Elevated medial-frontal cerebral blood flow in obsessive-compulsive patients: a SPECT study

Machlin, Steven R.; Harris, Gordon J.; Pearlson, Godfrey D.; Hoehn‐Saric, Rudolf; Jeffery, Petra J.; Camargo, Edwaldo E.

doi:10.1176/ajp.148.9.1240

Cited by 169 publications

(16 citation statements)

References 8 publications

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“…These findings, combined with prior evidence that mPFC activity is key to risk avoidance (Brown and Braver, 2005, 2007; Magno et al, 2006), are consistent with proposals that mPFC is a region crucial to the ability to anticipate and avoid adverse consequences even when a risky action is not planned to be executed immediately. Indeed, over-activity of the mPFC and especially ACC appears to be a key ingredient in obsessive–compulsive disorder (Machlin et al, 1991), in which the excessive urge to avoid potential dangers may be experienced even when no action is otherwise imminent.…”

Section: Discussionmentioning

confidence: 99%

The Neural Basis of Predicting the Outcomes of Imagined Actions

Jahn¹,

Nee²,

Brown³

2011

Front. Neurosci.

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A key feature of human intelligence is the ability to predict the outcomes of one’s own actions prior to executing them. Action values are thought to be represented in part in the dorsal and ventral medial prefrontal cortex (mPFC), yet current studies have focused on the value of executed actions rather than the anticipated value of a planned action. Thus, little is known about the neural basis of how individuals think (or fail to think) about their actions and the potential consequences before they act. We scanned individuals with fMRI while they thought about performing actions that they knew would likely be rewarded or unrewarded. Here we show that merely imagining an unrewarded action, as opposed to imagining a rewarded action, increases activity in the dorsal anterior cingulate cortex, independently of subsequent actions. This activity overlaps with regions that respond to actual unrewarded actions. The findings show a distinct network that signals the prospective outcomes of one’s possible actions. A number of clinical disorders such as schizophrenia and drug abuse involve a failure to take the potential consequences of an action into account prior to acting. Our results thus suggest how dysfunctions of the mPFC may contribute to such failures.

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Section: Discussionmentioning

confidence: 99%

The Neural Basis of Predicting the Outcomes of Imagined Actions

Jahn¹,

Nee²,

Brown³

2011

Front. Neurosci.

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“…These functions are important in OCD, in which obsessions and compulsions may be in part due to dysfunctional reward signaling and aberrant signaling of conflict between desired and current state. PET and single photon emission computed tomography (SPECT) studies have demonstrated increased ACC metabolism in OCD patients at rest (Swedo et al, 1989; Machlin et al, 1991; Perani et al, 1995) and PET and fMRI studies have also found increased ACC activity with symptom provocation (Rauch et al, 1994; Breiter et al, 1996; Adler et al, 2000) and error or high conflict trials on an interference processing task (Fitzgerald et al, 2005; Maltby et al, 2005; Schlosser et al, 2010). ACC metabolism measured with PET decreases following treatment with selective serotonin reuptake inhibitors (SSRIs), correlating with decreases in Yale Brown Obsessive Compulsive Scale (Y-BOCS) score (Perani et al, 1995), a commonly used metric of OCD severity.…”

Section: Pathology Of Ocdmentioning

confidence: 99%

Mechanisms of deep brain stimulation for obsessive compulsive disorder: effects upon cells and circuits

Bourne¹,

Eckhardt²,

Sheth³

et al. 2012

Front. Integr. Neurosci.

118

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Deep brain stimulation (DBS) has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive compulsive disorder (OCD), which is characterized by recurrent unwanted thoughts or ideas (obsessions) and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions). Abnormal activity in cortico-striato-thalamo-cortical (CSTC) circuits including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), ventral striatum, and mediodorsal (MD) thalamus has been implicated in OCD. To this end a number of DBS targets including the anterior limb of the internal capsule (ALIC), ventral capsule/ventral striatum (VC/VS), ventral caudate nucleus, subthalamic nucleus (STN), and nucleus accumbens (NAc) have been investigated for the treatment of OCD. Despite its efficacy and widespread use in movement disorders, the mechanism of DBS is not fully understood, especially as it relates to psychiatric disorders. While initially thought to create a functional lesion akin to ablative procedures, it is increasingly clear that DBS may induce clinical benefit through activation of axonal fibers spanning the CSTC circuits, alteration of oscillatory activity within this network, and/or release of critical neurotransmitters. In this article we review how the use of DBS for OCD informs our understanding of both the mechanisms of DBS and the circuitry of OCD. We review the literature on DBS for OCD and discuss potential mechanisms of action at the neuronal level as well as the broader circuit level.

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“…In OCD patients, the ACC has been found to be hyperactive at rest, during symptom provocation and during performance of high-conflict cognitive tasks (Swedo et al, 1989; Machlin et al, 1991; Perani et al, 1995). This hyperactivity has been suggested to be associated with an excessive evaluation of performance in OCD, leading to inappropriate doubting, the need for correction and consequently, repetitive actions (Ursu et al, 2003; Fitzgerald et al, 2011).…”

Section: Neuroimaging Findings In Ocd: the Role Of The Ofc Acc And Bgmentioning

confidence: 99%

The extended fronto-striatal model of obsessive compulsive disorder: convergence from event-related potentials, neuropsychology and neuroimaging

Melloni¹,

Urbistondo²,

Sedeño³

et al. 2012

Front. Hum. Neurosci.

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In this work, we explored convergent evidence supporting the fronto-striatal model of obsessive-compulsive disorder (FSMOCD) and the contribution of event-related potential (ERP) studies to this model. First, we considered minor modifications to the FSMOCD model based on neuroimaging and neuropsychological data. We noted the brain areas most affected in this disorder -anterior cingulate cortex (ACC), basal ganglia (BG), and orbito-frontal cortex (OFC) and their related cognitive functions, such as monitoring and inhibition. Then, we assessed the ERPs that are directly related to the FSMOCD, including the error-related negativity (ERN), N200, and P600. Several OCD studies present enhanced ERN and N2 responses during conflict tasks as well as an enhanced P600 during working memory (WM) tasks. Evidence from ERP studies (especially regarding ERN and N200 amplitude enhancement), neuroimaging and neuropsychological findings suggests abnormal activity in the OFC, ACC, and BG in OCD patients. Moreover, additional findings from these analyses suggest dorsolateral prefrontal and parietal cortex involvement, which might be related to executive function (EF) deficits. Thus, these convergent results suggest the existence of a self-monitoring imbalance involving inhibitory deficits and executive dysfunctions. OCD patients present an impaired ability to monitor, control, and inhibit intrusive thoughts, urges, feelings, and behaviors. In the current model, this imbalance is triggered by an excitatory role of the BG (associated with cognitive or motor actions without volitional control) and inhibitory activity of the OFC as well as excessive monitoring of the ACC to block excitatory impulses. This imbalance would interact with the reduced activation of the parietal-DLPC network, leading to executive dysfunction. ERP research may provide further insight regarding the temporal dynamics of action monitoring and executive functioning in OCD.

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Elevated medial-frontal cerebral blood flow in obsessive-compulsive patients: a SPECT study

Cited by 169 publications

References 8 publications

The Neural Basis of Predicting the Outcomes of Imagined Actions

The Neural Basis of Predicting the Outcomes of Imagined Actions

Mechanisms of deep brain stimulation for obsessive compulsive disorder: effects upon cells and circuits

The extended fronto-striatal model of obsessive compulsive disorder: convergence from event-related potentials, neuropsychology and neuroimaging

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