. Blair Simpson
- New York State Psychiatric Institute, Columbia University Irving Medical Center (CUIMC), USA; CUIMC, USA
| | - Odile A. van den Heuvel
- Vrije Universiteit Amsterdam, The Netherlands; Vrije Universiteit Amsterdam, The Netherlands
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22
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Xiong A, Lai X, Wu S, Yuan X, Tang J, Chen J, Liu Y, Hu M. Relationship Between Cognitive Fusion, Experiential Avoidance, and Obsessive-Compulsive Symptoms in Patients With Obsessive-Compulsive Disorder. Front Psychol 2021; 12:655154. [PMID: 33912117 PMCID: PMC8072044 DOI: 10.3389/fpsyg.2021.655154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/03/2021] [Indexed: 12/21/2022] Open
Abstract
Objective: This study aimed to explore the relationship among cognitive fusion, experiential avoidance, and obsessive-compulsive symptoms in patients with obsessive-compulsive disorder (OCD). Methods: A total of 118 outpatient and inpatient patients with OCD and 109 healthy participants, gender- and age-matched, were selected using cognitive fusion questionnaire (CFQ), acceptance and action questionnaire-2nd edition (AAQ-II), Yale-Brown scale for obsessive-compulsive symptoms, Hamilton anxiety scale, and Hamilton depression scale for questionnaire testing and data analysis. Results: The levels of cognitive fusion and experiential avoidance in the OCD group were significantly higher than those in the healthy control group (P < 0.05). Regression analysis results showed that, in predicting the total score of obsessive-compulsive symptoms, AAQ-II (β = 0.233, P < 0.05) and CFQ (β = 0.262, P < 0.01) entered the equation, which explained 17.1% variance. In predicting anxiety, only AAQ-II (β = 0.222, P < 0.05) entered the equation, which explained 13% variance. In the prediction of depression, AAQ-II (β = 0.412, P < 0.001) entered the equation, which explained 17.7% variance. Conclusion: Cognitive fusion and experiential avoidance may be important factors for the maintenance of OCD, and experiential avoidance can positively predict the anxiety and depression of OCD patients.
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Affiliation(s)
- Ai Xiong
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiong Lai
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Siliang Wu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xin Yuan
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun Tang
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jinyuan Chen
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yang Liu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Maorong Hu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Mantovani A, Neri F, D'Urso G, Mencarelli L, Tatti E, Momi D, Menardi A, Sprugnoli G, Santarnecchi E, Rossi S. Functional connectivity changes and symptoms improvement after personalized, double-daily dosing, repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: A pilot study. J Psychiatr Res 2021; 136:560-570. [PMID: 33158554 DOI: 10.1016/j.jpsychires.2020.10.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND intrusive thoughts and compulsive behaviors that characterize obsessive compulsive disorder (OCD) are associated to aberrant resting state functional connectivity (rsFC) patterns within the cortico-striatal-thalamo-cortical (CSTC) circuits. A high percentage of OCD patients do not respond to conventional pharmacological treatments or psychotherapy. In these patients, inhibitory repetitive transcranial magnetic stimulation (rTMS) of the Supplementary Motor Area (SMA) resulted in a significant clinical benefit. METHODS In the current study, we applied a novel protocol of 1-week MRI-guided individualized double-daily sessions of rTMS treatment (1-Hz; 110% of resting Motor Threshold/7200 pulses/day), to bilateral SMA in 9 OCD patients. We tested its (i) feasibility-safety, (ii) clinical efficacy and (iii) rsFC related changes. RESULTS Patients reported no side effects during and after rTMS. Personalized rTMS treatment led to a significant improvement of OCD symptoms (average 25%; p = .005) and persistence of benefit up to 3-month follow-up. rsFC analysis revealed a significant reduction of connectivity patterns between bilateral SMA and subcortical regions, specifically in the basal ganglia and thalamus. Additional analysis showed that OCD symptoms severity correlates with a higher connectivity pattern between bilateral SMA and subcortical regions. CONCLUSIONS rTMS double-daily sessions are safe, feasible and effective in OCD. The clinical outcomes, that are consistent with those found in our previous RCT, are linked to a decreased connectivity between SMA and subcortical brain areas implicated in control over obsessions and maladaptive compulsive behavior.
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Affiliation(s)
- Antonio Mantovani
- Department of Molecular, Cellular and Biomedical Sciences, CUNY, School of Medicine, New York, USA
| | - Francesco Neri
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
| | - Giordano D'Urso
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Lucia Mencarelli
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy; Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Elisa Tatti
- Department of Molecular, Cellular and Biomedical Sciences, CUNY, School of Medicine, New York, USA
| | - Davide Momi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy; Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Arianna Menardi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy; Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Giulia Sprugnoli
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Emiliano Santarnecchi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy; Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Simone Rossi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy; Department of Medicine, Surgery and Neuroscience, University of Siena School of Medicine, Siena, Italy
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Gilbertson H, Fang L, Andrzejewski JA, Carlson JM. Dorsal anterior cingulate cortex intrinsic functional connectivity linked to electrocortical measures of error monitoring. Psychophysiology 2021; 58:e13794. [PMID: 33624288 DOI: 10.1111/psyp.13794] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 01/03/2023]
Abstract
The error-related negativity (ERN) is a response-locked event-related potential, occurring approximately 50 ms following an erroneous response at frontocentral electrode sites. Source localization and functional magnetic resonance imaging (fMRI) research indicate that the ERN is likely generated by activity in the dorsal anterior cingulate cortex (dACC). The dACC is thought to be a part of a broader network of brain regions that collectively comprise an error monitoring network. However, little is known about how intrinsic connectivity within the dACC-based error monitoring network contributes to variability in ERN amplitude. The purpose of this study was to assess the relationship between dACC functional connectivity and ERN amplitude. In a sample of highly trait anxious individuals, the ERN was elicited in a flanker task and functional connectivity was assessed in a 10-min resting-state fMRI scan. Results suggest that the strength of dACC seeded functional connectivity with the supplementary motor area is correlated with the ΔERN (i.e., incorrect-correct responses) amplitude such that greater ΔERN amplitude was accompanied by greater functional coupling between these regions. In sum, ERN amplitude appears to be related to the strength of functional connectivity between error monitoring and motor control regions of the brain.
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Affiliation(s)
- Hayley Gilbertson
- Department of Psychological Science, Northern Michigan University, Marquette, MI, USA
| | - Lin Fang
- Department of Psychological Science, Northern Michigan University, Marquette, MI, USA
| | - Jeremy A Andrzejewski
- Department of Psychological Science, Northern Michigan University, Marquette, MI, USA
| | - Joshua M Carlson
- Department of Psychological Science, Northern Michigan University, Marquette, MI, USA
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Effects of adaptive and non-adaptive three-week executive control training on interference control: Evidence from the N2, CRN, and ERN. Int J Psychophysiol 2021; 162:8-21. [PMID: 33476706 DOI: 10.1016/j.ijpsycho.2021.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/18/2020] [Accepted: 01/14/2021] [Indexed: 11/24/2022]
Abstract
The current pilot study investigated if interference control can be improved by a three-week at-home training comprising a flanker and a n-back task in healthy adults, thus exploring the training's suitability for future clinical application, i.e. as a treatment augmentation for psychological disorders. As training gains are assumed to be modulated by the amount of mismatch between task demands and brain resources, an adaptive and a non-adaptive training were contrasted in separate experiments. In the adaptive training, task difficulty was continuously adapted to participants' performance. In the non-adaptive training procedure, task difficulty remained stable on the lowest difficulty level. As deficits in interference control in psychological disorders often predominantly manifest on the electrophysiological level, the impact of the training procedures on medio-frontal negativities (N2, CRN, ERN) was investigated in addition to behavioral measures. The adaptive training led to significant improvements in interference control, as reflected in reduced response times and error rates in incompatible trials. This was accompanied by specific and complementary changes in medio-frontal negativities: After the adaptive training the N2 in incompatible trials was larger and the CRN in incompatible trials was reduced. The non-adaptive training procedure led to generally faster response times but also an increased error rate, indicating a speed-accuracy trade-off. This was accompanied by global changes to medio-frontal negativities irrespective of compatibility, possibly indicating task disengagement. Taken together, the current studies demonstrate that an adaptive training procedure can improve interference control thereby opening up possible clinical applications.
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Frota Lisbôa Pereira de Souza AM. Electroencephalographic Correlates of Obsessive-Compulsive Disorder. Curr Top Behav Neurosci 2021; 49:169-199. [PMID: 33590459 DOI: 10.1007/7854_2020_200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This chapter reviews EEG research in Obsessive-Compulsive Disorder (OCD), focusing on Event-Related Potentials (ERPs) such as the Contingent Negative Variation, N2, Error-Related Negativity, the feedback Error-Related Negativity and the Readiness Potential and their neural bases. The functional significance, utility and correlation of these ERPs with OCD symptoms will be discussed, alongside novel theories for integrating the research findings. I will consider hypotheses including goal-directed behaviour, overreliance on habits, dissociations between action and knowledge, and excessive intolerance of uncertainty in the context of EEG studies, thus providing a comprehensive framework of the electroencephalographic literature concerning OCD.
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Abstract
In this chapter, I address the concept of endophenotypes for obsessive-compulsive disorder (OCD). Endophenotypes are objective and heritable quantitative traits hypothesized to be more biologically tractable than distal clinical phenotypes. This approach has been adopted to gain a better understanding of psychiatric conditions in general. It is theorized that endophenotypes will particularly assist in clarifying both the diagnostic status and aetiological origins of complex neuropsychiatric conditions such as OCD. At the cognitive level, separable constructs of relevance for OCD have been identified. The prevailing model for OCD assumes the development of abnormalities within fronto-striatal neural circuits leading to impairment of executive functions and their neuropsychological subcomponents. Here, I address whether this model can guide towards the identification of endophenotypes for this condition and discuss possible implications.
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Affiliation(s)
- Matilde M Vaghi
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, London, UK.
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28
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Abstract
In the last 20 years, functional magnetic resonance imaging (fMRI) has been extensively used to investigate system-level abnormalities in the brain of patients with obsessive-compulsive disorder (OCD). In this chapter, we start by reviewing the studies assessing regional brain differences between patients with OCD and healthy controls in task-based fMRI. Specifically, we review studies on executive functioning and emotional processing, protocols in which these patients have been described to show alterations at the behavioral level, as well as research using symptom provocation protocols. Next, we review studies on brain connectivity alterations, focusing on resting-state studies evaluating disruptions in fronto-subcortical functional connectivity and in cortical networks. Likewise, we also review research on effective connectivity, which, different from functional connectivity, allows for ascertaining the directionality of inter-regional connectivity alterations. We conclude by reviewing the most significant findings on a topic of translational impact, such as the use of different fMRI measurements to predict response across a variety of treatment approaches. Overall, results suggest that there exists a pattern of regions, involving, but not limited to, different nodes of the cortico-striatal-thalamo-cortical circuits, showing robust evidence of functional alteration across studies, although the nature of the alterations critically depends on the specific tasks and their particular demands. Moreover, such findings have been, to date, poorly translated into clinical practice. It is suggested that this may be partially accounted for by the difficulty to integrate into a common framework results obtained under a wide variety of analysis approaches.
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Affiliation(s)
- Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain. .,Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain.
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29
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Zou J, Wu S, Yuan X, Hu Z, Tang J, Hu M. Effects of Acceptance and Commitment Therapy and Repetitive Transcranial Magnetic Stimulation on Obsessive-Compulsive Disorder. Front Psychiatry 2021; 12:720518. [PMID: 35095583 PMCID: PMC8790139 DOI: 10.3389/fpsyt.2021.720518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aims to explore the difference of clinical efficacy and psychological flexibility of sertraline hydrochloride combined with acceptance and commitment therapy (ACT) or repeated transcranial magnetic stimulation (rTMS) in patients with obsessive-compulsive disorder (OCD). Materials and Methods: Sixty-three inpatients diagnosed with OCD were randomly divided into ACT group (N = 32) and rTMS group (N = 31), both of which were combined with sertraline hydrochloride. The following assessments were completed by the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Symptom Checklist 90 (SCL-90), Acceptance and Action Questionnaire (AAQ-II), and Cognitive Fusion Questionnaire (CFQ) during pretreatment, 4 weeks posttreatment, and 8-week follow-up. Results: After treatment: (1) the SCL-90 score of two groups significantly decreased from pretreatment to 8-week follow-up (P < 0.01 and P < 0.001); (2) The HAMA, HAMD, and Y-BOCS scores of the two groups significantly decreased from pretreatment to 8-week follow-up (P < 0.001 and P < 0.05); (3) No statistically significant difference of the SCL-90, HAMA, HAMD and Y-BOCS between two groups; (4) The AAQ-II and CFQ scores of the ACT group significantly decreased from 4 weeks posttreatment to 8-week follow-up (P < 0.01). However, no statistically significant difference was observed in the rTMS group (P > 0.05). Conclusions: Overall, our study suggested that sertraline hydrochloride combined with ACT or rTMS can improve the obsessive-compulsive symptoms, anxiety, and depression and has equivalent efficacy. Moreover, ACT can more effectively and durably improve the psychological flexibility of patients compared with rTMS.
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Affiliation(s)
- Jingzhi Zou
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Siliang Wu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xin Yuan
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhizhong Hu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun Tang
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Maorong Hu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
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30
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Meram TD, Chowdury A, Easter P, Attisha T, Kallabat E, Hanna GL, Arnold P, Rosenberg DR, Diwadkar VA. Evoking network profiles of the dorsal anterior cingulate in youth with Obsessive-Compulsive Disorder during motor control and working memory. J Psychiatr Res 2021; 132:72-83. [PMID: 33068817 PMCID: PMC9351617 DOI: 10.1016/j.jpsychires.2020.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/04/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022]
Abstract
Interest in the pathology of Obsessive-Compulsive Disorder\has focused on brain network profiles of the dorsal Anterior Cingulate Cortex (dACC), given its role as a principal control region. Both motor control and working memory tasks induce dysfunctional dACC profiles in OCD. H H We contrasted dACC network profiles in OCD and age-comparable controls during both tasks (from data collected in the same participants). The motor task required participants to tap their right forefinger in response to a flashing white probe; the memory task was a standard n-back (2-Back) requiring participants to identify if a current stimulus was identical to the one presented two items before it in the sequence. Network interactions were modeled using Psychophysiological Interactions (PPI), a model of directional functional connectivity. Inter-group analyses indicated a) that the motor control task evoked greater dACC modulation than the working memory task, and b) that the modulatory effect was significantly greater in the OCD group. We also investigated the relationship between OCD symptom dimensions (lifetime obsession and lifetime compulsion measured using the CY-BOCS) and dACC network profiles in OCD. This analysis revealed a dichotomy between Obsessive-Compulsive symptom dimensions and the degree of dACC modulation: primarily increased obsessions predicted increased modulation during the motor control task, but primarily increased compulsions predicted increased modulation during the working memory task. These results re-emphasize the salience of the dACC in OCD, and the primacy of tasks of motor control in evoking dACC pathology in the disorder.
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Affiliation(s)
- Thomas D. Meram
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Asadur Chowdury
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Philip Easter
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Tyler Attisha
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Ellanya Kallabat
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Gregory L. Hanna
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd, Ann Arbor, MI 48109, USA
| | - Paul Arnold
- Department of Psychiatry & Medical Genetics, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - David R. Rosenberg
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
| | - Vaibhav A. Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Brain Imaging Research Division, Wayne State University School of Medicine, 3901 Chrysler Service Dr Suite 5B, Tolan Park Medical Bldg, Detroit, MI 48201, USA
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Abstract
OCD has lagged behind other psychiatric illnesses in the identification of molecular treatment targets, due in part to a lack of significant findings in genome-wide association studies. However, while progress in this area is being made, OCD's symptoms of obsessions, compulsions, and anxiety can be deconstructed into distinct neural functions that can be dissected in animal models. Studies in rodents and non-human primates have highlighted the importance of cortico-basal ganglia-thalamic circuits in OCD pathophysiology, and emerging studies in human post-mortem brain tissue point to glutamatergic synapse abnormalities as a potential cellular substrate for observed dysfunctional behaviors. In addition, accumulated evidence points to a potential role for neuromodulators including serotonin and dopamine in both OCD pathology and treatment. Here, we review current efforts to use animal models for the identification of molecules, cell types, and circuits relevant to OCD pathophysiology. We start by describing features of OCD that can be modeled in animals, including circuit abnormalities and genetic findings. We then review different strategies that have been used to study OCD using animal model systems, including transgenic models, circuit manipulations, and dissection of OCD-relevant neural constructs. Finally, we discuss how these findings may ultimately help to develop new treatment strategies for OCD and other related disorders.
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Affiliation(s)
- Brittany L Chamberlain
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh, Pittsburgh, PA, USA.,Center for Neuroscience Program and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Susanne E Ahmari
- Department of Psychiatry, Translational Neuroscience Program, University of Pittsburgh, Pittsburgh, PA, USA. .,Center for Neuroscience Program and Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA.
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32
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Seow TXF, Benoit E, Dempsey C, Jennings M, Maxwell A, McDonough M, Gillan CM. A dimensional investigation of error-related negativity (ERN) and self-reported psychiatric symptoms. Int J Psychophysiol 2020; 158:340-348. [PMID: 33080287 PMCID: PMC7612131 DOI: 10.1016/j.ijpsycho.2020.09.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 08/05/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Abstract
Alterations in error processing are implicated in a range of DSM-defined psychiatric disorders. For instance, obsessive-compulsive disorder (OCD) and generalised anxiety disorder show enhanced electrophysiological responses to errors-i.e. error-related negativity (ERN)-while others like schizophrenia have an attenuated ERN. However, as diagnostic categories in psychiatry are heterogeneous and also highly intercorrelated, the precise mapping of ERN enhancements/impairments is unclear. To address this, we recorded electroencephalograms (EEG) from 196 participants who performed the Flanker task and collected scores on 9 questionnaires assessing psychiatric symptoms to test if a dimensional framework could reveal specific transdiagnostic clinical manifestations of error processing dysfunctions. Contrary to our hypothesis, we found non-significant associations between ERN amplitude and symptom severity of OCD, trait anxiety, depression, social anxiety, impulsivity, eating disorders, alcohol addiction, schizotypy and apathy. A transdiagnostic approach did nothing to improve signal; there were non-significant associations between all three transdiagnostic dimensions (anxious-depression, compulsive behaviour and intrusive thought, and social withdrawal) and ERN magnitude. In these same individuals, we replicated a previously published transdiagnostic association between goal-directed learning and compulsive behaviour and intrusive thought. Possible explanations discussed are (i) that associations between the ERN and psychopathology might be smaller than previously assumed, (ii) that these associations might depend on a greater level of symptom severity than other transdiagnostic cognitive biomarkers, or (iii) that task parameters, such as the ratio of compatible to incompatible trials, might be crucial for ensuring the sensitivity of the ERN to clinical phenomena.
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Affiliation(s)
- T X F Seow
- School of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
| | - E Benoit
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - C Dempsey
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - M Jennings
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - A Maxwell
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - M McDonough
- St. Patrick's University Hospital, Dublin, Ireland
| | - C M Gillan
- School of Psychology, Trinity College Dublin, Dublin, Ireland; Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Li K, Zhang H, Wang B, Yang Y, Zhang M, Li W, Li X, Lv L, Zhao J, Zhang H. Hippocampal functional network: The mediating role between obsession and anxiety in adult patients with obsessive-compulsive disorder. World J Biol Psychiatry 2020; 21:685-695. [PMID: 32174208 DOI: 10.1080/15622975.2020.1733082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Anxiety is a very common symptom and closely related to obsessive-compulsive symptoms in obsessive-compulsive disorder (OCD). However, the association between anxiety and obsessive-compulsive symptoms at the hippocampus network level remains unclear. METHODS This study enrolled 42 patients with OCD and 42 healthy controls (HCs), who underwent resting-state functional magnetic resonance imaging (fMRI) and clinical evaluation. Multiple linear regression analysis was performed to investigate the behavioural significance and interactive effects of obsessive-compulsive and anxiety symptoms on the hippocampus functional connectivity (HFC). The mediation analysis model was used to explore whether the hippocampus functional connectivity (FC) network indirectly mediated the relationship between obsessive-compulsive symptoms and anxiety. RESULTS Results showed that the FCs with the cerebellum, middle temporal gyrus (MTG) and anterior cingulate gyrus (ACG) were increased in the hippocampus FC network in patients with OCD compared with those in HCs. The regions of interactive effects between anxiety and obsession, which are mainly located in the prefrontal cortex and MTG, were positively correlated. The mediation effect is 0.018 between obsession and anxiety on the HFC networks in patients with OCD. CONCLUSIONS The FC between the hippocampus and MTG plays a key role in the relationship between anxiety and obsession.
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Affiliation(s)
- Kun Li
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China
| | - Haisan Zhang
- Department of Radiology, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China
| | - Bi Wang
- Department of Radiology, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China
| | - Yongfeng Yang
- Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China
| | - Meng Zhang
- School of Psychology, Xinxiang Medical University, Xinxiang, P. R. China
| | - Wenqiang Li
- Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China
| | - Xianrui Li
- School of Psychology, Xinxiang Medical University, Xinxiang, P. R. China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China.,Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, P. R. China
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China.,Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China.,School of Psychology, Xinxiang Medical University, Xinxiang, P. R. China
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Lillevik Thorsen A, de Wit SJ, Hagland P, Ousdal OT, Hansen B, Hagen K, Kvale G, van den Heuvel OA. Stable inhibition-related inferior frontal hypoactivation and fronto-limbic hyperconnectivity in obsessive-compulsive disorder after concentrated exposure therapy. NEUROIMAGE-CLINICAL 2020; 28:102460. [PMID: 33395956 PMCID: PMC7606869 DOI: 10.1016/j.nicl.2020.102460] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/09/2020] [Accepted: 10/02/2020] [Indexed: 01/03/2023]
Abstract
Less IFG activation and more fronto-limbic connectivity was found in OCD. IFG hypoactivation and fronto-limbic hyperconnectivity persisted after exposure therapy. Activation and connectivity before treatment did not predict treatment outcome.
Response inhibition has previously been suggested as an endophenotype for obsessive–compulsive disorder (OCD), evidenced by studies showing worse task performance, and altered task-related activation and connectivity. However, it’s unclear if these measures change following treatment. In this study, 31 OCD patients and 28 healthy controls performed a stop signal task during 3 T functional magnetic resonance imaging before treatment, while 24 OCD patients and 17 healthy controls were rescanned one week and three months after concentrated exposure and response prevention over four consecutive days using Bergen 4-Day Format. To study changes over time we performed a longitudinal analysis on stop signal reaction time and task-related activation and amygdala connectivity during successful and failed inhibition. Results showed that there was no group difference in task performance. Before treatment, OCD patients compared to controls showed less inhibition-related activation in the right inferior frontal gyrus, and increased functional connectivity between the right amygdala and the right inferior frontal gyrus and pre-supplementary motor area. During error-processing, OCD patients versus controls showed less activation in the pre-SMA before treatment. These group differences did not change after treatment. Pre-treatment task performance, brain activation, and connectivity were unrelated to the degree of symptom improvement after treatment. In conclusion, inferior frontal gyrus hypoactivation and increased fronto-limbic connectivity are likely trait markers of OCD that remain after effective exposure therapy.
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Affiliation(s)
- Anders Lillevik Thorsen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway.
| | - Stella J de Wit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Pernille Hagland
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Olga Therese Ousdal
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Department of Radiology, Haukeland University Hospital, Bergen, Norway; Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Kristen Hagen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Psychiatric Department, Hospital of Molde, Molde, Norway
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Odile A van den Heuvel
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, Netherlands
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35
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Härpfer K, Carsten HP, Spychalski D, Kathmann N, Riesel A. Were we erring? The impact of worry and arousal on error-related negativity in a non-clinical sample. Psychophysiology 2020; 57:e13661. [PMID: 32804403 DOI: 10.1111/psyp.13661] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 12/28/2022]
Abstract
The monitoring of one's own actions allows humans to adjust to a changing and complex world. Previous neuroscientific research found overactive action monitoring and increased sensitivity to errors to be associated with anxiety and it is assumed to contribute to the development and maintenance of anxiety symptoms. A largely shared decomposition of anxiety differentiates two dimensions: anxious apprehension (i.e., worry) and anxious arousal (i.e., physiological hyperarousal). Alterations in neural correlates of error monitoring have been more closely linked to anxious apprehension compared to anxious arousal. This study examined the relationship between anxiety dimensions and electrophysiological correlates of action monitoring (i.e., error-related negativity, ERN, and correct-response negativity, CRN). A total of 135 non-clinical participants performed a flanker task while their electroencephalogram was recorded. We recruited participants with converging and diverging anxiety dimension profiles (i.e., above or below median in anxious apprehension and anxious arousal or above median in one and below in the other dimension). This grouping strategy facilitates disentangling possible interactions and allows the investigation of the isolated effect of each anxiety dimension. Regression analyses did not reveal a significant main or interaction effect of anxiety dimensions on ERN or CRN, irrespective of gender. In addition, Bayesian statistical analyzes yielded evidence for the absence of an association between both anxiety dimensions and ERN and CRN. Altogether, our results suggest that the association of anxiety dimensions, particularly anxious apprehension, and action monitoring might be smaller in non-clinical samples as previous studies indicate.
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Affiliation(s)
- Kai Härpfer
- Department of Psychology, University of Hamburg, Hamburg, Germany
| | | | - Daniel Spychalski
- Department of Psychology, Dresden University of Technology, Dresden, Germany
| | - Norbert Kathmann
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | - Anja Riesel
- Department of Psychology, University of Hamburg, Hamburg, Germany
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36
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Harika-Germaneau G, Heit D, Chatard A, Thirioux B, Langbour N, Jaafari N. Treating refractory obsessive-compulsive disorder with transcranial direct current stimulation: An open label study. Brain Behav 2020; 10:e01648. [PMID: 32406608 PMCID: PMC7375126 DOI: 10.1002/brb3.1648] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/30/2020] [Accepted: 04/03/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a complex disorder with 40%-60% of patients' refractory to treatment. Transcranial direct current stimulation (tDCS) has been shown to induce potent and long-lasting effects on cortical excitability. The aim of the present clinical trial was to evaluate the therapeutic efficacy and tolerability of cathodal tDCS over the supplementary motor area (SMA) in treatment-resistant OCD patients. METHODS Twenty-one treatment-resistant OCD outpatients received 10 sessions of tDCS. Each treatment session consisted of 2 mA stimuli for 30 min. The cathode was positioned over the bilateral SMA and the anode over the right supraorbital area. Patients were evaluated at baseline, end of treatment, one-month follow-up, and three-month follow-up. Response to treatment was defined as at least a decrease of 35% on the Yale-Brown Obsessive-Compulsive Scale (YBOCS) and a score of 2 or less on the Clinical Global Impressions-Improvement (CGI-I) between baseline and 1-month follow-up. RESULTS There was a significant decrease of YBOCS scores between baseline and one-month assessment. At one month, five patients (24%) were considered as responders and 3 (15%) at 3 months. We also observed concomitant changes in depressive symptoms, and insight. The treatment was well tolerated. Short-lasting side effects were reported as localized tingling sensation and skin redness. CONCLUSION Our results suggest that the use of cathodal tDCS over the SMA and anodal tDCS over the right supraorbital area in OCD treatment-refractory patients is safe and promising to improve obsessive and compulsive symptoms. Large randomized controlled trials are needed to confirm this positive result.
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Affiliation(s)
- Ghina Harika-Germaneau
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France.,Université de Poitiers, Poitiers, France.,Laboratoire de Neurosciences Expérimentales et Cliniques, INSERM U 1084, Poitiers, France
| | - Damien Heit
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Armand Chatard
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France.,Université de Poitiers, Poitiers, France.,Laboratoire CeRCA, CNRS 7295, Poitiers, France
| | - Berangere Thirioux
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Nicolas Langbour
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France
| | - Nemat Jaafari
- Unité de Recherché Clinique Intersectorielle en Psychiatrie à vocation régionale, Centre Hospitalier Henri Laborit, Poitiers, France.,Université de Poitiers, Poitiers, France.,Laboratoire de Neurosciences Expérimentales et Cliniques, INSERM U 1084, Poitiers, France
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37
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Abstract
Event-related potentials (ERPs) are direct measures of brain activity that can be leveraged for clinically meaningful research. They can relate robustly both to continuous measures of individual difference and to categorical diagnoses in ways that clarify similarities and distinctions between apparently related disorders and traits. ERPs can be linked to genetic risk, can act as moderators of developmental trajectories and responses to stress, and can be leveraged to identify those at greater risk for psychopathology, especially when used in combination with other neural and self-report measures. ERPs can inform models of the development of, and risk for, psychopathology. Finally, ERPs can be used as targets for existing and novel interventions and prevention efforts. We provide concrete examples for each of these possibilities by focusing on programmatic research on the error-related negativity and anxiety, and thus show that ERPs are poised to make greater contributions toward the identification, prediction, treatment, and prevention of mental disorders.
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Affiliation(s)
- Greg Hajcak
- Department of Biomedical Sciences, Florida State University, Tallahassee, Florida 32306, USA; .,Department of Psychology, Florida State University, Tallahassee, Florida 32306, USA
| | - Julia Klawohn
- Department of Biomedical Sciences, Florida State University, Tallahassee, Florida 32306, USA; .,Department of Psychology, Florida State University, Tallahassee, Florida 32306, USA
| | - Alexandria Meyer
- Department of Psychology, Florida State University, Tallahassee, Florida 32306, USA
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38
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Riesel A. The erring brain: Error-related negativity as an endophenotype for OCD-A review and meta-analysis. Psychophysiology 2020; 56:e13348. [PMID: 30838682 DOI: 10.1111/psyp.13348] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/12/2018] [Accepted: 01/20/2019] [Indexed: 12/29/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a complex and heterogeneous disorder that is associated with high personal and societal costs. Feelings of doubt, worry, and repetitive behavior, key symptoms of OCD, have been linked to hyperactive error signals in the brain. The error-related negativity (ERN) represents a validated marker of error processing in the ERP. Increased ERN amplitudes in OCD have been reported very robustly over the last 20 years. This article integrates results from 38 studies analyzing the ERN in OCD, using a quantitative meta-analysis. Meta-regressions were used to examine potential moderators such as task type, symptom severity, age, and sample size. The meta-analysis reveals a robust increase of ERN in OCD patients compared to healthy participants in response-conflict tasks (SMD -0.55) that is not modulated by symptom severity and age. No increase in ERN in OCD was observed in tasks that do not induce response conflict (SMD -0.10). In addition to the meta-analysis, the current article reviews evidence supporting that increased ERN amplitudes in OCD fulfill central criteria for an endophenotype. Further, the specificity of increased ERN amplitudes for OCD and its suitability as a potential transdiagnostic endophenotype is discussed. Finally, the clinical utility and clinical applications are examined. Overall, the evidence that increased ERN amplitudes represent a promising endophenotype indicating vulnerability for OCD is compelling. Furthermore, alterations in ERN are not limited to OCD and may constitute a transdiagnostic endophenotype. Altered neural error signals might serve as a diagnostic or predictive marker and represent a promising target for interventions.
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Affiliation(s)
- Anja Riesel
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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39
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Picó-Pérez M, Moreira PS, de Melo Ferreira V, Radua J, Mataix-Cols D, Sousa N, Soriano-Mas C, Morgado P. Modality-specific overlaps in brain structure and function in obsessive-compulsive disorder: Multimodal meta-analysis of case-control MRI studies. Neurosci Biobehav Rev 2020; 112:83-94. [PMID: 32006553 DOI: 10.1016/j.neubiorev.2020.01.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/03/2020] [Accepted: 01/27/2020] [Indexed: 10/25/2022]
Abstract
Neuroimaging research has shown that patients with obsessive-compulsive disorder (OCD) may present brain structural and functional alterations, but the results across imaging modalities and task paradigms are difficult to reconcile. Are the same brain systems that are structurally different in OCD patients also involved in executive function and emotional processing? To answer this, we conducted separate meta-analyses of voxel-based morphometry studies, executive function functional magnetic resonance imaging (fMRI) studies, and emotional processing fMRI studies. Next, with a multimodal approach (conjunction analysis), we identified the common alterations across meta-analyses. Patients presented increased gray matter volume and hyperactivation in the putamen, but the putamen subregions affected differed depending on the psychological process. Left posterior/dorsal putamen showed hyperactivation during executive processing tasks, while predominantly right anterior/ventral putamen showed hyperactivation during emotional processing tasks. Interestingly, age was significantly associated with increased right putamen volume. Finally, the left dorsolateral prefrontal cortex was hyperactive in both functional domains. Our findings highlight task-specific correlates of brain structure and function in OCD and help integrate a growing literature.
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Affiliation(s)
- Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Vanessa de Melo Ferreira
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain
| | - David Mataix-Cols
- Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Carles Soriano-Mas
- Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain.
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal.
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40
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Shafritz KM, Ikuta T, Greene A, Robinson DG, Gallego J, Lencz T, DeRosse P, Kingsley PB, Szeszko PR. Frontal lobe functioning during a simple response conflict task in first-episode psychosis and its relationship to treatment response. Brain Imaging Behav 2019; 13:541-553. [PMID: 29744804 DOI: 10.1007/s11682-018-9876-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Prior functional magnetic resonance imaging (fMRI) studies have investigated the neural mechanisms underlying cognitive control in patients with psychosis with findings of both hypo- and hyperfrontality. One factor that may contribute to inconsistent findings is the use of complex and polyfactorial tasks to investigate frontal lobe functioning. In the current study we employed a simple response conflict task during fMRI to examine differences in brain activation between patients experiencing their first-episode of psychosis (n = 33) and age- and sex-matched healthy volunteers (n = 33). We further investigated whether baseline brain activation among patients predicted changes in symptom severity and treatment response following 12 weeks of controlled antipsychotic treatment. During the task subjects were instructed to press a response button on the same side or opposite side of a circle that appeared on either side of a central fixation point. Imaging data revealed that for the contrast of opposite-side vs. same-side, patients showed significantly greater activation compared with healthy volunteers in the anterior cingulate cortex and intraparietal sulcus. Among patients, greater baseline anterior cingulate cortex, temporal-parietal junction, and superior temporal cortex activation predicted greater symptom reduction and therapeutic response following treatment. All findings remained significant after covarying for task performance. Intact performance on this relatively parsimonious task was associated with frontal hyperactivity suggesting the need for patients to utilize greater neural resources to achieve task performance comparable to healthy individuals. Moreover, frontal hyperactivity observed using a simple fMRI task may provide a biomarker for predicting treatment response in first-episode psychosis.
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Affiliation(s)
- Keith M Shafritz
- Department of Psychology, Hofstra University, Hempstead, NY, USA. .,Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, Oxford, MS, USA
| | - Allison Greene
- Department of Psychology, Hofstra University, Hempstead, NY, USA
| | - Delbert G Robinson
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Division of Psychiatry Research, Northwell Health System, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Departments of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Juan Gallego
- Weill Cornell Medical College, New York, NY, USA.,New York-Presbyterian Hospital/Westchester Division, White Plains, NY, USA
| | - Todd Lencz
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Division of Psychiatry Research, Northwell Health System, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Departments of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Pamela DeRosse
- Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Manhasset, NY, USA.,Division of Psychiatry Research, Northwell Health System, Zucker Hillside Hospital, Glen Oaks, NY, USA.,Departments of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA
| | - Peter B Kingsley
- Department of Radiology, North Shore University Hospital, Manhasset, NY, USA
| | - Philip R Szeszko
- James J. Peters VA Medical Center, Mental Illness Research Education Clinical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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41
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ERN as a transdiagnostic marker of the internalizing-externalizing spectrum: A dissociable meta-analytic effect. Neurosci Biobehav Rev 2019; 103:133-149. [DOI: 10.1016/j.neubiorev.2019.06.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/31/2019] [Accepted: 06/09/2019] [Indexed: 12/30/2022]
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42
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Hu X, Zhang L, Bu X, Li H, Li B, Tang W, Lu L, Hu X, Tang S, Gao Y, Yang Y, Roberts N, Gong Q, Huang X. Localized Connectivity in Obsessive-Compulsive Disorder: An Investigation Combining Univariate and Multivariate Pattern Analyses. Front Behav Neurosci 2019; 13:122. [PMID: 31249515 PMCID: PMC6584748 DOI: 10.3389/fnbeh.2019.00122] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 05/20/2019] [Indexed: 02/05/2023] Open
Abstract
Recent developments in psychoradiological researches have highlighted the disrupted organization of large-scale functional brain networks in obsessive-compulsive disorder (OCD). However, whether abnormal activation of localized brain areas would affect network dysfunction remains to be fully characterized. We applied both univariate analysis and multivariate pattern analysis (MVPA) approaches to investigate the abnormalities of regional homogeneity (ReHo), an index to measure the localized connectivity, in 88 medication-free patients with OCD and 88 healthy control subjects (HCS). Resting-state functional magnetic resonance imaging (RS-fMRI) data of all the participants were acquired in a 3.0-T scanner. First, we adopted a traditional univariate analysis to explore ReHo alterations between the patient group and the control group. Subsequently, we utilized a support vector machine (SVM) to examine whether ReHo could be further used to differentiate patients with OCD from HCS at the individual level. Relative to HCS, OCD patients showed lower ReHo in the bilateral cerebellum and higher ReHo in the bilateral superior frontal gyri (SFG), right inferior parietal gyrus (IPG), and precuneus [P < 0.05, family-wise error (FWE) correction]. ReHo value in the left SFG positively correlated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score (r = 0 0.241, P = 0.024) and obsessive subscale (r = 0.224, P = 0.036). The SVM classification regarding ReHo yielded an accuracy of 78.98% (sensitivity = 78.41%, specificity = 79.55%) with P < 0.001 after permutation testing. The most discriminative regions contributing to the SVM classification were mainly located in the frontal, temporal, and parietal regions as well as in the cerebellum while the right orbital frontal cortex was identified with the highest discriminative power. Our findings not only suggested that the localized activation disequilibrium between the prefrontal cortex (PFC) and the cerebellum appeared to be associated with the pathophysiology of OCD but also indicated the translational role of the localized connectivity as a potential discriminative pattern to detect OCD at the individual level.
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Affiliation(s)
- Xinyu Hu
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Xuan Bu
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Hailong Li
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Bin Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wanjie Tang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Lu
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoxiao Hu
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Shi Tang
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Yingxue Gao
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Yanchun Yang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Neil Roberts
- Clinical Research Imaging Centre (CRIC), The Queen's Medical Research Institute (QMRI), University of Edinburgh, Edinburgh, United Kingdom
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
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43
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Norman LJ, Taylor SF, Liu Y, Radua J, Chye Y, De Wit SJ, Huyser C, Karahanoglu FI, Luks T, Manoach D, Mathews C, Rubia K, Suo C, van den Heuvel OA, Yücel M, Fitzgerald K. Error Processing and Inhibitory Control in Obsessive-Compulsive Disorder: A Meta-analysis Using Statistical Parametric Maps. Biol Psychiatry 2019; 85:713-725. [PMID: 30595231 PMCID: PMC6474799 DOI: 10.1016/j.biopsych.2018.11.010] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/26/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Error processing and inhibitory control enable the adjustment of behaviors to meet task demands. Functional magnetic resonance imaging studies report brain activation abnormalities in patients with obsessive-compulsive disorder (OCD) during both processes. However, conclusions are limited by inconsistencies in the literature and small sample sizes. Therefore, the aim here was to perform a meta-analysis of the existing literature using unthresholded statistical maps from previous studies. METHODS A voxelwise seed-based d mapping meta-analysis was performed using t-maps from studies comparing patients with OCD and healthy control subjects (HCs) during error processing and inhibitory control. For the error processing analysis, 239 patients with OCD (120 male; 79 medicated) and 229 HCs (129 male) were included, while the inhibitory control analysis included 245 patients with OCD (120 male; 91 medicated) and 239 HCs (135 male). RESULTS Patients with OCD, relative to HCs, showed longer inhibitory control reaction time (standardized mean difference = 0.20, p = .03, 95% confidence interval = 0.016, 0.393) and more inhibitory control errors (standardized mean difference = 0.22, p = .02, 95% confidence interval = 0.039, 0.399). In the brain, patients showed hyperactivation in the bilateral dorsal anterior cingulate cortex, supplementary motor area, and pre-supplementary motor area as well as right anterior insula/frontal operculum and anterior lateral prefrontal cortex during error processing but showed hypoactivation during inhibitory control in the rostral and ventral anterior cingulate cortices and bilateral thalamus/caudate, as well as the right anterior insula/frontal operculum, supramarginal gyrus, and medial orbitofrontal cortex (all seed-based d mapping z value >2, p < .001). CONCLUSIONS A hyperactive error processing mechanism in conjunction with impairments in implementing inhibitory control may underlie deficits in stopping unwanted compulsive behaviors in the disorder.
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Affiliation(s)
- Luke J. Norman
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, USA,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Stephan F. Taylor
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, USA
| | - Yanni Liu
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, USA
| | - Joaquim Radua
- Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Barcelona, Spain,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Yann Chye
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Stella J. De Wit
- Amsterdam University Medical Centers, Vrije Universiteit, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Chaim Huyser
- Bascule, Academic Centre for Children and Adolescent Psychiatry, Amsterdam, Netherlands
| | - F. Isik Karahanoglu
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Tracy Luks
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA
| | - Dara Manoach
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, USA
| | - Carol Mathews
- Department of Psychiatry and Center for OCD, Anxiety and Related Disorders, University of Florida, Gainesville, Florida, USA
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Chao Suo
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Odile A. van den Heuvel
- Amsterdam University Medical Centers, Vrije Universiteit, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands,OCD-Team, Haukeland University Hospital, Bergen, Norway
| | - Murat Yücel
- Brain and Mental Health Research Hub, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia,Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Kate Fitzgerald
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, USA
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44
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Riesel A, Klawohn J, Grützmann R, Kaufmann C, Heinzel S, Bey K, Lennertz L, Wagner M, Kathmann N. Error-related brain activity as a transdiagnostic endophenotype for obsessive-compulsive disorder, anxiety and substance use disorder. Psychol Med 2019; 49:1207-1217. [PMID: 30744714 PMCID: PMC6498788 DOI: 10.1017/s0033291719000199] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/13/2018] [Accepted: 01/16/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Increased neural error-signals have been observed in obsessive-compulsive disorder (OCD), anxiety disorders, and inconsistently in depression. Reduced neural error-signals have been observed in substance use disorders (SUD). Thus, alterations in error-monitoring are proposed as a transdiagnostic endophenotype. To strengthen this notion, data from unaffected individuals with a family history for the respective disorders are needed. METHODS The error-related negativity (ERN) as a neural indicator of error-monitoring was measured during a flanker task from 117 OCD patients, 50 unaffected first-degree relatives of OCD patients, and 130 healthy comparison participants. Family history information indicated, that 76 healthy controls were free of a family history for psychopathology, whereas the remaining had first-degree relatives with depression (n = 28), anxiety (n = 27), and/or SUD (n = 27). RESULTS Increased ERN amplitudes were found in OCD patients and unaffected first-degree relatives of OCD patients. In addition, unaffected first-degree relatives of individuals with anxiety disorders were also characterized by increased ERN amplitudes, whereas relatives of individuals with SUD showed reduced amplitudes. CONCLUSIONS Alterations in neural error-signals in unaffected first-degree relatives with a family history of OCD, anxiety, or SUD support the utility of the ERN as a transdiagnostic endophenotype. Reduced neural error-signals may indicate vulnerability for under-controlled behavior and risk for substance use, whereas a harm- or error-avoidant response style and vulnerability for OCD and anxiety appears to be associated with increased ERN. This adds to findings suggesting a common neurobiological substrate across psychiatric disorders involving the anterior cingulate cortex and deficits in cognitive control.
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Affiliation(s)
- Anja Riesel
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Julia Klawohn
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Departments of Biomedical Sciences and Psychology, Florida State University, Tallahassee, FL, USA
| | - Rosa Grützmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephan Heinzel
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychology, Freie University Berlin, Berlin, Germany
| | - Katharina Bey
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Leonhard Lennertz
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
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Grützmann R, Riesel A, Kaufmann C, Kathmann N, Heinzel S. Emotional interference under low versus high executive control. Psychophysiology 2019; 56:e13380. [PMID: 31020677 DOI: 10.1111/psyp.13380] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 04/04/2019] [Accepted: 04/04/2019] [Indexed: 11/30/2022]
Abstract
Previous research has demonstrated that task-irrelevant emotional distractors interfere with task performance especially under low phasic executive control (i.e., in nonconflict trials). In the present study, we measured medio-frontal ERPs (N2 and correct-related negativity, CRN) to elucidate which aspects of task performance are affected by emotional interference in a flanker task. To create emotional interference, negative and neutral pictures were presented during the flanker stimuli. N2 and CRN were reduced after negative pictures, indicating that conflict processing and performance monitoring are both affected by emotional interference. On the behavioral level, prolonged response times after negative pictures were observed under low phasic executive control (i.e., in compatible trials). Additionally, we explored whether emotional interference is modulated not only by phasic changes in executive control (i.e., conflict vs. nonconflict trials) but also by tonic changes in executive control (i.e., low vs. high overall conflict frequency). To this end, the flanker task consisted of two blocks with 25% versus 75% incompatible trials. Prolonged response times after negative pictures in compatible trials were observed only under low tonic executive control but not under high executive control.
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Affiliation(s)
- Rosa Grützmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anja Riesel
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stephan Heinzel
- Department of Psychology, Freie Universität Berlin, Berlin, Germany
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Corbit VL, Manning EE, Gittis AH, Ahmari SE. Strengthened Inputs from Secondary Motor Cortex to Striatum in a Mouse Model of Compulsive Behavior. J Neurosci 2019; 39:2965-2975. [PMID: 30737313 PMCID: PMC6462450 DOI: 10.1523/jneurosci.1728-18.2018] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/19/2018] [Accepted: 12/19/2018] [Indexed: 12/15/2022] Open
Abstract
Hyperactivity in striatum is associated with compulsive behaviors in obsessive-compulsive disorder (OCD) and related illnesses, but it is unclear whether this hyperactivity is due to intrinsic striatal dysfunction or abnormalities in corticostriatal inputs. Understanding the cellular and circuit properties underlying striatal hyperactivity could help inform the optimization of targeted stimulation treatments for compulsive behavior disorders. To investigate the cellular and synaptic abnormalities that may underlie corticostriatal dysfunction relevant to OCD, we used the Sapap3 knock-out (Sapap3-KO) mouse model of compulsive behaviors, which also exhibits hyperactivity in central striatum. Ex vivo electrophysiology in double-transgenic mice was used to assess intrinsic excitability and functional synaptic input in spiny projection neurons (SPNs) and fast-spiking interneurons (FSIs) in central striatum of Sapap3-KOs and wild-type (WT) littermates. While we found no differences in intrinsic excitability of SPNs or FSIs between Sapap3-KOs and WTs, excitatory drive to FSIs was significantly increased in KOs. Contrary to predictions, lateral orbitofrontal cortex-striatal synapses were not responsible for this increased drive; optogenetic stimulation revealed that lateral orbitofrontal cortex input to SPNs was reduced in KOs (∼3-fold) and unchanged in FSIs. However, secondary motor area (M2) postsynaptic responses in central striatum were significantly increased (∼6-fold) in strength and reliability in KOs relative to WTs. These results suggest that increased M2-striatal drive may contribute to both in vivo striatal hyperactivity and compulsive behaviors, and support a potential role for presupplementary/supplementary motor cortical regions in the pathology and treatment of compulsive behavior disorders.SIGNIFICANCE STATEMENT These findings highlight an unexpected contribution of M2 projections to striatal dysfunction in the Sapap3-KO obsessive-compulsive disorder (OCD)-relevant mouse model, with M2 inputs strengthened by at least sixfold onto both spiny projection neurons and fast-spiking interneurons in central striatum. Because M2 is thought to be homologous to presupplementary/supplementary motor areas (pre-SMA/SMA) in humans, regions important for movement preparation and behavioral sequencing, these data are consistent with a model in which increased drive from M2 leads to excessive selection of sequenced motor patterns. Together with observations of hyperactivity in pre-SMA/SMA in both OCD and Tourette syndrome, and evidence that pre-SMA is a potential target for repetitive transcranial magnetic stimulation treatment in OCD, these results support further dissection of the role of M2 in compulsivity.
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Affiliation(s)
- Victoria L Corbit
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania 15260
- Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, and
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - Elizabeth E Manning
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania 15260
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
| | - Aryn H Gittis
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213
- Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, and
| | - Susanne E Ahmari
- Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213,
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania 15260
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15219
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Perera MPN, Bailey NW, Herring SE, Fitzgerald PB. Electrophysiology of obsessive compulsive disorder: A systematic review of the electroencephalographic literature. J Anxiety Disord 2019; 62:1-14. [PMID: 30469123 DOI: 10.1016/j.janxdis.2018.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 10/04/2018] [Accepted: 11/03/2018] [Indexed: 01/04/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a chronic disease that causes significant decline in the quality of life of those affected. Due to our limited understanding of the underlying pathophysiology of OCD, successful treatment remains elusive. Although many have studied the pathophysiology of OCD through electroencephalography (EEG), limited attempts have been made to synthesize and interpret their findings. To bridge this gap, we conducted a comprehensive literature review using Medline/PubMed and considered the 65 most relevant studies published before June 2018. The findings are categorised into quantitative EEG, sleep related EEG and event related potentials (ERPs). Increased frontal asymmetry, frontal slowing and an enhancement in the ERP known as error related negativity (ERN) were consistent findings in OCD. However, sleep EEG and other ERP (P3 and N2) findings were inconsistent. Additionally, we analysed the usefulness of ERN as a potential candidate endophenotype. We hypothesize that dysfunctional frontal circuitry and overactive performance monitoring are the major underlying impairments in OCD. Additionally, we conceptualized that defective fronto-striato-thalamic circuitry causing poor cerebral functional connectivity gives rise to the OCD behavioural manifestations. Finally, we have discussed transcranial magnetic stimulation and EEG (TMS-EEG) applications in future research to further our knowledge of the underlying pathophysiology of OCD.
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Affiliation(s)
- M Prabhavi N Perera
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Level 4, 607, St. Kilda Road, Melbourne, Victoria 3004, Australia.
| | - Neil W Bailey
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Level 4, 607, St. Kilda Road, Melbourne, Victoria 3004, Australia; Epworth Centre for Innovation in Mental Health, Epworth HealthCare, 888 Toorak Rd, Camberwell, Victoria 3124, Australia.
| | - Sally E Herring
- Epworth Centre for Innovation in Mental Health, Epworth HealthCare, 888 Toorak Rd, Camberwell, Victoria 3124, Australia.
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and Alfred Hospital, Level 4, 607, St. Kilda Road, Melbourne, Victoria 3004, Australia; Epworth Centre for Innovation in Mental Health, Epworth HealthCare, 888 Toorak Rd, Camberwell, Victoria 3124, Australia.
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Theiss JD, McHugo M, Zhao M, Zald DH, Olatunji BO. Neural correlates of resolving conflict from emotional and nonemotional distracters in obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2019; 284:29-36. [PMID: 30641435 DOI: 10.1016/j.pscychresns.2019.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 01/06/2019] [Accepted: 01/06/2019] [Indexed: 11/23/2022]
Abstract
Obsessive compulsive disorder (OCD) is associated with altered processing in brain regions involved in conflict resolution. However, limited research has examined the extent to which conflict from emotional distracters characterizes OCD such that responsiveness to task-irrelevant emotional stimuli is altered compared to controls. In the present study, 16 patients with OCD and 15 healthy controls underwent functional magnetic resonance imaging (fMRI) during resolution of conflict from emotional or nonemotional distracters. Results in healthy controls demonstrated that rostral anterior cingulate cortex (rACC), middle frontal gyrus (MFG), and medial superior frontal gyrus (MSFG) showed greater activation for high conflict versus low conflict. Responses in these regions differed between the emotional and nonemotional distracter tasks, with rACC and MSFG having greater activation for conflict from nonemotional distracters and anterior MFG showing greater activation for conflict from emotional distracters. Furthermore, between-group differences revealed a region in right posterior MFG in which controls similarly exhibited greater activation during high conflict versus low conflict with emotional distracters; however, OCD patients showed the opposite pattern with greater activation during low conflict compared to high conflict. These findings suggest that activity of right posterior MFG may be relevant in better understanding inefficient responding during emotional conflict in OCD.
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Affiliation(s)
- Justin D Theiss
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maureen McHugo
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mimi Zhao
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, Nashville, TN, USA; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
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Fan S, Cath DC, van der Werf YD, de Wit S, Veltman DJ, van den Heuvel OA. Trans-diagnostic comparison of response inhibition in Tourette's disorder and obsessive-compulsive disorder. World J Biol Psychiatry 2018; 19:527-537. [PMID: 28741401 DOI: 10.1080/15622975.2017.1347711] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Impaired response inhibition is related to neurodevelopmental disorders, such as Tourette's disorder (TD) and obsessive-compulsive disorder (OCD). Unlike OCD, in which neural correlates of response inhibition have been extensively studied, TD literature is limited. By using a Stop-Signal task, we investigated the neural mechanisms underlying response inhibition deficits in TD compared to OCD and healthy controls (HCs). METHODS Twenty-three TD patients, 20 OCD patients and 22 HCs were scanned (3T MRI). Region-of-interest analyses were performed between TD, OCD and HCs. RESULTS Performance was similar across all subject groups. During inhibition TD compared with HCs showed higher right inferior parietal cortex (IPC) activation. During error processing TD compared with HCs showed hyperactivity in the left cerebellum, right mesencephalon, and right insula. Three-group comparison showed an effect of group for error-related activation in the supplementary motor area (SMA). Post-hoc analyses showed higher error-related SMA activity in TD compared with OCD and HCs. Error-related left cerebellar activity correlated positively with tic severity. CONCLUSIONS Hyperactivation of IPC during inhibition and a widespread hyperactivated network during error processing in TD suggest compensatory inhibition- and error-related circuit recruitment to boost task performance. The lack of overlap with activation pattern in OCD suggests such compensatory mechanism is TD-specific.
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Affiliation(s)
- Siyan Fan
- a Division of Social and Behavioural Science , Utrecht University , Utrecht , The Netherlands.,b Department of Anatomy and Neurosciences , VU University Medical Center (VUmc) , Amsterdam , The Netherlands.,c Department of Psychiatry , VUmc , Amsterdam , The Netherlands
| | - Danielle C Cath
- a Division of Social and Behavioural Science , Utrecht University , Utrecht , The Netherlands.,d Department of Psychiatry and RGOC , Groningen , The Netherlands
| | - Ysbrand D van der Werf
- b Department of Anatomy and Neurosciences , VU University Medical Center (VUmc) , Amsterdam , The Netherlands.,e Amsterdam Neuroscience , Amsterdam , The Netherlands
| | - Stella de Wit
- c Department of Psychiatry , VUmc , Amsterdam , The Netherlands
| | - Dick J Veltman
- c Department of Psychiatry , VUmc , Amsterdam , The Netherlands.,d Department of Psychiatry and RGOC , Groningen , The Netherlands
| | - Odile A van den Heuvel
- b Department of Anatomy and Neurosciences , VU University Medical Center (VUmc) , Amsterdam , The Netherlands.,c Department of Psychiatry , VUmc , Amsterdam , The Netherlands.,e Amsterdam Neuroscience , Amsterdam , The Netherlands.,f The OCD team , Haukeland University Hospital , Bergen , Norway
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Development of Posterior Medial Frontal Cortex Function in Pediatric Obsessive-Compulsive Disorder. J Am Acad Child Adolesc Psychiatry 2018; 57:397-406. [PMID: 29859555 PMCID: PMC5990044 DOI: 10.1016/j.jaac.2018.02.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 02/18/2018] [Accepted: 04/13/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Abnormal engagement of the posterior medial frontal cortex (pMFC) occurs during performance monitoring in obsessive-compulsive disorder (OCD), including in pediatric patients. Yet, the development of pMFC function in OCD-affected youth remains poorly understood. METHOD A total of 69 patients with pediatric OCD and 72 healthy controls (HC), 8 to 19 years of age, were scanned during the Multisource Interference Task (MSIT). The effects of group, age, performance, and interactions on pMFC response to errors and interference were tested in the region of interest [ROI]) and whole-brain analyses. Secondary analyses considered bilateral anterior insula/frontal operculum (aI/fO), given the contribution of these regions with pMFC to a cingulo-opercular network (CON) for task control (e.g., error and interference processing). RESULTS Error-related pMFC activity was greater for OCD patients than for HC, increased with age in OCD patients, but decreased with age in HC. Greater pMFC activation associated with better performance in HC but not OCD patients. In the patients, greater pMFC activation to errors was associated with lower OCD severity. Altered error-related activation and performance associations were also observed in the right aI/fO in OCD patients, whereas the left aI/fO response to interference was associated with lower OCD severity. CONCLUSION Atypical increase in error-related pMFC activation with age in pediatric OCD suggests altered development of pMFC function during the early course of illness. Greater pMFC activation with better performance in HC, and with age and lower symptom severity in OCD patients, suggests an adaptive function of heightened pMFC response to errors that could be further enhanced (e.g., via cognitive training) to improve outcomes in OCD from the early course of illness.
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