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Common limbic and frontal-striatal disturbances in patients with obsessive compulsive disorder, panic disorder and hypochondriasis

Published online by Cambridge University Press:  05 May 2011

O. A. van den Heuvel ,
D. Mataix-Cols ,
G. Zwitser ,
D. C. Cath ,
Y. D. van der Werf ,
H. J. Groenewegen ,
A. J. L. M. van Balkom  and
D. J. Veltman
O. A. van den Heuvel*
Affiliation:
Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands Department of Anatomy & Neurosciences, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
D. Mataix-Cols
Affiliation:
King's College London, Institute of Psychiatry, London, UK
G. Zwitser
Affiliation:
Department of Anatomy & Neurosciences, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
D. C. Cath
Affiliation:
Altrecht, Utrecht, The Netherlands
Y. D. van der Werf
Affiliation:
Department of Anatomy & Neurosciences, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands Department Sleep & Cognition, Netherlands Institute for Neurosciences, anInstitute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
H. J. Groenewegen
Affiliation:
Department of Anatomy & Neurosciences, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
A. J. L. M. van Balkom
Affiliation:
Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands GGZ InGeest, Amsterdam, The Netherlands
D. J. Veltman
Affiliation:
Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
*
*Address for correspondence: O. A. van den Heuvel, MD PhD, Department of Psychiatry, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands. (Email: oa.vandenheuvel@vumc.nl)
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Abstract

Background

Direct comparisons of brain function between obsessive compulsive disorder (OCD) and other anxiety or OCD spectrum disorders are rare. This study aimed to investigate the specificity of altered frontal-striatal and limbic activations during planning in OCD, a prototypical anxiety disorder (panic disorder) and a putative OCD spectrum disorder (hypochondriasis).

Method

The Tower of London task, a ‘frontal-striatal’ task, was used during functional magnetic resonance imaging measurements in 50 unmedicated patients, diagnosed with OCD (n=22), panic disorder (n=14) or hypochondriasis (n=14), and in 22 healthy subjects. Blood oxygen level-dependent (BOLD) signal changes were calculated for contrasts of interest (planning versus baseline and task load effects). Moreover, correlations between BOLD responses and both task performance and state anxiety were analysed.

Results

Overall, patients showed a decreased recruitment of the precuneus, caudate nucleus, globus pallidus and thalamus, compared with healthy controls. There were no statistically significant differences in brain activation between the three patient groups. State anxiety was negatively correlated with dorsal frontal-striatal activation. Task performance was positively correlated with dorsal frontal-striatal recruitment and negatively correlated with limbic and ventral frontal-striatal recruitment. Multiple regression models showed that adequate task performance was best explained by independent contributions from dorsolateral prefrontal cortex (positive correlation) and amygdala (negative correlation), even after controlling for state anxiety.

Conclusions

Patients with OCD, panic disorder and hypochondriasis share similar alterations in frontal-striatal brain regions during a planning task, presumably partly related to increased limbic activation.

Keywords

DSM-5executivehypochondriasisfMRIOCDpanicperformancestate anxiety
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 11 , November 2011 , pp. 2399 - 2410
Copyright
Copyright © Cambridge University Press 2011

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