Doubt in the Insula: Risk Processing in Obsessive-Compulsive Disorder

Luigjes, Judy; Figee, Martijn; Tobler, Philippe N.; Brink, Wim van den; Kwaasteniet, Bart de; Wingen, Guido van; Denys, Damiaan

doi:10.3389/fnhum.2016.00283

Cited by 15 publications

(8 citation statements)

References 38 publications

(59 reference statements)

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“…Additionally, in individuals with SPD, this study found a positive correlation in NE-YBOCS score with increased cortical thickness in the left insula. This finding correlates with previous research that has shown insula activity to correlate directly with risk aversion in individuals with OCD (Luigjes et al, 2016). The finding of this study thus lends partial support for the inclusion of SPD as an ‘obsessive-compulsive related disorder’ in the DSM-5.…”

Section: Discussionsupporting

confidence: 91%

A structural MRI study of excoriation (skin-picking) disorder and its relationship to clinical severity

Harries

Chamberlain

Redden

et al. 2017

Psychiatry Research: Neuroimaging

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Excoriation (skin-picking) disorder (SPD) shares symptomology with other obsessive-compulsive and related disorders. Few studies, however, have examined the neurological profile of patients with SPD. This study examined differences in cortical thickness and basal ganglia structural volumes between 20 individuals with SPD and 16 healthy controls using magnetic resonance imaging (MRI). There were no significant differences in demographic variables (age, gender, education and race) between groups. All subjects completed a structural MRI scan and completed a battery of clinical assessments focusing on SPD symptom severity, depression and anxiety symptoms, and quality of life. No statistically significant differences in basal ganglia (caudate, putamen, and nucleus accumbens) structural volumes were found between groups. In individuals with SPD, increasing impulsiveness correlated positively with increased cortical thickness in the left insula, and skin picking severity correlated negatively with cortical thickness in the left supramarginal gyrus and a region encompassing the right inferior parietal, right temporal and right supramarginal gyrus. This study suggests similarities and differences exist in symptomology between SPD and the other obsessive-compulsive and related disorders. Additional neuroimaging research is needed to better delineate the underlying neurobiology of SPD.

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Section: Discussionsupporting

confidence: 91%

A structural MRI study of excoriation (skin-picking) disorder and its relationship to clinical severity

Harries

Chamberlain

Redden

et al. 2017

Psychiatry Research: Neuroimaging

View full text Add to dashboard Cite

show abstract

“…In addition to main effects of condition and probability, this analysis also demonstrated a three-way interaction between age group × condition × reward probability for both sides of the VS such that adolescents exhibited the strongest activation for the lowest reward probability (33%) when it was challenging to gain a reward whereas adults demonstrated this for the highest reward probability (88%) when the reward was certain. This points in the direction that adolescents and adults demonstrate a different tolerance toward uncertainty (Luigjes et al, 2016). This could further be linked to regulative aspects of rewardresponses and goal-directed behavior.…”

Section: Discussionmentioning

confidence: 79%

Ventral Striatal Activation During Reward Anticipation of Different Reward Probabilities in Adolescents and Adults

Bretzke

Wahl

Plichta

et al. 2021

Front. Hum. Neurosci.

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Adolescence has been linked to an enhanced tolerance of uncertainty and risky behavior and is possibly connected to an increased response toward rewards. However, previous research has produced inconsistent findings. To investigate whether these findings are due to different reward probabilities used in the experimental design, we extended a monetary incentive delay (MID) task by including three different reward probabilities. Using functional magnetic resonance imaging, 25 healthy adolescents and 22 adults were studied during anticipation of rewards in the VS. Differently colored cue stimuli indicated either a monetary or verbal trial and symbolized different reward probabilities, to which the participants were blinded. Results demonstrated faster reaction times for lower reward probabilities (33%) in both age groups. Adolescents were slower through all conditions and had less activation on a neural level. Imaging results showed a three-way interaction between age group x condition x reward probability with differences in percent signal change between adolescents and adults for the high reward probabilities (66%, 88%) while adolescents demonstrated differences for the lowest (33%). Therefore, previous inconsistent findings could be due to different reward probabilities, which makes examining these crucial for a better understanding of adolescent and adult behavior.

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“…Whereas some studies found hyperactivity of the AI/LO hub in OCD 55 , other found hypoactivation. OCD patients displayed reduced serotonin binding in AI/LO 56 and reduced cognitive flexibility correlated with lower activity in the insular region 7 .…”

Section: Clinical Relevancementioning

confidence: 89%

Prolonged avoidance training exacerbates OCD-like behaviors in a rodent model

et al. 2020

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Obsessive-compulsive disorder (OCD) is characterized by compulsive behaviors that often resemble avoidance of perceived danger. OCD can be treated with exposure-with-response prevention (ERP) therapy in which patients are exposed to triggers but are encouraged to refrain from compulsions, to extinguish compulsive responses. The compulsions of OCD are strengthened by many repeated exposures to triggers, but little is known about the effects of extended repetition of avoidance behaviors on extinction. Here we assessed the extent to which overtraining of active avoidance affects subsequent extinction-with-response prevention (Ext-RP) as a rodent model of ERP, in which rats are extinguished to triggers, while the avoidance option is prevented. Male rats conditioned for 8d or 20d produced similar avoidance behavior to a tone paired with a shock, however, the 20d group showed a severe impairment of extinction during Ext-RP, as well as heightened anxiety. Furthermore, the majority of overtrained (20d) rats (75%) exhibited persistent avoidance following Ext-RP. In the 8d group, only a minority of rats (37%) exhibited persistent avoidance, and this was associated with elevated activity (c-Fos) in the prelimbic cortex and nucleus accumbens. In the 20d group, the minority of non-persistent rats (25%) showed elevated activity in the insular-orbital cortex and paraventricular thalamus. Lastly, extending the duration of Ext-RP prevented the deleterious effects of overtraining on extinction and avoidance. These rodent findings suggest that repeated expression of compulsion-like behaviors biases individuals toward persistent avoidance and alters avoidance circuits, thereby reducing the effectiveness of current extinction-based therapies.

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Doubt in the Insula: Risk Processing in Obsessive-Compulsive Disorder

Cited by 15 publications

References 38 publications

A structural MRI study of excoriation (skin-picking) disorder and its relationship to clinical severity

A structural MRI study of excoriation (skin-picking) disorder and its relationship to clinical severity

Ventral Striatal Activation During Reward Anticipation of Different Reward Probabilities in Adolescents and Adults

Prolonged avoidance training exacerbates OCD-like behaviors in a rodent model

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