Differential neural network of checking versus washing symptoms in obsessive-compulsive disorder

Prog Neuropsychopharmacol Biol Psychiatry. 2013 Jan 10:40:160-6. doi: 10.1016/j.pnpbp.2012.09.002. Epub 2012 Sep 17.

Abstract

Obsessive-compulsive disorder (OCD) is clinically heterogeneous. The aim of this study was to investigate differential neural responses to a symptom provocation task in drug-free patients who have predominantly aggression/checking symptoms (Checkers) and patients with contamination/washing symptoms (Washers). We compared the Checkers (n=10) and the Washers (n=12) separately to normal controls during the symptom provocation tasks using fMRI (functional magnetic resonance imaging). Moreover, we performed correlative analysis in each OCD group between brain activation and symptom severity. The Checkers showed hypoactivation in the left caudate and left anterior cingulate cortex (ACC) compared to the normal controls and a positive correlation between activated brain areas and symptom severity in the left ACC. The Washers showed hyperactivation in several bilateral cortico-cerebellar regions and a positive correlation between symptom severity and the bilateral fronto-temporal gyrus. We suggest that the caudate and ACC are associated with checking rituals and that large cortical brain regions are related to washing rituals.

MeSH terms

  • Adolescent
  • Adult
  • Brain / physiopathology*
  • Brain Mapping
  • Compulsive Behavior / physiopathology*
  • Compulsive Behavior / psychology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Obsessive Behavior / physiopathology*
  • Obsessive Behavior / psychology
  • Obsessive-Compulsive Disorder / physiopathology*
  • Obsessive-Compulsive Disorder / psychology
  • Peripheral Nervous System Neoplasms / physiopathology*