04-03-2024 | Original Article
Altered Neural Activity during Negative Reinforcement in People with Obsessive-Compulsive Disorder
Gepubliceerd in: Cognitive Therapy and Research | Uitgave 4/2024
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Background
Compulsive behaviors in Obsessive-Compulsive Disorder (OCD) are
posited to be negatively reinforced via short-term negation of distress-inducing
triggers, but neural activity during negative reinforcement in the context of
OCD remains poorly understood.
Methods
In 18 people with OCD and 16 healthy matched comparison subjects
completing functional MRI, we tested the effect of a novel negative
reinforcement behavioral paradigm. Three visual stimulus types
(Compulsion-Related, Negative, Neutral) were displayed in the scanner and
removed by participants pressing a button, yielding two analysis epochs: image
presentation and image removal.
Results
OCD patients showed a larger increase in medial orbitofrontal cortex
(mOFC; BA11) activation after image removal that was specific to
compulsion-related images. People with OCD also showed altered patterns of
deactivation following compulsion-related and negative image removal in the
right and left amygdala, respectively. People with OCD also showed larger
deactivations in the ventral tegmental area (VTA) after removal of all image
types, and increased overall activation to negative images in the right nucleus
accumbens (NAcc).
Conclusion
We provide initial data demonstrating altered neural activity during
negative reinforcement in OCD patients, providing empirical support for dominant
behavioral models emphasizing the role of negative reinforcement in etiology and
maintenance of pathological compulsive behaviors.