Abstract
Neuropsychological studies indicate the presence of cognitive changes in patients with obsessive-compulsive disorder (OCD). Indeed, OCD may be included among the dysfunctions of the frontal lobes and their connections with the limbic system, associative cortex, and basal ganglia. P300 is a positive component of the human event-related potential (ERP); it is associated with processes of encoding, identification, and categorization constituting, as a whole, the superior cortical function of information processing. Thus, P300 explores several areas that are implicated in OCD pathophysiology. Our aim is to review all relevant studies on the P300 component of the human ERP in order to recognize any significant central nervous system (CNS) correlate of cognitive dysfunction in OCD. A PubMed-based literature search resulted in 35 articles assessing P300 in OCD and reporting neurophysiological correlates of response inhibition, cortical hyperarousal, and over-focused attention. A decreased P300 amplitude was reported in both adult and pediatric patients, with a trend toward normalization after pharmacological treatment. Source localization studies disclosed an association between P300 abnormalities and the functioning of brain regions involved in the pathophysiology of OCD. Moreover, studies converge on the evidence of neurophysiological dysfunction in the frontal areas with impairment of the normal inhibitory processes in OCD. At least some of these electrophysiological correlates might reflect the obsessive thoughts and compulsions that characterize this disorder. These findings may also support cognitive-behavioral therapy (CBT) approaches on over-focused attention and inflexibility of compulsive behaviors, which should be associated to pharmacological treatment in these patients.
Highlights
Obsessive-compulsive disorder (OCD) affects approximately 2–3% of people at some point of their life [1]
It was found to correlate with illness severity, suggesting that the reduction in P300 amplitude may be a sensitive tool for measuring some biological aspects of obsessive-compulsive disorder (OCD) severity [64, 68], based on the evidence that P300 is generated along a widely distributed network that includes several brain areas implicated in the pathophysiology of OCD [12–18, 26]
Notwithstanding the limitations of the studies and their heterogeneous methodology, the findings reviewed here seem to support that the different P300 patterns observed might suggest the presence of different expressions within the clinical spectrum of OCD
Summary
Obsessive-compulsive disorder (OCD) affects approximately 2–3% of people at some point of their life [1]. In the Diagnostic and Statistical Manual of Mental Disorders— Fifth Edition [2], OCD was moved from the group of anxiety disorders to a new category, named Obsessive-Compulsive and Related Disorders [1]. Obsessive-compulsive disorder usually first appears during adolescence or in early adults, treatment may not be sought until the middle age. The onset of OCD is typically gradual and cannot be accurately dated, in some cases, it is triggered by a particular event in the patient’s life.
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