RT Journal Article
SR Electronic
T1 Altered reward-related effective connectivity in obsessive-compulsive disorder: an fMRI study
JF Journal of Psychiatry and Neuroscience
JO J Psychiatry Neurosci
FD Canadian Medical Association
SP 395
OP 406
DO 10.1503/jpn.180195
VO 44
IS 6
A1 Ana Alves-Pinto
A1 Oana Georgiana Rus
A1 Tim Jonas Reess
A1 Afra Wohlschläger
A1 Gerd Wagner
A1 Götz Berberich
A1 Kathrin Koch
YR 2019
UL http://jpn.ca/content/44/6/395.abstract
AB Background: Obsessive–compulsive disorder (OCD) is characterized by anxiety-provoking, obsessive thoughts. Patients usually react to these thoughts with repetitive behaviours that reduce anxiety and are perceived as rewarding. Hence, reward plays a major role in the psychopathology of OCD. Previous studies showed altered activation in frontostriatal networks, among others, in association with the processing of reward in patients with OCD. Potential alterations in connectivity within these networks have, however, barely been explored.Methods: We investigated a sample of patients with OCD and healthy controls using functional MRI and a reward learning task presented in an event-related design. Dynamic causal modelling (DCM) was used to estimate effective connectivity.Results: Our sample included 37 patients with OCD and 39 healthy controls. Analyses of task-related changes in connectivity showed a significantly altered effective connectivity between the ventromedial prefrontal cortex (vmPFC) and the orbitofrontal cortex (OFC), among others, both in terms of endogenous connectivity as well as modulatory effects under positive feedback. Clinical measures of compulsion correlated with the effect of feedback input on visual sensory areas.Limitations: The reported alterations should be interpreted within the context of the task and the a priori–defined network considered in the analysis.Conclusion: This disrupted connectivity in parts of the default mode network and the frontostriatal network may indicate increased rumination and self-related processing impairing the responsiveness toward external rewards. This, in turn, may underlie the general urge for reinforcement accompanying compulsive behaviours.