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Patterns of Neural Response to Emotive Stimuli Distinguish the Different Symptom Dimensions of Obsessive-Compulsive Disorder

Published online by Cambridge University Press:  07 November 2014

Mary L. Phillips  and
David Mataix-Cols
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Abstract

Despite its heterogeneous symptomatology, obsessive-compulsive disorder (OCD) is currently conceptualized as a unitary diagnostic entity. Recent factor-analytic studies have identified several OCD symptom dimensions that are associated with different demographic variables, comorbidity, patterns of genetic transmission, and treatment response. Functional abnormalities in neural systems important for emotion perception, including the orbitofrontal cortex, lateral prefrontal cortex, anterior cingulate gyrus, and limbic regions, have been reported in OCD. In this review, we discuss the extent to which neurobiological markers may distinguish these different symptom dimensions and whether specific symptom dimensions, such as contamination/washing, are associated with abnormalities in emotion and, in particular, disgust, perception in OCD. Also discussed are findings that indicate that anxiety can be induced in healthy volunteers in response to OCD symptom-related material, and that associated increases in activity within neural systems important for emotion perception occur to washing- and hoarding-related material in particular in these subjects. Further examination of neural responses during provocation of different symptom dimensions in OCD patients will help determine the extent to which specific abnormalities in neural systems underlying emotion perception are associated with different symptom dimensions and predict treatment response in OCD.

Type
Review Article
Information
CNS Spectrums , Volume 9 , Issue 4 , April 2004 , pp. 275 - 283
Copyright
Copyright © Cambridge University Press 2004

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References

REFERENCES

1. Baer, L. Factor analysis of symptom subtypes of obsessive compulsive disorder and their relation to personality and tic disorders. J Clin Psychiatry. 1994;55:18–23.Google Scholar
2. Leckman, JF, Grice, DE, Boardman, J, et al. Symptoms of obsessive-compulsive disorder. Am J Psychiatry. 1997;154:911–917.Google Scholar
3. Mataix-Cols, D, Rauch, SL, Manzo, PA, Jenike, MA, Baer, L. Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive-compulsive disorder. Am J Psychiatry. 1999;156:1409–1416.CrossRefGoogle ScholarPubMed
4. Mataix-Cols, D, Rauch, SL, Baer, L, et al. Symptom stability in adult obsessive-compulsive disorder: data from a two-year naturalistic study. Am J Psychiatry. 2002;159:263–268.Google Scholar
5. Mataix-Cols, D, Marks, IM, Greist, JH, Kobak, KA, Baer, L. Obsessive-compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial. Psychother Psychosom. 2002;71:255–262.CrossRefGoogle ScholarPubMed
6. Alsobrook, JP II, Leckman, JF, Goodman, WK, Rasmussen, SA, Pauls, DL. Segregation analysis of obsessive-compulsive disorder using symptom-based factor scores. Am J Med Genet. 1999;88:669–675.Google Scholar
7. Zhang, H, Leckman, JF, Tsai, C-P, et al. Genome wide scan of hoarding in sibling pairs both diagnosed with Gilles de la Tourette syndrome. Am J Hum Genet. 2002;70:896–904.CrossRefGoogle Scholar
8. Leckman, JF, Pauls, DL, Zhang, H, et al. Obsessive-compulsive symptom dimensions in affected sibling pairs diagnosed with Gilles de la Tourette syndrome. Am J Med Genet. 2003;116:60–68.Google Scholar
9. Black, DW, Monahan, P, Gable, J, Blum, N, Clancy, G, Baker, P. Hoarding and treatment response in 38 nondepressed subjects with obsessive-compulsive disorder. J Clin Psychiatry. 1998;59:420–425.Google Scholar
10. Winsberg, ME, Cassie, KS, Koran, LM. Hoarding in obsessive-compulsive disorder: report of 20 cases. J Clin Psychiatry. 1999;60:591–597.Google Scholar
11. Alonso, MP, Menchón, JM, Pifarré, J, et al. Long-term follow-up and predictors of clinical outcome in obsessive-compulsive patients treated with serotonin reuptake inhibitors and behavioral therapy. J Clin Psychiatry. 2001;62:535–540.Google Scholar
12. Saxena, S, Maidment, KM, Vapnik, T, et al. Obsessive-compulsive hoarding: Symptom severity and response to multimodal treatment. J Clin Psychiatry. 2002;63:21–27.Google Scholar
13. Darwin, C. The Expression of the Emotions in Man and Animals. Chicago, Ill: University of Chicago Press; 1872/1965.Google Scholar
14. Ekman, P. An argument for basic emotions. Cognition and Emotion. 1992;6:169–200.Google Scholar
15. Rozin, P, Fallon, AE. A perspective on disgust. Psychol Rev. 1987;94:23–41.Google Scholar
16. Angyal, A. Disgust and related aversions. J Abnorm Soc Psychol 1941;36:93–112.CrossRefGoogle Scholar
17. Ekman, P, Friesen, WV. Pictures of Facial Affect. Palo Alto, Calif: Consulting Psychologists; 1976.Google Scholar
18. Lang, PJ, Bradley, MM, Fitzsimmons, JR, et al. Emotional arousal and activation of the visual cortex: an fMRI analysis. Psychophysiobgy. 1998;35:199–210.Google Scholar
19. Morris, JS, Frith, CD, Perrett, DI, et al. A differential neural response in the human amygdala to fearful and happy facial expressions. Nature. 1996;383:812–815.Google Scholar
20. Breiter, HC, Etcoff, NL, Whalen, PJ, et al. Response and habituation of the human amygdala during visual processing of facial expression. Neuron. 1996;17:875–887.Google Scholar
21. Sprengelmeyer, R, Young, AW, Calder, AJ, Karnat, A, Lange, H, Homberg, V. Loss of disgust: perception of faces and emotions in Huntington's disease. Brain. 1996;119:1647–1665.CrossRefGoogle ScholarPubMed
22. Phillips, ML, Young, AW, Senior, C, et al. A specific neural substrate for perception of facial expressions of disgust. Nature. 1997;389:495–498.CrossRefGoogle ScholarPubMed
23. Phillips, ML, Senior, C, Fahy, T, David, AS. Disgust—the forgotten emotion of psychiatry. Br J Psychiatry. 1998;172:373–375.Google Scholar
24. Sprengelmeyer, R, Rausch, M, Eysel, UT, Przunte, H. Neural structures associated with recognition of facial expressions of basic emotions. Proc R Soc Lond B Biol Sci. 1998;265:1927–1931.Google Scholar
25. Calder, AJ, Keane, J, Manes, F, Antoun, N, Young, AW. Impaired recognition of disgust following brain injury. Nat Neurosci. 2000;3:1077–1078.CrossRefGoogle ScholarPubMed
26. Rolls, ET. Central taste anatomy and physiology. In: Doty, RL, ed. Handbook of Clinical Olfaction and Gustation. New York, NY: Dekker; 1994.Google Scholar
27. Sprengelmeyer, R, Young, AW, Pundt, I, et al. Disgust implicated in obsessive-compulsive disorder. Prac R Soc Land B Biol Sci. 1997;264:1767–1773.CrossRefGoogle ScholarPubMed
28. Power, M, Dalgleish, T. Cognition and Emotion. From Order to Disorder. Erlbaum Taylor and Francis: Hove, United Kingdom: Psychology Press; 1997.Google Scholar
29. Phillips, ML, Marks, IM, Senior, C, et al. A differential neural response in obsessive-compulsive disorder patients with washing compared with checking symptoms to disgust. Psychol Med. 2000;30:1037–1050.Google Scholar
30. Woody, SR, Tolin, DF. The telationship between disgust sensitivity and avoidant behavior: Studies of clinical and non-clinical samples. J Anxiety Disord. 2002;16:543–559.Google Scholar
31. Purcell, R, Maruff, P, Kyrios, M, Pantelis, C. Cognitive deficits in obsessive-compulsive disorder on tests of frontal-striatal function. Biol Psychiatry. 1998;43:348–357.CrossRefGoogle ScholarPubMed
32. Purcell, R, Maruff, P, Kyrios, M, Pantelis, C. Neuropsychological deficits in obsessive-compulsive disorder. A comparison with unipolar depression, panic disorder, and normal controls. Arch Gen Psychiatry. 1998;55:415–423.Google Scholar
33. Savage, CR, Baer, L, Keuthen, NJ, Brown, HD, Rauch, SL, Jenike, MA. Organizational strategies mediate nonverbal memory impairment in obsessive-compulsive disotder. Biol Psychiatry. 1999;45:905–916.Google Scholar
34. Hollander, E, Schiffman, E, Cohen, B, et al. Signs of central nervous system dysfunction in obsessive-compulsive disorder. Arch Gen Psychiatry. 1990;47:27–32.Google Scholar
35. Bihari, K, Pato, MT, Hill, JL, Murphy, DL. Neurological soft signs in obsessive compulsive disorder. Arch Gen Psychiatry. 1991;48:278–279.Google Scholar
36. Bolton, D, Gibb, W, Lees, A, et al. Neurological soft signs in obsessive compulsive disorder: standardised assessment and comparison with schizophrenia. Behavioural Neurology. 1998;11:197–204.Google Scholar
37. Jenike, MA, Breiter, HC, Baer, L, et al. Cerebral structural abnormalities in obsessive compulsive disorder. Arch Gen Psychiatry. 1996;53:625–632.Google Scholar
38. Rubin, RT, Villanueva-Meyer, J, Ananth, J, Trajmar, PG, Mena, I. Regional xenon 133 cerebral blood flow and cerebral technetium Tc 99m-HMPAO uptake in unmedicated patients with obsessive-compulsive disorder and matched normal control subjects: determination by high-resolution single photon emission computed tomography. Arch Gen Psychiatry. 1992;49:695–702.Google Scholar
39. Baxter, LR, Schwartz, JM, Bergman, KS, et al. Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder. Arch Gen Psychiatry. 1992;49:681–688.Google Scholar
40. Breiter, HC, Rauch, SL, Kwong, KK, et al. Functional magnetic resonance imaging of symptom provocation in obsessive-compulsive disorder. Arch Gen Psychiatry. 1996;49:595–606.Google Scholar
41. Swedo, SE, Pietrini, P, Leonard, HL, et al. Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder. Arch Gen Psychiatry. 1992;49:690–694.Google Scholar
42. Saxena, S, Brody, AL, Scwartz, JM, Baxter, LR. Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder. Br J Psychiatry. 1998;173(suppl 35):26–37.Google Scholar
43. Rauch, SL, Jenike, MA, Alpert, NM, et al. Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using oxygen 15-labeled carbon dioxide and positron emission tomography. Arch Gen Psychiatry. 1994;51:62–70.Google Scholar
44. McGuire, PK, Bench, CJ, Frith, CD, Marks, IM, Frackowiak, RSJ, Dolan, RJ. Functional anatomy of obsessive-compulsive phenomena. Br J Psychiatry. 1994;164:459–468.Google Scholar
45. Cottraux, J, Gerard, D, Cinotti, L, et al. A controlled positron emission tomography study of obsessive and neutral auditory stimulation in obsessive-compulsive disorder with checking rituals. Psychiatry Res. 1996;60:101–112.Google Scholar
46. Rauch, SL, Dougherty, DD, Shin, LM, et al. Neural correlates of factor-analyzed OCD symptom dimensions: a PET study. CNS Spectr. 1998;3:37–43.Google Scholar
47. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Press; 1994.Google Scholar
48. Lang, PJ, Bradley, MM, Cuthbert, BN. International Affective Picture System (IAPS). NIMH Center for the Study of Emotion and Attention; 1997.Google Scholar
49. Ungerlieder, LG, Mishkin, M. Two cortical visual systems. In: Ingle, DJ, Goodale, MA, Mansfield, RJW, eds. Analysis of Visual Behaviour. Cambridge, Mass: MIT Press; 1982:549–586.Google Scholar
50. Shapira, NA, Liu, Y, He, AG, et al. Brain activation by disgust-inducing pictures in obsessive-compulsive disorder. Biol Psychiatry. In press.Google Scholar
51. Rauch, SL, Savage, CR, Alpert, NM, Fischman, AJ, Jenike, MA. The functional neuroanatomy of anxiety: a study of three disorders using positron emission tomography and symptom provocation. Biol Psychiatry. 1997;42:446–452.Google Scholar
52. Rachman, S, de Silva, P. Abnormal and normal obsessions. Behav Res Ther. 1978;16:233–248.Google Scholar
53. Muris, P, Merckelbach, H, Clavan, M. Abnormal and normal compulsions. Behav Res Ther. 1997;35:249–252.Google Scholar
54. Gibbs, NA. Nonclinical populations in research on obsessive-compulsive disorder: a critical review. Clin Psychol Rev. 1996;16:729–773.Google Scholar
55. Mataix-Cols, D, Junqué, C, Sánchez-Turet, M, Vallejo, J, Verger, K, Barrios, M. Neuropsychological functioning in a sub-clinical obsessive sample. Biol Psychiatry. 1999;45:898–904.Google Scholar
56. Mataix-Cols, D, Barrios, M, Sánchez-Turet, M, Vallejo, J, Junqué, C. Reduced design fluency in sub-clinical obsessive-compulsive subjects. J Neuropsychiatr Clin Neurosci. 1999;11:395–397.Google Scholar
57. Mataix-Cols, D, Cullen, S, Lange, K, et al. Neural correlates of anxiety associated with obsessive-compulsive symptom dimensions in normal volunteers. Biol Psychiatry. 2003;53:482–493.CrossRefGoogle ScholarPubMed
58. Pardo, JV, Pardo, PJ, Raichle, ME. Neural correlates of self-induced dysphoria. Am J Psychiatry. 1993;150:713–719.Google Scholar
59. George, MS, Ketter, TA, Parekh, PI, Horwitz, B, Herscovitch, P, Post, RM. Brain activity during transient sadness and happiness in healthy women. Am J Psychiatry. 1995;152:341–351.Google Scholar
60. Reiman, EM, Lane, RD, Ahern, GL, Schwartz, GE, Davidson, RJ, Friston, KJ. Neuroanatomical correlates of externally and internally generated human emotion. AmJ Psychiatry. 1997;154:918–925.Google Scholar
61. Drevets, WC, Raichle, ME. Reciprocal suppression of regional cerebral blotxl flow during emotional versus higher cognitive processes: implications for interactions between emotion and cognition. Cognition and Emotion. 1998;12:353–385.CrossRefGoogle Scholar
62. Saxena, S, Brody, A, Baxter, L. Functional neuroanaotmy of symptom expression and treatment response on OCD. Abstract presented at annual meeting of the American College of Neuropsychopharmacology. December 8–12, 2002; San Juan, Puerto Rico.Google Scholar
63. Frost, RO, Steketee, G. Hoarding. Clinical aspects and tteatment strategies. In: Jenike, MA, Baer, L, Minichiello, WE, eds. Obsessive-Compulsive Disorders: Practical Management. 3rd ed. St Louis; Mo: Mosby-Yeat Books; 1998:533–554.Google Scholar
64. Mataix-Cols, D, Baer, L, Rauch, SL, Jenike, MA. Relation of factor-analyzed symptom dimensions of obsessive-compulsive disorder to personality disorders. Acta Psychiatr Scand. 2000;102:199–202.Google Scholar