Search our Database of Scientific Publications and Authors

I’m looking for a
    Imbalance in habitual versus goal directed neural systems during symptom provocation in obsessive-compulsive disorder.
    Brain 2015 Mar 6;138(Pt 3):798-811. Epub 2015 Jan 6.
    1 Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Portugal 5 ICNAS, Brain Imaging Network of Portugal
    Intrusive thoughts and compulsive urges to perform stereotyped behaviours are typical symptoms of obsessive-compulsive disorder. Emerging evidence suggests a cognitive bias towards habit formation at the expense of goal-directed performance in obsessive-compulsive disorder. In this study, we test this hypothesis using a novel individualized ecologically valid symptom provocation design: a live provocation functional magnetic resonance imaging paradigm with synchronous video-recording of behavioural avoidance responses. By pairing symptom provocation with online avoidance responses on a trial-by-trial basis, we sought to investigate the neural mechanisms leading to the compulsive avoidance response. In keeping with the model of habit formation in obsessive-compulsive disorder, we hypothesized that this disorder would be associated with lower activity in regions implicated in goal-directed behaviours and higher activity in regions implicated in habitual behaviours. Fifteen patients with obsessive-compulsive disorder and 15 healthy control volunteers participated in this functional magnetic resonance imaging study. Online stimuli were individually tailored to achieve effective symptom provocation at neutral, intermediate and strong intensity levels. During the symptom provocation block, the participant could choose to reject or terminate the provoking stimuli resulting in cessation of the symptom provocation. We thus separately analysed the neural correlates of symptom provocation, the urge to avoid, rejection and relief. Strongly symptom-provoking conditions evoked a dichotomous pattern of deactivation/activation in patients, which was not observed either in control conditions or in healthy subjects: a deactivation of caudate-prefrontal circuits accompanied by hyperactivation of subthalamic nucleus/putaminal regions. This finding suggests a dissociation between regions engaged in goal-directed and habitual behaviours. The putaminal hyperactivity during patients' symptom provocation preceded subsequent deactivation during avoidance and relief events, indicating a pivotal role of putamen in regulation of behaviour and habit formation in obsessive-compulsive disorder. Effective connectivity analysis identified the ventromedial prefrontal cortex/orbitofrontal cortex as the main structure in this circuitry involved in the modulation of compulsivity in obsessive-compulsive disorder. These findings suggest an imbalance in circuitry underlying habitual and goal-directed action control, which may represent a fundamental mechanism underlying compulsivity in obsessive-compulsive disorder. Our results complement current models of symptom generation in obsessive-compulsive disorder and may enable the development of future therapeutic approaches that aim to alleviate this imbalance.

    Similar Publications

    Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder.
    Arch Gen Psychiatry 2004 Jun;61(6):564-76
    Department of Psychological Medicine, Institute of Psychiatry, London, England.
    Context: Obsessive-compulsive disorder (OCD) is clinically heterogeneous, yet most previous functional neuroimaging studies grouped together patients with mixed symptoms, thus potentially reducing the power and obscuring the findings of such studies.

    Objective: To investigate the neural correlates of washing, checking, and hoarding symptom dimensions in OCD.

    Design: Symptom provocation paradigm, functional magnetic resonance imaging, block design, and nonparametric brain mapping analyses. Read More
    Specific Frontostriatal Circuits for Impaired Cognitive Flexibility and Goal-Directed Planning in Obsessive-Compulsive Disorder: Evidence From Resting-State Functional Connectivity.
    Biol Psychiatry 2017 Apr 11;81(8):708-717. Epub 2016 Aug 11.
    Departments of Psychology, University of Cambridge, Cambridge; Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge.
    Background: A recent hypothesis has suggested that core deficits in goal-directed behavior in obsessive-compulsive disorder (OCD) are caused by impaired frontostriatal function. We tested this hypothesis in OCD patients and control subjects by relating measures of goal-directed planning and cognitive flexibility to underlying resting-state functional connectivity.

    Methods: Multiecho resting-state acquisition, combined with micromovement correction by blood oxygen level-dependent sensitive independent component analysis, was used to obtain in vivo measures of functional connectivity in 44 OCD patients and 43 healthy comparison subjects. Read More
    Neuroimaging in obsessive-compulsive disorder.
    Expert Rev Neurother 2009 Feb;9(2):255-69
    Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, Korea 110-744.
    Many neuroimaging studies have investigated the pathophysiology of obsessive-compulsive disorder. These studies have contributed greatly to the development of contemporary neurocircuitry models of obsessive-compulsive disorder, which emphasize the dysfunction of fronto-striato-thalamocortical circuitry in obsessive-compulsive disorder patients. Specifically, dysfunctions of the orbitofrontal cortex, anterior cingulate cortex, thalamus and caudate nucleus have been revealed through resting state or symptom provocation studies. Read More
    Functional neuroimaging of avoidance habits in obsessive-compulsive disorder.
    Am J Psychiatry 2015 Mar 19;172(3):284-93. Epub 2014 Dec 19.
    From the Departments of Psychology and Psychiatry, and the Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom; the Department of Psychology at New York University, New York; South Essex Partnership University NHS Foundation Trust, Springhouse, Biggleswade Hospital, Bedfordshire, United Kingdom; the Department of Psychiatry, Queen Elizabeth II Hospital, Welwyn Garden City, Hertfordshire, United Kingdom; and the Postgraduate Medical School, University of Hertfordshire, Hatfield, United Kingdom.
    Objective: The purpose of this study was to determine the neural correlates of excessive habit formation in obsessive-compulsive disorder (OCD). The authors aimed to test for neurobiological convergence with the known pathophysiology of OCD and to infer, based on abnormalities in brain activation, whether these habits arise from dysfunction in the goal-directed or habit system.

    Method: Thirty-seven OCD patients and 33 healthy comparison subjects learned to avoid shocks while undergoing a functional MRI scan. Read More