Emotional interference modulates performance monitoring in patients with obsessive-compulsive disorder

Task relevance alters the effect of emotion on congruency judgments during action understanding

The congruency judgments in action understanding helps individuals make timely adjustments to unexpected occurrence, and this process may be influenced by emotion. Previous research has showed contradictory effect of emotion on conflict processing, possibly due to the degree of relevance between emotion and task. However, to date, no study has systematically manipulated the relevance to explore how emotion affects congruency judgments in action understanding. We employed a cue-target paradigm and controlled the way emotional stimuli were presented on the target interface, setting up three experiments: emotion served as task-irrelevant distractor, task-irrelevant target and task-relevant target. The results showed that when emotion was irrelevant to the task, it impaired congruency judgements performance, regardless of a distractor or a target, while task-relevant emotion facilitated this process. These findings indicate that the impact of emotion on congruency judgements during action understanding depends on the degree of emotion-task relevance.

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

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.

EEG correlates of attentional control in anxiety disorders: A systematic review of error-related negativity and correct-response negativity findings

BACKGROUND

Anxiety disorders are highly prevalent and cause substantial personal, social and economic burden. Altered attentional control has been shown to be present across anxiety disorders and is associated with specific changes in brain activity which can be recorded by electroencephalogram (EEG). These include changes in the EEG markers of error-related negativity (ERN) and correct-response negativity (CRN), both believed to reflect response monitoring and attentional control pathophysiology in anxiety. The aim of this review was to systematically assess the research on ERN and CRN in attentional control in individuals with clinical anxiety and healthy controls, across emotional and non-emotional attentional control.

METHODS

A comprehensive literature search was conducted for studies published prior to October 22^nd, 2020. Details of the protocol for this systematic review were registered on PROSPERO (CRD42019144885).

RESULTS

66 studies had their data extracted. All 66 studies measured ERN, with 85% finding significantly increased ERN amplitudes associated with clinical anxiety. Only 44 of the extracted studies analysed CRN and only ~20% of these found significant changes in CRN amplitude associated with individuals with clinical anxiety.

LIMITATIONS

There were several anxiety disorders that had either limited literature (i.e. specific phobia, separation anxiety disorder or agoraphobia) or nil literature (i.e. selective mutism) available. No extracted studies included samples of older adults (i.e. aged 60+ years), and only six extracted studies included measures of emotional attentional control.

CONCLUSIONS

Findings indicate the promising utility of ERN of attentional control as a robust, transdiagnostic trait marker of clinical anxiety.

Conflict monitoring and the affective-signaling hypothesis-An integrative review

Conflict-monitoring theory proposes that conflict between incompatible responses is registered by a dedicated monitoring system, and that this conflict signal triggers changes of attentional filters and adapts control processes according to the current task demands. Extending the conflict-monitoring theory, it has been suggested that conflict elicits a negative affective reaction, and that it is this affective signal that is monitored and then triggers control adaptation. This review article summarizes research on a potential signaling function of affect for cognitive control. First, we provide an overview of the conflict-monitoring theory, discuss neurophysiological and behavioral markers of monitoring and control adaptation, and introduce the affective-signaling hypothesis. In a second part, we review relevant studies that address the questions of (i) whether conflict elicits negative affect, (ii) whether negative affect is monitored, and (iii) whether affect modulates control. In sum, the reviewed literature supports the claim that conflict and errors trigger negative affect and provides some support for the claim that affect modulates control. However, studies on the monitoring of negative affect and the influence of phasic affect on control are ambiguous. On the basis of these findings, in a third part, we critically reassess the affective-signaling hypothesis, discuss relevant challenges to this account, and suggest future research strategies.

The erring brain: Error-related negativity as an endophenotype for OCD-A review and meta-analysis

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.

Modulation of error monitoring in obsessive-compulsive disorder by individually tailored symptom provocation

BACKGROUND

The enhanced error monitoring in patients with obsessive-compulsive disorder (OCD), typically measured with the error-related negativity (ERN), has been found to be temporally stable and independent of symptom expression. Here, we examined whether the error monitoring in patients with OCD could be experimentally modulated by individually tailored symptom provocation.

METHOD

Twenty patients with OCD and 20 healthy controls performed a flanker task in which OCD-relevant or neutral pictures were presented prior to a flanker stimulus. An individualized stimulus set consisting of the most provoking images in terms of OCD symptoms was selected for each patient with OCD. Response-locked event-related potentials were recorded and used to examine the error-related brain activity.

RESULTS

Patients with OCD showed larger ERN amplitudes than did control subjects in both the OCD-symptom provocation and neutral conditions. Additionally, while patients with OCD exhibited a significant increase in the ERN under the OCD-symptom provocation condition when compared with the neutral condition, control subjects showed no variation in the ERN between the conditions.

CONCLUSIONS

Our results strengthen earlier findings of hyperactive error monitoring in OCD, as indexed by higher ERN amplitudes in patients with OCD than in controls. Importantly, we showed that the patients' overactive error-signals were experimentally enhanced by individually tailored OCD-symptom triggers, thus suggesting convincing evidence between OCD-symptoms and ERN. Such findings imply that therapeutic interventions should target affective regulation in order to alleviate the perceived threatening value of OCD triggers.