Childhood trauma is associated with theory of mind deficits in obsessive-compulsive disorder

Background: Previous studies have indicated the resting-state default mode network (DMN) related connectivity serving as predictor of sustained attention performance in healthy people. Interestingly, sustained attention deficits as well as DMN-involved functional connectivity (FC) alterations are common in both patients with schizophrenia (SCZ) and with obsessive-compulsive disorder (OCD). Thus, the present study was designed to investigate whether the DMN related resting-state connectivity alterations in these two psychiatric disorders were neural correlates of their sustained attention impairments.Methods: The study included 17 SCZ patients, 35 OCD patients and 36 healthy controls (HCs). Sustained attention to response task was adopted to assess the sustained attention. Resting-state scan was administrated and seed-based whole-brain FC analyses were performed with seeds located in classical DMN regions including bilateral medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC).Results: Both SCZ and OCD patients had poorer sustained attention than HCs. Sustained attention deficits in OCD was negatively correlated with their impaired FC of right mPFC-left superior frontal gyrus (SFG) within DMN, and that in SCZ was significantly correlated with their altered FC of left mPFC-bilateral anterior cingulate cortex (ACC) which indicated interaction between DMN and salience network. In addition, the FC between left mPFC and right parietal lobe indicating the interaction between DMN and frontal-parietal network was correlated with sustained attention in both SCZ and OCD.Conclusion: These findings suggest the importance of DMN-involved connectivity, both within and between networks in underlying sustained attention deficits in OCD and SCZ. Results further support the potential of resting-state FC in complementing information for cognitive deficits in psychiatric disorders.

Background:Obsessive compulsive disorder (OCD) is a chronic distressing condition that is marked with impairment in daily functioning including social, family, and occupational areas of life. Depression is the most common comorbidity among patients with OCD. The presence of co-occurring depressive symptoms adds to the burden of the OCD. Previous studies with neuropsychological testing reveals a pattern of cognitive deficits among patients with OCD. Few studies have also shown that the cognitive deficits in OCD are mediated by comorbid depressive symptoms.Objective:The objective of this study was to assess whether the comorbid depressive symptoms have any role on the cognitive deficits in OCD.Methodology:Forty patients diagnosed with OCD with an elevated rating in Beck Depression Inventory (BDI) and 20 normal controls were chosen for the study. The forty patients were split according to the severity scores of BDI as per one group consisting of patients with only mild depression and other group consisting of patients with moderate and severe depression. Yale–Brown Obsessive Compulsive Scale has been administered to assess the severity and symptoms of the disorder. Digit Vigilance Test and Triads Test have been administered to assess attention; Comprehensive Trial Making Test (CTMT) and Rey Complex Figure Test have been administered to assess attention, executive function, and memory.Results:OCD patients have significantly performed poor than the normal controls. On further analysis, OCD patients with moderate and severe depressive features have performed poor than the patients with mild depressive features on the tests administered for attention, executive function, and memory. On assessing the role of comorbid depressive features on cognitive deficits, having mild depressive features were not found to be significantly correlated to the cognitive deficits, whereas patients having moderate and severe depressive features were found to be significantly correlated to the cognitive deficits among OCD patients.Conclusion:The findings suggest that the higher level of depressive symptoms is associated with cognitive deficits in OCD patients. It can be suggested that the comorbid moderate-to-severe depressive symptoms play an important role in the cognitive deficits found among the OCD patients.

Reversal Learning as a Neuropsychological Indicator for the Neuropathology of Obsessive Compulsive Disorder? A Behavioral Study

A dysfunction of the fronto-striatal loop has been associated with obsessive-compulsive disorder (OCD). Functional imaging studies suggest that reversal learning is affected by deficits in fronto-striatal brain areas and thus should be impaired in patients with OCD. The authors compared patients with OCD and healthy comparison subjects on a reversal learning task. Correlation analyses and group comparisons showing prolonged reaction times of different response parameters are associated with increasing severity of compulsions. The reversal learning task has been shown to be associated with ventral fronto-striatal brain activation by functional magnetic resonance imaging (fMRI) in healthy comparison subjects. The purpose of this article is to suggest that the reversal learning task can be used as a neuropsychiatric measurement of the ventral fronto-striatal dysfunction in OCD.

Visuospatial working memory (VSWM) is the ability of the brain to transiently store and manipulate visual information. VSWM deficiencies have been reported in obsessive-compulsive disorder (OCD), but not consistently, perhaps due to variability in task design and clinical patient factors. To explore this variability, this study assessed effects of the design factors task difficulty and executive organizational strategy and of the clinical factors gender, OCD symptom dimension, and duration of illness on VSWM in OCD. The CANTAB spatial working memory, spatial recognition memory, delayed matching to sample, and stop signal tasks were administered to 42 adult OCD patients and 42 age- and sex-matched healthy controls. Aims were to detect a possible VSWM deficit in the OCD sample, to evaluate influences of the above task and patient factors, to determine the specificity of the deficit to the visuospatial subdomain, and to examine effects of sustained attention as potential neurocognitive confound. We confirmed previous findings of a VSWM deficit in OCD that was more severe for greater memory load (task difficulty) and that was affected by task strategy (executive function). We failed to demonstrate significant deficits in neighboring or confounding neurocognitive subdomains (visual object recognition or visual object short-term memory, sustained attention). Notably, the VSWM deficit was only significant for female patients, adding to evidence for sexual dimorphism in OCD. Again as in prior work, more severe OCD symptoms in the symmetry dimension (but no other dimension) significantly negatively impacted VSWM. Duration of illness had no significant effect on VSWM. VSWM deficits in OCD appear more severe with higher task load and may be mediated through poor task strategy. Such deficits may present mainly in female patients and in (male and female) patients with symmetry symptoms.

Théorie de l’esprit et schizotypie : une revue de la littérature

Examining procedural working memory processing in obsessive-compulsive disorder

Anosognosia for theory of mind deficits: A single case study and a review of the literature

To explore the function of the default mode network (DMN) in the psychopathological mechanisms of theory of mind deficits in patients with an esophageal cancer concomitant with depression in resting the state. Twenty-five cases of esophageal cancer with theory of mind deficits (test group) that meet the diagnostic criteria of esophageal cancer and neuropsychological tests, including Beck depression inventory, reading the mind in the eyes, and Faux pas, were included, Another 25 cases of esophageal cancer patients but without theory of mind deficits (control group) were enrolled. Each patient completed a resting-state functional magnetic resonance imaging. The functional connectivity intensities within the cerebral regions in the DMN of all the enrolled patients were analyzed. The results of each group were compared. The functional connectivity of the bilateral prefrontal central region with the precuneus, bilateral posterior cingulate gyrus and bilateral ventral anterior cingulate gyrus in the patients of the test group were all reduced significantly (P < 0.05). In the resting state, the functional connectivity is abnormal in the cerebral regions in the DMN of esophageal cancer patients with theory of mind deficits. The theory of mind deficits might have an important function in the pathogenesis of esophageal cancer.

Obsessive compulsive disorder (OCD) is a prevalent psychiatric disorder characterized by obsessions and compulsions. Studies investigating symptomatology and cognitive deficits in OCD frequently implicate the striatum. The aim of this study was to explore striatum-mediated cognitive deficits in patients with OCD as they complete a stimulus-response learning task previously shown to differentially rely on the dorsal (DS) and ventral striatum (VS). We hypothesized that patients with OCD will show both impaired decision-making and learning, coupled with reduced task-relevant activity in DS and VS, respectively, compared to healthy controls. We found that patients with OCD (n = 14) exhibited decision-making deficits and learned associations slower compared to healthy age-matched controls (n = 16). Along with these behavioral deficits, OCD patients had reduced task-relevant activity in DS and VS, compared to controls. This study reveals that responses in DS and VS are altered in OCD, and sheds light on the cognitive deficits and symptoms experienced by patients with OCD.

Obsessive-compulsive disorder (OCD) has been linked to functional abnormalities in fronto-striatal networks as well as impairments in decision making and learning. Little is known about the neurocognitive mechanisms causing these decision-making and learning deficits in OCD, and how they relate to dysfunction in fronto-striatal networks. We investigated neural mechanisms of decision making in OCD patients, including early and late onset of disorder, in terms of reward prediction errors (RPEs) using functional magnetic resonance imaging. RPEs index a mismatch between expected and received outcomes, encoded by the dopaminergic system, and are known to drive learning and decision making in humans and animals. We used reinforcement learning models and RPE signals to infer the learning mechanisms and to compare behavioural parameters and neural RPE responses of the OCD patients with those of healthy matched controls. Patients with OCD showed significantly increased RPE responses in the anterior cingulate cortex (ACC) and the putamen compared with controls. OCD patients also had a significantly lower perseveration parameter than controls. Enhanced RPE signals in the ACC and putamen extend previous findings of fronto-striatal deficits in OCD. These abnormally strong RPEs suggest a hyper-responsive learning network in patients with OCD, which might explain their indecisiveness and intolerance of uncertainty.

Objective: Obsessive compulsive disorder (OCD) is cha racterized by recurrent intrusive thoughts and repetitive behaviors or mental acts compulsions. Previous studies obviously indicate that OCD patients have several impairments in memory and other neurocognitive functions. Our primary aim is to assess the cognitive impairment in OCD patients through Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS-Cog) which is widely used in Alzheimer's Dementia. Method: Thirty two patients with a diagnosis of OCD and twenty six healthy controls were administrated Structured Clinical Interview for DSM Disorders (SCID-I), Yale Brown Obsessive Compulsive Scale (Y-BOKS), ADAS-Cog Scale, Mini Mental Status Examination (MMSE), Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scales (HARS). Results: When we compared two groups, OCD subjects performed significantly worse in the fields of ADAS-Cog Total (p<0.0001), Word Recall (p<0.0001), Word Recognition (p<0.0001) Commands (p<0.0001), Constructional Praxis (p<0.05) and Orientation (p<0.05) Tests of ADAS-Cog compared to the healthy control group. Conclusion: We suggest that ADAS-Cog might be used as an available tool to assess some neurocognitive deficits in OCD patients. Further studies in larger samples of OCD patients are needed to assess the availability of ADAS-Cog in measuring the neurocognitive impairments.

Few studies have examined the relation between neurological soft signs (NSS) and neuropsychological performance in Obsessive-Compulsive Disorder (OCD). Thirty outpatients with primary OCD and 30 matched normal controls were administered the Cambridge Neurological Inventory and the Rey-Osterrieth Complex Figure Test (RCFT). A series of multiple regression models tested the relationship between NSS and performance on the RCFT. Patients presented significantly more neurological soft signs than controls on both sides of the body, and were impaired on the free recall and organization scores of the RCFT. Nonverbal memory deficits in OCD were predicted independently by organizational strategies during the copy condition of the RCFT, and neurological soft signs. There might be at least two variables independently mediating nonverbal memory deficits in OCD: (1) a cognitive organization and planning component, and (2) a complex motor regulatory component.

Investigating Retrospective and Prospective Metamemory Judgments During Episodic Memory in Patients With Obsessive-Compulsive Disorders

BackgroundA history of Childhood Trauma (CT), i.e., physical or emotional abuse or neglect, and sexual abuse, is reportedly more prevalent in individuals suffering from psychosis than in the general population. Crucial questions remain unclear about the nature of interpersonal functioning in CT survivors, involving the capacity to understand and interpret other people′s thoughts and feelings, especially in individuals with First-Episode of Schizophrenia (FESz). We investigated the Theory of Mind (ToM) performance of patients with FESz related to CT in comparison to healthy controls (HC).MethodsParticipants (n=77) completed the Eye Task Revised (RMET) and the Childhood Experience of Care Abuse Questionnaire (CECA-Q). The Word Accentuation Test (TAP) was used to estimate a premorbid IQ. Seven-teen patients with FESz (Mean age = 24.9, SD = 5.4, Male = 79.6%; Education = 10.7, SD = 1.5 years) were recruited at the First-Episode Psychosis Program, Hospital 12 de Octubre Madrid, and 60 HC (Mean age = 27.6, SD = 7.2; Male = 45.6%; Education = 14.5, SD = 2.8 years) were healthy volunteers. Between-group comparisons were made using ANCOVA, considering group and CT as fixed factors. Age, years of education and IQ were included as covariates.ResultsPreliminary results showed that compared to controls, patients with FESz performed worse on the recognition and interpretation of facial expressions, in both male and female faces (p < .001). Patients with FESz did not perform differently than HC in the recognition and interpretation of positive facial expressions (p = .074). However, lower interpretation of negative facial expressions (p < .001) and of neutral facial expressions (p < .001) was shown in patients with FESz compared to HC. Higher interpretation of facial expressions was shown in FESz patients with CT (n = 12), only of female faces (p < .001), compared to patients without CT (n = 7). It was also shown higher interpretation of facial expressions in HC with CT (n = 28), only of negative facial expressions (p = .014), compared to HC without CT (n = 32). Female patients with FESz performed worse on the recognition and interpretation of negative (p = .024) and neutral faces (p < .001), only of male faces (p = .038), compared to female HC. Male patients with FESz performed worse on the recognition and interpretation of positive (p = .038) and negative facial expressions (p = .001) of male faces (p < .001), compared to male HC. In comparison to male FESz patients without CT, male FESz patients with CT showed higher interpretation of female faces (p = .030). In comparison to male HC without CT, male HC with CT showed higher interpretation of male faces (p = .031).DiscussionAccording to previous research, our preliminary findings indicated theory of mind deficits in patients with FESz. Interestingly, in our study the alterations on the interpretation and recognition of facial expressions were shown only of negative and neutral, but not of positive facial expressions. Furthermore, and contrary to literature, we found more interpretation and recognition of facial expressions in patients and healthy controls survivors of CT. However, the above-mentioned was specifically observed of female faces in patients and of negative facial expressions in healthy controls. In addition, female and male patients and healthy controls seem to interpret differently facial expressions related to childhood trauma. Nevertheless, increasing our sample size would give us the opportunity to draw further conclusions about how adverse experiences during childhood may influence social abilities in patients with FESz.