Maintained Visual-, Auditory-, and Multisensory-Guided Associative Learning Functions in Children With Obsessive-Compulsive Disorder.

Ákos Pertich,András Puszta,Szabolcs Kéri,Laura Németh,Péter Nagy,Dorottya Öri,Orsolya Hegedüs,Attila Nagy,Gabriella Eördegh

doi:10.3389/fpsyt.2020.571053

Abstract

Sensory-guided acquired equivalence learning, a specific kind of non-verbal associative learning, is associated with the frontal cortex–basal ganglia loops and hippocampi, which seem to be involved in the pathogenesis of obsessive–compulsive disorder (OCD). In this study, we asked whether visual-, auditory-, and multisensory-guided associative acquired equivalence learning is affected in children with OCD. The first part of the applied learning paradigm investigated association building between two different sensory stimuli (where feedback was given about the correctness of the choices), a task that critically depends upon the basal ganglia. During the test phases, which primarily depended upon the hippocampi, the earlier learned and hitherto not shown but predictable associations were asked about without feedback. This study involved 31 children diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) criteria and 31 matched healthy control participants. The children suffering from OCD had the same performance as the control children in all phases of the applied visual-, auditory-, and multisensory-guided associative learning paradigms. Thus, both the acquisition and test phases were not negatively affected by OCD. The reaction times did not differ between the two groups, and the applied medication had no effect on the performances of the OCD patients. Our results support the findings that the structural changes of basal ganglia and hippocampi detected in adult OCD patients are not as pronounced in children, which could be the explanation of the maintained associative equivalence learning functions in children suffering from OCD.

Highlights

Obsessive–compulsive disorder (OCD) is one of the most prevalent human psychiatric disorders, affecting 2–3% of the adult population, and its prevalence is the same in children and adolescents [1]
Each pediatric OCD patient without any comorbidities finished all of the aforementioned tasks, with only two of patients being ineligible for the visual paradigm based on disabilities in color sight, as measured by the Ishihara plates
The original visually guided Rutgers Acquired Equivalence Test [the other name is the face–fish test [8]] was developed in order to learn about visually guided associative learning of neurological patients with basal ganglia and hippocampus dysfunction

Summary

Introduction

Obsessive–compulsive disorder (OCD) is one of the most prevalent human psychiatric disorders, affecting 2–3% of the adult population, and its prevalence is the same in children and adolescents [1]. A specific kind of non-verbal associative learning, is connected to the abovementioned frontal cortex–basal ganglia loops and hippocampi but has not yet been investigated in children and adolescents with OCD. The Rutgers Acquired Equivalence Test developed by Myers et al [8] is a commonly applied test to investigate this learning function [9,10,11,12,13,14] A great advantage of this test is that each phase of the paradigm has well-described neural substrates It has two main phases, the acquisition phase, which depends primarily upon the function of the frontal cortex– basal ganglia loop [8, 12], and the test phase, which depends primarily upon the hippocampi and the mediotemporal lobe [8, 15].

Objectives

Methods

Results

Conclusion