Imbalance in habitual versus goal directed neural systems during symptom provocation in obsessive-compulsive disorder
| Autor: | Valerie Voon, João B. Relvas, Miguel Castelo-Branco, Inês Almeida, Martin D. Vestergaard, Gregor Philipiak, Paula Banca, Fernando Pocinho |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Obsessive-Compulsive Disorder Equilíbrio Postural Provocation test Ventromedial prefrontal cortex Imbalanced circuitry Avoidance response Developmental psychology 03 medical and health sciences Young Adult 0302 clinical medicine medicine Humans Perturbações das Sensações Prefrontal cortex Live symptom provocation Postural Balance Metas Analysis of Variance medicine.diagnostic_test Brain Original Articles Magnetic Resonance Imaging Cognitive bias Perturbação Obsessivo-Compulsiva 030227 psychiatry Causality medicine.anatomical_structure Compulsive behavior Caudate/putamen Sensation Disorders Linear Models Orbitofrontal cortex Female Neurology (clinical) medicine.symptom Psychology Functional magnetic resonance imaging Cognition Disorders Goals Perturbações Cognitivas 030217 neurology & neurosurgery Clinical psychology |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal Repositório Científico de Acesso Aberto de Portugal (RCAAP) instacron:RCAAP CIÊNCIAVITAE |
| Popis: | Intrusive thoughts and compulsive urges to perform stereotyped behaviours are typical symptoms of obsessive-compulsive disorder. Emerging evidence suggests a cognitive bias towards habit formation at the expense of goal-directed performance in obsessive-compulsive disorder. In this study, we test this hypothesis using a novel individualized ecologically valid symptom provocation design: a live provocation functional magnetic resonance imaging paradigm with synchronous video-recording of behavioural avoidance responses. By pairing symptom provocation with online avoidance responses on a trial-by-trial basis, we sought to investigate the neural mechanisms leading to the compulsive avoidance response. In keeping with the model of habit formation in obsessive-compulsive disorder, we hypothesized that this disorder would be associated with lower activity in regions implicated in goal-directed behaviours and higher activity in regions implicated in habitual behaviours. Fifteen patients with obsessive-compulsive disorder and 15 healthy control volunteers participated in this functional magnetic resonance imaging study. Online stimuli were individually tailored to achieve effective symptom provocation at neutral, intermediate and strong intensity levels. During the symptom provocation block, the participant could choose to reject or terminate the provoking stimuli resulting in cessation of the symptom provocation. We thus separately analysed the neural correlates of symptom provocation, the urge to avoid, rejection and relief. Strongly symptom-provoking conditions evoked a dichotomous pattern of deactivation/activation in patients, which was not observed either in control conditions or in healthy subjects: a deactivation of caudate-prefrontal circuits accompanied by hyperactivation of subthalamic nucleus/putaminal regions. This finding suggests a dissociation between regions engaged in goal-directed and habitual behaviours. The putaminal hyperactivity during patients' symptom provocation preceded subsequent deactivation during avoidance and relief events, indicating a pivotal role of putamen in regulation of behaviour and habit formation in obsessive-compulsive disorder. Effective connectivity analysis identified the ventromedial prefrontal cortex/orbitofrontal cortex as the main structure in this circuitry involved in the modulation of compulsivity in obsessive-compulsive disorder. These findings suggest an imbalance in circuitry underlying habitual and goal-directed action control, which may represent a fundamental mechanism underlying compulsivity in obsessive-compulsive disorder. Our results complement current models of symptom generation in obsessive-compulsive disorder and may enable the development of future therapeutic approaches that aim to alleviate this imbalance. |
| Databáze: | OpenAIRE |
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