Oculomotor response inhibition abnormalities in pediatric obsessive-compulsive disorder

Arch Gen Psychiatry. 1997 Sep;54(9):831-8. doi: 10.1001/archpsyc.1997.01830210075008.

Abstract

Background: Disturbances in the orbital prefrontal cortex and its ventral striatal target fields have been identified in neuroimaging studies of obsessive-compulsive disorder (OCD). In animal models and studies of patients with lesions to this brain circuitry, a selective disturbance in the ability to suppress responses to irrelevant stimuli has been demonstrated. Such a deficit in response suppression might underlie the apparent inhibitory deficit suggested by the symptoms of OCD. To date, little direct evidence of such a deficit has been reported. Further, although OCD commonly emerges during childhood or adolescence, few studies have examined psychotropic-naive pediatric patients near the onset of illness to find the possible role of atypical developmental processes in this disorder.

Methods: Oculomotor tests were administered to 18 psychotropic medication-naive, nondepressed patients with OCD aged 8.8 to 16.9 years and 18 case-matched healthy comparison subjects to assess the following 3 well-delineated aspects of prefrontal cortical function: the ability to suppress responses, the volitional execution of delayed responses, and the anticipation of predictable events.

Results: A significantly higher percentage of response suppression failures was observed in patients with OCD (P = .003), particularly in younger patients compared with their case-matched controls. No significant differences between patients with OCD and controls were observed on other prefrontal cortical functions. Severity of OCD symptoms was related to response suppression deficits.

Conclusions: A basic disturbance of behavioral inhibition in OCD was detected that may underlie the repetitive symptomatic behavior that characterizes the illness.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Corpus Striatum / physiology
  • Eye Movements / physiology*
  • Female
  • Functional Laterality / physiology
  • Humans
  • Male
  • Neural Pathways / physiology
  • Neuropsychological Tests
  • Obsessive-Compulsive Disorder / diagnosis*
  • Obsessive-Compulsive Disorder / physiopathology
  • Personality Inventory
  • Prefrontal Cortex / physiology*
  • Psychiatric Status Rating Scales
  • Reaction Time / physiology
  • Saccades / physiology
  • Severity of Illness Index