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Neural correlates of affective and non-affective cognition in obsessive compulsive disorder: A meta-analysis of functional imaging studies

Published online by Cambridge University Press:  23 March 2020

A. Rasgon
Department of psychiatry, Icahn school of medicine, 1425, Madison avenue, 10029 New York, Mount Sinai, USA
W.H. Lee
Department of psychiatry, Icahn school of medicine, 1425, Madison avenue, 10029 New York, Mount Sinai, USA
E. Leibu
Department of psychiatry, Icahn school of medicine, 1425, Madison avenue, 10029 New York, Mount Sinai, USA
A. Laird
Neuroinformatics and brain connectivity laboratory, Florida international university, Florida, USA
D. Glahn
Division of neurocognition, neurocomputation, and neurogenetics, Yale university, New Haven, CT, USA
W. Goodman
Menninger department of psychiatry and behavioral sciences, Baylor college of medicine, Waco, TX, USA
S. Frangou*
Department of psychiatry, Icahn school of medicine, 1425, Madison avenue, 10029 New York, Mount Sinai, USA
* Corresponding author. E-mail (S. Frangou).
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Obsessive compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive ritualistic behaviors and has been associated with diverse functional brain abnormalities. We sought to synthesize current evidence from functional magnetic resonance imaging (fMRI) studies and examine their alignment to pathogenetic models of OCD. Following systematic review, we identified 54 task-fMRI studies published in the last decade comparing adults with OCD (n = 1186) to healthy adults (n = 1159) using tasks of affective and non-affective cognition. We used voxel-based quantitative meta-analytic methods to combine primary data on anatomical coordinates of case-control differences, separately for affective and non-affective tasks. We found that functional abnormalities in OCD cluster within cortico-striatal thalamic circuits. Within these circuits, the abnormalities identified showed significant dependence on the affective or non-affective nature of the tasks employed as circuit probes. In studies using affective tasks, patients overactivated regions involved in salience, arousal and habitual responding (anterior cingulate cortex, insula, caudate head and putamen) and underactivated regions implicated in cognitive and behavioral control (medial prefrontal cortex, posterior caudate). In studies using non-affective cognitive tasks, patients overactivated regions involved in self-referential processing (precuneus, posterior cingulate cortex) and underactivated subcortical regions that support goal-directed cognition and motor control (pallidum, ventral anterior thalamus, posterior caudate). The overall pattern suggests that OCD-related brain dysfunction involves increased affective and self-referential processing, enhanced habitual responding and blunted cognitive control.

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Copyright © European Psychiatric Association 2017

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