Elsevier

Biological Psychiatry

Volume 85, Issue 9, 1 May 2019, Pages 713-725
Biological Psychiatry

Archival Report
Error Processing and Inhibitory Control in Obsessive-Compulsive Disorder: A Meta-analysis Using Statistical Parametric Maps

https://doi.org/10.1016/j.biopsych.2018.11.010Get rights and content

Abstract

Background

Error processing and inhibitory control enable the adjustment of behaviors to meet task demands. Functional magnetic resonance imaging studies report brain activation abnormalities in patients with obsessive-compulsive disorder (OCD) during both processes. However, conclusions are limited by inconsistencies in the literature and small sample sizes. Therefore, the aim here was to perform a meta-analysis of the existing literature using unthresholded statistical maps from previous studies.

Methods

A voxelwise seed-based d mapping meta-analysis was performed using t-maps from studies comparing patients with OCD and healthy control subjects (HCs) during error processing and inhibitory control. For the error processing analysis, 239 patients with OCD (120 male; 79 medicated) and 229 HCs (129 male) were included, while the inhibitory control analysis included 245 patients with OCD (120 male; 91 medicated) and 239 HCs (135 male).

Results

Patients with OCD, relative to HCs, showed longer inhibitory control reaction time (standardized mean difference = 0.20, p = .03, 95% confidence interval = 0.016, 0.393) and more inhibitory control errors (standardized mean difference = 0.22, p = .02, 95% confidence interval = 0.039, 0.399). In the brain, patients showed hyperactivation in the bilateral dorsal anterior cingulate cortex, supplementary motor area, and pre-supplementary motor area as well as right anterior insula/frontal operculum and anterior lateral prefrontal cortex during error processing but showed hypoactivation during inhibitory control in the rostral and ventral anterior cingulate cortices and bilateral thalamus/caudate, as well as the right anterior insula/frontal operculum, supramarginal gyrus, and medial orbitofrontal cortex (all seed-based d mapping z value >2, p < .001).

Conclusions

A hyperactive error processing mechanism in conjunction with impairments in implementing inhibitory control may underlie deficits in stopping unwanted compulsive behaviors in the disorder.

Section snippets

Search and Inclusion of Studies

The meta-analysis was conducted in line with Meta-analysis of Observational Studies in Epidemiology group guidelines (43). The study protocol was registered with PROSPERO (No. CRD42017062495) and is accessible from http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017062495.

A comprehensive literature search was performed using the PubMed, ScienceDirect, Web of Knowledge, and Scopus research databases through August 1, 2017. Reference lists of retrieved studies and recent

Included Studies and Characteristics

Nine datasets were available to be included as whole-brain t-maps in the current meta-analysis 4, 18, 23, 26, 35, 37, 41, 51, 52. One study was originally included as a conference abstract (51) but has been published subsequently as a full journal article (24). Peak coordinate data from a whole-brain analysis were available for a 10th dataset for the between-group error contrast (40). Yücel et al. provided a new unpublished dataset that partially overlapped with data included in their published

Discussion

Error processing and inhibitory control enable adaptive behavioral regulation and are hypothesized to be abnormal in OCD 3, 53. In this meta-analysis, patients with OCD showed impaired task performance relative to HCs during tasks of inhibitory control. In addition, patients showed hyperactivation relative to HCs during error processing in cingulo-opercular regions, including the dACC/SMA, pre-SMA, and right aI/fO, as well as in the right aLPFC. In contrast, patients primarily showed

Acknowledgments and Disclosures

This work was funded by National Institute of Mental Health Grant No. R01 MH102242 (to KF and SFT). LJN was supported as a postdoctoral fellow funded by Grant No. R01 MH102242 awarded to KF and SFT.

This work was presented as a poster presentation at the American College of Neuropsychopharmacology 56th annual meeting, Palm Springs, California, in 2017 as well as at the Society of Biological Psychiatry 73rd annual meeting, New York City, New York, in 2018.

SFT has received research support from

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