Increased error-related brain activity in pediatric obsessive-compulsive disorder before and after treatment

Am J Psychiatry. 2008 Jan;165(1):116-23. doi: 10.1176/appi.ajp.2007.07010143. Epub 2007 Nov 6.


Objective: The error-related negativity is a negative deflection in the event-related potential maximal approximately 50 msec after the commission of errors. The error-related negativity is generated in the anterior cingulate cortex, and both anterior cingulate cortex hyperactivity and increased error-related brain activity have been reported in adults with obsessive-compulsive disorder (OCD). However, no study to date, to the authors' knowledge, has examined error-related brain activity in pediatric patients with OCD, and no study has examined error-related brain activity in OCD both before and after treatment.

Method: The error-related negativity was measured in 18 treatment-seeking pediatric patients with OCD and 18 age-matched comparison subjects. Of these patients, 10 returned for a second testing session after cognitive behavior therapy; 13 comparison children participated a second time after a comparable interval.

Results: In the pretreatment group, the error-related negativity was reliably larger in pediatric patients with OCD in relation to comparison subjects. This difference was also evident after treatment. There was no relationship between error-related negativity and symptom severity or changes in symptom severity.

Conclusions: Consistent with studies in adult patients, increased error-related brain activity is evident in pediatric patients with OCD. Furthermore, increased error-related brain activity does not appear to change as a function of symptom reduction after therapy. These results suggest that an increased error-related negativity may be a trait-like marker for psychopathology and might be a useful endophenotype.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Brain / physiopathology*
  • Cognitive Behavioral Therapy / methods
  • Diagnostic and Statistical Manual of Mental Disorders
  • Electroencephalography / statistics & numerical data
  • Evoked Potentials / physiology*
  • Female
  • Gyrus Cinguli / physiopathology*
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Motor Skills / physiology
  • Obsessive-Compulsive Disorder / diagnosis
  • Obsessive-Compulsive Disorder / physiopathology*
  • Obsessive-Compulsive Disorder / therapy
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychomotor Performance / physiology*
  • Reaction Time / physiology*
  • Severity of Illness Index
  • Task Performance and Analysis
  • Treatment Outcome
  • Visual Perception / physiology