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Divergent subcortical activity for distinct executive functions: stopping and shifting in obsessive compulsive disorder.

Published version
Peer-reviewed

Repository DOI


Type

Article

Change log

Authors

Morein-Zamir, S 
Dodds, CM 
Sule, A 
van Niekerk, J 

Abstract

BACKGROUND: There is evidence of executive function impairment in obsessive compulsive disorder (OCD) that potentially contributes to symptom development and maintenance. Nevertheless, the precise nature of these executive impairments and their neural basis remains to be defined. METHOD: We compared stopping and shifting, two key executive functions previously implicated in OCD, in the same task using functional magnetic resonance imaging, in patients with virtually no co-morbidities and age-, verbal IQ- and gender-matched healthy volunteers. The combined task allowed direct comparison of neural activity in stopping and shifting independent of patient sample characteristics and state variables such as arousal, learning, or current symptom expression. RESULTS: Both OCD patients and controls exhibited right inferior frontal cortex activation during stopping, and left inferior parietal cortex activation during shifting. However, widespread under-activation across frontal-parietal areas was found in OCD patients compared to controls for shifting but not stopping. Conservative, whole-brain analyses also indicated marked divergent abnormal activation in OCD in the caudate and thalamus for these two cognitive functions, with stopping-related over-activation contrasting with shift-related under-activation. CONCLUSIONS: OCD is associated with selective components of executive function, which engage similar common elements of cortico-striatal regions in different abnormal ways. The results implicate altered neural activation of subcortical origin in executive function abnormalities in OCD that are dependent on the precise cognitive and contextual requirements, informing current theories of symptom expression.

Description

Keywords

Cognitive flexibility, OCD, functional magnetic resonance imaging (fMRI), response inhibition, shifting, stopping, Adult, Arousal, Brain, Case-Control Studies, Caudate Nucleus, Cognition, Executive Function, Frontal Lobe, Functional Neuroimaging, Humans, Magnetic Resonance Imaging, Middle Aged, Neostriatum, Obsessive-Compulsive Disorder, Parietal Lobe, Task Performance and Analysis, Thalamus

Journal Title

Psychol Med

Conference Name

Journal ISSN

0033-2917
1469-8978

Volume Title

46

Publisher

Cambridge University Press (CUP)
Sponsorship
Medical Research Council (MR/J012084/1)
Medical Research Council (G0001354)
Wellcome Trust (089589/Z/09/Z)
Wellcome Trust (093875/Z/10/Z)
Wellcome Trust (104631/Z/14/Z)
This research was funded by a Wellcome Trust grant (089589/Z/09/Z) awarded to TW Robbins, BJ Everitt, AC Roberts, JW Dalley and BJ Sahakian. Work was completed at the Behavioural and Clinical Neuroscience Institute which is supported by a joint award from the Medical Research Council and Wellcome Trust (G00001354).