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Divergent subcortical activity for distinct executive functions: stopping and shifting in obsessive compulsive disorder.

ABSTRACT: BACKGROUND:There is evidence of executive function impairment in obsessive compulsive disorder (OCD) that potentially contributes to symptom development and maintenance. Nevertheless, the precise nature of these executive impairments and their neural basis remains to be defined. METHOD:We compared stopping and shifting, two key executive functions previously implicated in OCD, in the same task using functional magnetic resonance imaging, in patients with virtually no co-morbidities and age-, verbal IQ- and gender-matched healthy volunteers. The combined task allowed direct comparison of neural activity in stopping and shifting independent of patient sample characteristics and state variables such as arousal, learning, or current symptom expression. RESULTS:Both OCD patients and controls exhibited right inferior frontal cortex activation during stopping, and left inferior parietal cortex activation during shifting. However, widespread under-activation across frontal-parietal areas was found in OCD patients compared to controls for shifting but not stopping. Conservative, whole-brain analyses also indicated marked divergent abnormal activation in OCD in the caudate and thalamus for these two cognitive functions, with stopping-related over-activation contrasting with shift-related under-activation. CONCLUSIONS:OCD is associated with selective components of executive function, which engage similar common elements of cortico-striatal regions in different abnormal ways. The results implicate altered neural activation of subcortical origin in executive function abnormalities in OCD that are dependent on the precise cognitive and contextual requirements, informing current theories of symptom expression.

SUBMITTER: Morein-Zamir S

PROVIDER: S-EPMC4754830 | biostudies-literature | 2016 Mar

REPOSITORIES: biostudies-literature

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Divergent subcortical activity for distinct executive functions: stopping and shifting in obsessive compulsive disorder.

Morein-Zamir S S Voon V V Dodds C M CM Sule A A van Niekerk J J Sahakian B J BJ Robbins T W TW

Psychological medicine 20151106 4

<h4>Background</h4>There is evidence of executive function impairment in obsessive compulsive disorder (OCD) that potentially contributes to symptom development and maintenance. Nevertheless, the precise nature of these executive impairments and their neural basis remains to be defined.<h4>Method</h4>We compared stopping and shifting, two key executive functions previously implicated in OCD, in the same task using functional magnetic resonance imaging, in patients with virtually no co-morbiditie ...[more]

PMID: 26541510

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Project description:Introduction: Studies have shown that patients with obsessive compulsive disorder (OCD) often perform more poorly than healthy control (HC) participants on cognitive tasks involving executive functions. Most studies, however, have been performed in Western countries and societies, making it uncertain whether impaired executive functions can also be observed among non-Western patients with OCD. To address this gap in the literature, we evaluated several executive functions in Chinese patients with OCD and HCs. Methods: Participants included consisted of 46 Chinese patients with OCD (25 men, 21 women), ranging in age from 19 to 56 years, and 45 matched HCs without any self-reported lifetime psychiatric disorder. They all lived in Shanghai or the surrounding area. Five tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used to evaluate several executive functions (response inhibition, spatial working memory, planning, and cognitive flexibility) along with testing basic learning and visual recognition memory. Statistical tests using a Bonferroni-corrected significance level of p = 0.003 were performed to assess overall patient-control group differences in cognitive performance. Additionally, we explored performance differences between patients classified as having either relatively mild symptoms or severe symptoms based on the individual total scores on the Yale-Brown Obsessive-Compulsive Scale. Results: There were no significant performance differences between patients with OCD and HC in any of the cognitive tests. Similarly, cognitive performance of patients with relatively mild OCD symptoms did not differ significantly from that of patients with severe symptoms. Conclusions: These results do not seem to support the view that impaired executive functioning represents a basic cognitive and pathophysiological feature of Chinese patients with OCD. However, due to study limitations, additional research is required before this conclusion can be well accepted.

Dataset Information

Divergent subcortical activity for distinct executive functions: stopping and shifting in obsessive compulsive disorder.

Publications

Divergent subcortical activity for distinct executive functions: stopping and shifting in obsessive compulsive disorder.

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