Cognitive and Emotional Impairments in Obsessive-compulsive Disorder: Evidence from Functional Brain Alterations

Overview

Journal Porto Biomed J

Publisher Wolters Kluwer

Specialty Biomedical Engineering

Date 2020 Apr 8

PMID 32258557

Citations 21

Authors

Oscar F Goncalves

Sandra Carvalho

Jorge Leite

Ana Fernandes-Goncalves

Angel Carracedo

Adriana Sampaio

Affiliations

Soon will be listed here.

Abstract

There is a common agreement on the existence of dysfunctional cortico-striatal-thalamus-cortical pathways in OCD. Despite this consensus, recent studies showed that brain regions other than the CSTC loops are needed to understand the complexity and diversity of cognitive and emotional deficits in OCD. This review presents examples of research using functional neuroimaging, reporting abnormal brain processes in OCD that may underlie specific cognitive/executive (inhibitory control, cognitive flexibility, working memory), and emotional impairments (fear/defensive, disgust, guilt, shame). Studies during resting state conditions show that OCD patients have alterations in connectivity not only within the CSTC pathways but also in more extended resting state networks, particularly the default mode network and the fronto-parietal network. Additionally, abnormalities in brain functioning have been found in several cognitive and emotionally task conditions, namely: inhibitory control (e.g., CSTC loops, fronto-parietal networks, anterior cingulate); cognitive flexibility (e.g., CSTC loops, extended temporal, parietal, and occipital regions); working memory (e.g., CSTC loops, frontal parietal networks, dorsal anterior cingulate); fear/defensive (e.g., amygdala, additional brain regions associated with perceptual - parietal, occipital - and higher level cognitive processing - prefrontal, temporal); disgust (e.g., insula); shame (e.g., decrease activity in middle frontal gyrus and increase in frontal, limbic, temporal regions); and guilt (e.g., decrease activity anterior cingulate and increase in frontal, limbic, temporal regions). These findings may contribute to the understanding of OCD as both an emotional (i.e., anxiety) and cognitive (i.e., executive control) disorder.

Citing Articles

MAGNITUDE: Transcranial Magnetic Stimulation for Treatment-Resistant Obsessive-Compulsive Disorder: A Randomized Sham-Controlled Phase II Trial Protocol.

Rech L, Vivanco R, Guersoni A, Ninapaytan G, Rivera P, Ramos-Orosco E Brain Sci. 2025; 15(2).

PMID: 40002439 PMC: 11853550. DOI: 10.3390/brainsci15020106.

Dysregulated connectivity configuration of triple-network model in obsessive-compulsive disorder.

Li H, Li B, Cao L, Jiang J, Chai S, Zhou H Mol Psychiatry. 2025; .

PMID: 39966625 DOI: 10.1038/s41380-025-02921-5.

In Humans, Insulo-striate Structural Connectivity is Largely Biased Toward Either Striosome-like or Matrix-like Striatal Compartments.

Funk A, Hassan A, Waugh J Neurosci Insights. 2024; 19:26331055241268079.

PMID: 39280330 PMC: 11402065. DOI: 10.1177/26331055241268079.

Lower synaptic density and its association with cognitive dysfunction in patients with obsessive-compulsive disorder.

Xiao Q, Hou J, Xiao L, Zhou M, He Z, Dong H Gen Psychiatr. 2024; 37(3):e101208.

PMID: 38894874 PMC: 11184172. DOI: 10.1136/gpsych-2023-101208.

In humans, insulo-striate structural connectivity is largely biased toward either striosome-like or matrix-like striatal compartments.

Funk A, Hassan A, Waugh J bioRxiv. 2024; .

PMID: 38645229 PMC: 11030402. DOI: 10.1101/2024.04.07.588409.

References

Zhu Y, Fan Q, Zhang Z, Zhang H, Tong S, Li Y . Spontaneous neuronal activity in insula predicts symptom severity of unmedicated obsessive compulsive disorder adults. Annu Int Conf IEEE Eng Med Biol Soc. 2016; 2015:5445-8. DOI: 10.1109/EMBC.2015.7319623. View

Tian L, Meng C, Jiang Y, Tang Q, Wang S, Xie X . Abnormal functional connectivity of brain network hubs associated with symptom severity in treatment-naive patients with obsessive-compulsive disorder: A resting-state functional MRI study. Prog Neuropsychopharmacol Biol Psychiatry. 2015; 66:104-111. DOI: 10.1016/j.pnpbp.2015.12.003. View

Whiteside S, Port J, Abramowitz J . A meta-analysis of functional neuroimaging in obsessive-compulsive disorder. Psychiatry Res. 2004; 132(1):69-79. DOI: 10.1016/j.pscychresns.2004.07.001. View

Simon D, Adler N, Kaufmann C, Kathmann N . Amygdala hyperactivation during symptom provocation in obsessive-compulsive disorder and its modulation by distraction. Neuroimage Clin. 2014; 4:549-57. PMC: 3984443. DOI: 10.1016/j.nicl.2014.03.011. View

Anticevic A, Hu S, Zhang S, Savic A, Billingslea E, Wasylink S . Global resting-state functional magnetic resonance imaging analysis identifies frontal cortex, striatal, and cerebellar dysconnectivity in obsessive-compulsive disorder. Biol Psychiatry. 2013; 75(8):595-605. PMC: 3969771. DOI: 10.1016/j.biopsych.2013.10.021. View

Van der Wee N, Ramsey N, van Megen H, Denys D, Westenberg H, Kahn R . Spatial working memory in obsessive-compulsive disorder improves with clinical response: A functional MRI study. Eur Neuropsychopharmacol. 2006; 17(1):16-23. DOI: 10.1016/j.euroneuro.2006.04.012. View

Jang J, Kim J, Jung W, Choi J, Jung M, Lee J . Functional connectivity in fronto-subcortical circuitry during the resting state in obsessive-compulsive disorder. Neurosci Lett. 2010; 474(3):158-162. DOI: 10.1016/j.neulet.2010.03.031. View

Maltby N, Tolin D, Worhunsky P, OKeefe T, Kiehl K . Dysfunctional action monitoring hyperactivates frontal-striatal circuits in obsessive-compulsive disorder: an event-related fMRI study. Neuroimage. 2005; 24(2):495-503. DOI: 10.1016/j.neuroimage.2004.08.041. View

Murayama K, Nakao T, Sanematsu H, Okada K, Yoshiura T, Tomita M . Differential neural network of checking versus washing symptoms in obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2012; 40:160-6. DOI: 10.1016/j.pnpbp.2012.09.002. View

10.

Schienle A, Schafer A, Stark R, Walter B, Vaitl D . Neural responses of OCD patients towards disorder-relevant, generally disgust-inducing and fear-inducing pictures. Int J Psychophysiol. 2005; 57(1):69-77. DOI: 10.1016/j.ijpsycho.2004.12.013. View

11.

Nakao T, Nakagawa A, Nakatani E, Nabeyama M, Sanematsu H, Yoshiura T . Working memory dysfunction in obsessive-compulsive disorder: a neuropsychological and functional MRI study. J Psychiatr Res. 2008; 43(8):784-91. DOI: 10.1016/j.jpsychires.2008.10.013. View

12.

Shapiro L, Stewart E . Pathological guilt: a persistent yet overlooked treatment factor in obsessive-compulsive disorder. Ann Clin Psychiatry. 2011; 23(1):63-70. View

13.

Berle D, Starcevic V, Brakoulias V, Sammut P, Milicevic D, Hannan A . Disgust propensity in obsessive-compulsive disorder: cross-sectional and prospective relationships. J Behav Ther Exp Psychiatry. 2011; 43(1):656-63. DOI: 10.1016/j.jbtep.2011.09.002. View

14.

Kozlowska K, Walker P, McLean L, Carrive P . Fear and the Defense Cascade: Clinical Implications and Management. Harv Rev Psychiatry. 2015; 23(4):263-87. PMC: 4495877. DOI: 10.1097/HRP.0000000000000065. View

15.

Hughes M, Johnston P, Fulham W, Budd T, Michie P . Stop-signal task difficulty and the right inferior frontal gyrus. Behav Brain Res. 2013; 256:205-13. DOI: 10.1016/j.bbr.2013.08.026. View

16.

Van der Wee N, Ramsey N, Jansma J, Denys D, van Megen H, Westenberg H . Spatial working memory deficits in obsessive compulsive disorder are associated with excessive engagement of the medial frontal cortex. Neuroimage. 2003; 20(4):2271-80. DOI: 10.1016/j.neuroimage.2003.05.001. View

17.

Peng Z, Xu T, He Q, Shi C, Wei Z, Miao G . Default network connectivity as a vulnerability marker for obsessive compulsive disorder. Psychol Med. 2013; 44(7):1475-84. DOI: 10.1017/S0033291713002250. View

18.

Hennig-Fast K, Michl P, Muller J, Niedermeier N, Coates U, Muller N . Obsessive-compulsive disorder--A question of conscience? An fMRI study of behavioural and neurofunctional correlates of shame and guilt. J Psychiatr Res. 2015; 68:354-62. DOI: 10.1016/j.jpsychires.2015.05.001. View

19.

Del Casale A, Kotzalidis G, Rapinesi C, Serata D, Ambrosi E, Simonetti A . Functional neuroimaging in obsessive-compulsive disorder. Neuropsychobiology. 2011; 64(2):61-85. DOI: 10.1159/000325223. View

20.

Sakai Y, Narumoto J, Nishida S, Nakamae T, Yamada K, Nishimura T . Corticostriatal functional connectivity in non-medicated patients with obsessive-compulsive disorder. Eur Psychiatry. 2010; 26(7):463-9. DOI: 10.1016/j.eurpsy.2010.09.005. View