Obsessive-compulsive Disorder Participants Research Articles

Long-range temporal correlations in resting state alpha oscillations in major depressive disorder and obsessive-compulsive disorder.

Mental disorders are a significant concern in contemporary society, with a pressing need to identify biological markers. Long-range temporal correlations (LRTC) of brain rhythms have been widespread in clinical cohort studies, especially in major depressive disorder (MDD). However, research on LRTC in obsessive-compulsive disorder (OCD) is severely limited. Given the high co-occurrence of OCD and MDD, we conducted a comparative LRTC investigation. We assumed that the LRTC patterns will allow us to compare measures of brain cortical balance of excitation and inhibition in OCD and MDD, which will be useful in the area of differential diagnosis. In this study, we used the 64-channel resting state EEG of 29 MDD participants, 26 OCD participants, and a control group of 37 volunteers. Detrended fluctuation analyzes was used to assess LRTC. Our results indicate that all scaling exponents of the three subject groups exhibited persistent LRTC of EEG oscillations. There was a tendency for LRTC to be higher in disorders than in controls, but statistically significant differences were found between the OCD and control groups in the entire frontal and left parietal occipital areas, and between the MDD and OCD groups in the middle and right frontal areas. We believe that these results indicate abnormalities in the inhibitory and excitatory neurotransmitter systems, predominantly affecting areas related to executive functions.

Veil-of-ignorance reasoning affects moral judgment and cognitive flexibility in people with obsessive-compulsive disorder

Individuals with obsessive-compulsive disorder (OCD) have rigid moral judgments compared to healthy people. They tend to prefer deontological options when they face moral dilemmas. Recent research has indicated that activating the Veil-of-Ignorance (VOI) reasoning changes moral judgment in healthy participants, leading them to favor utilitarian choices. However, the effect of VOI reasoning on OC patients' moral judgment has not been studied. The present research aimed to investigate the effect of VOI reasoning on moral judgment and cognitive flexibility of OC patients across two studies (N = 336). In study 1, we recruited 80 OCD participants and 80 healthy participants via convenience sampling and assigned them randomly to either the VOI or non-VOI group. Participants in the VOI group read the VOI versions of the footbridge (personal dilemma) and trolley (impersonal dilemma) dilemmas prior to answering the standard scenarios. In the control group, participants only responded to the standard versions of the dilemmas. In study 2, 88 OCD participants and 88 healthy participants were recruited and followed the same procedure as the first study except that they responded to the bioethical personal and impersonal dilemmas. At the end of each experiment, participants answered the cognitive flexibility test. Results indicated that OCD participants who engaged in VOI reasoning subsequently made more utilitarian choices in response to impersonal dilemmas compared to the OCD participants in the non-VOI condition. However, VOI reasoning did not change their choices in response to personal dilemmas. On the other hand, healthy participants favored utilitarian options in response to personal dilemmas. Both healthy and OC participants performed better on the cognitive flexibility test after engaging in VOI reasoning.

Clinical outcomes of deep brain stimulation for obsessive-compulsive disorder: Insight as a predictor of symptom changes.

Deep brain stimulation (DBS) is a safe and effective treatment option for people with refractory obsessive-compulsive disorder (OCD). Yet our understanding of predictors of response and prognostic factors remains rudimentary, and long-term comprehensive follow-ups are lacking. We aim to investigate the efficacy of DBS therapy for OCD patients, and predictors of clinical response. Eight OCD participants underwent DBS stimulation of the nucleus accumbens (NAc) in an open-label longitudinal trial, duration of follow-up varied between 9 months and 7 years. Post-operative care involved comprehensive fine tuning of stimulation parameters and adjunct multidisciplinary therapy. Six participants achieved clinical response (35% improvement in obsessions and compulsions on the Yale Brown Obsessive Compulsive Scale (YBOCS)) within 6-9 weeks, response was maintained at last follow up. On average, the YBOCS improved by 45% at last follow up. Mixed linear modeling elucidated directionality of symptom changes: insight into symptoms strongly predicted (P = 0.008) changes in symptom severity during DBS therapy, likely driven by initial changes in depression and anxiety. Precise localization of DBS leads demonstrated that responders most often had their leads (and active contacts) placed dorsal compared to non-responders, relative to the Nac. The clinical efficacy of DBS for OCD is demonstrated, and mediators of changes in symptoms are proposed. The symptom improvements within this cohort should be seen within the context of the adjunct psychological and biopsychosocial care that implemented a shared decision-making approach, with flexible iterative DBS programming. Further research should explore the utility of insight as a clinical correlate of response. The trial was prospectively registered with the ANZCTR (ACTRN12612001142820).

Brain activation during fear extinction recall in unmedicated patients with obsessive-compulsive disorder

Specific brain activation patterns during fear conditioning and the recall of previously extinguished fear responses have been associated with obsessive-compulsive disorder (OCD). However, further replication studies are necessary. We measured skin-conductance response and blood oxygenation level-dependent responses in unmedicated adult patients with OCD (n = 27) and healthy participants (n = 22) submitted to a two-day fear-conditioning experiment comprising fear conditioning, extinction (day 1) and extinction recall (day 2). During conditioning, groups differed regarding the skin conductance reactivity to the aversive stimulus (shock) and regarding the activation of the right opercular cortex, insular cortex, putamen, and lingual gyrus in response to conditioned stimuli. During extinction recall, patients with OCD had higher responses to stimuli and smaller differences between responses to conditioned and neutral stimuli. For the entire sample, the higher the response delta between conditioned and neutral stimuli, the greater the dACC activation for the same contrast during early extinction recall. While activation of the dACC predicted the average difference between responses to stimuli for the entire sample, groups did not differ regarding the activation of the dACC during extinction recall. Larger unmedicated samples might be necessary to replicate the previous findings reported in patients with OCD.

A prospective investigation of impacts of comorbid attention deficit hyperactivity disorder (ADHD) on clinical features and long-term treatment response in adult patients with obsessive-compulsive disorder (OCD)

BackgroundA close association between obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in children and adolescents has been investigated in previous studies. However, few studies examined the relationship between lifetime comorbidity of ADHD and OCD in adults. Therefore, we sought to investigate the clinical and psychopathological features related to comorbid ADHD in Japanese adult patients with OCD. MethodsWe assessed lifetime comorbidity of ADHD in 93 adult Japanese patients with OCD. Additionally, we used the Japanese version of Conners' Adult ADHD Rating Scales to assess the characteristics and severity of ADHD in each participant. According to the results, we excluded OCD patients that did not have ADHD but who exhibited elevated levels of ADHD traits. We compared OCD patients with ADHD (ADHD+ group) and those without ADHD or its trait (ADHD− group) in terms of background profiles and clinical features, such as OCD symptomatology and psychometric test results. Additionally, the 6-month treatment outcome was compared prospectively between groups. ResultsOf the 93 OCD participants, the prevalence of lifetime comorbidity of ADHD was estimated as 16.1%. Compared with the ADHD− group, participants in the ADHD+ group had an earlier age of onset of OCD, higher frequencies of hoarding symptoms, higher levels of depressive and anxiety symptoms and lower quality of life, more elevated levels of impulsivity, and higher rates of substance or behavioral addiction and major depression. Finally, the mean improvement rate on the Yale-Brown Obsessive Compulsive Scale after 6 months of standardized OCD treatment in the ADHD+ group (16.1%) was significantly lower than that in the ADHD− group (44.6%). ConclusionThe lifetime comorbidity of ADHD is likely to exert a significant effect on clinical features and treatment outcome in adult patients with OCD. It is important to consider that underlying ADHD pathology may function as a facilitator for increased severity of global clinical features and treatment refractory conditions in OCD patients. Further studies are required to examine treatment strategies for such patients.

The relevance of dysfunctional reasoning to OCD and its treatment: Further evidence for inferential confusion utilizing a new task-based measure

Background and objectivesPrevious research has highlighted the role of dysfunctional reasoning processes (i.e. “inferential confusion”) in the development and maintenance of Obsessive-Compulsive Disorder (OCD). Inferential confusion has previously been found to be a unique predictor of OC symptoms and has shown specificity for OCD. However, these findings have primarily relied on a single self-report questionnaire, and only a limited number of experimentations have been conducted to establish the specificity of inferential confusion to OCD with alternate measures. The current paper demonstrates the relationship of inferential confusion with OCD symptoms in clinical samples by using a task-based measure of inferential confusion. MethodsSixty-four OCD participants, as well as thirty anxious and thirty-four healthy controls completed the recently developed Dysfunctional Reasoning Processes Task (DRPT) and related measures. Thirty-five OCD participants then completed sixteen sessions of cognitive-behavioural therapy (CBT) and completed the same measures post-treatment. ResultsAs predicted, dysfunctional reasoning was significantly more elevated for those with OCD relative to control groups. Reduced levels of dysfunctional reasoning during CBT were significantly associated with successful treatment outcome. LimitationsClinical implications should be interpreted with caution due to the relatively small sample size. ConclusionsOur findings support the notion that inferential confusion is an important cognitive factor particularly relevant to OCD that needs to be directly addressed as a mechanism of change in CBT.

Psychological distress modulates dorsal anterior cingulate cortex responses to salient stimuli in obsessive-compulsive disorder

BackgroundPatients with obsessive-compulsive disorder (OCD) experience an exacerbation of symptoms under psychological distress. The neurobiological underpinnings of this effect of stress remain elusive. Here, we induced psychological distress to explore its effect on neural reactivity of the salience network during a symptom provocation task. MethodsTwenty-three patients with OCD and twenty-three healthy volunteers underwent functional magnetic resonance imaging scanning after stress induction and a control condition in a cross-over design. Psychological distress was induced using the socially evaluated cold pressor test (SECPT) and neural responses were measured during a symptom provocation task. ResultsOCD participants showed a blunted cortisol response to the stressor. We found a group by stress interaction effect in the dorsal anterior cingulate cortex (dACC), such that psychological distress reduced dACC reactivity to emotionally salient pictures in OCD participants, whereas it increased dACC reactivity in healthy controls. LimitationsA considerable proportion of OCD participants was on medication, and the neuroimaging session was conducted more than 1 h after the initial stressor. ConclusionsConsidering this timeline, we speculate that the blunted dACC reactivity towards emotionally salient pictures in OCD participants may reflect impaired emotion regulation in the aftermath of stress.

Mechanisms of imbalanced frontostriatal functional connectivity in obsessive-compulsive disorder.

The diagnosis of obsessive-compulsive disorder (OCD) has been linked with changes in frontostriatal resting-state connectivity. However, replication of prior findings is lacking, and the mechanistic understanding of these effects is incomplete. To confirm and advance knowledge on changes in frontostriatal functional connectivity in OCD, participants with OCD and matched healthy controls underwent resting-state functional, structural and diffusion neuroimaging. Functional connectivity changes in frontostriatal systems were here replicated in individuals with OCD (n = 52) compared with controls (n = 45). OCD participants showed greater functional connectivity (t = 4.3, PFWE = 0.01) between the nucleus accumbens (NAcc) and the orbitofrontal cortex (OFC) but lower functional connectivity between the dorsal putamen and lateral prefrontal cortex (t = 3.8, PFWE = 0.04) relative to controls. Computational modelling suggests that NAcc-OFC connectivity changes reflect an increased influence of NAcc over OFC activity and reduced OFC influence over NAcc activity (posterior probability, Pp > 0.66). Conversely, dorsal putamen showed reduced modulation over lateral prefrontal cortex activity (Pp > 0.90). These functional deregulations emerged on top of a generally intact anatomical substrate. We provide out-of-sample replication of opposite changes in ventro-anterior and dorso-posterior frontostriatal connectivity in OCD and advance the understanding of the neural underpinnings of these functional perturbations. These findings inform the development of targeted therapies normalizing frontostriatal dynamics in OCD.

Global prevalence of smoking among individuals with obsessive-compulsive disorder and symptoms: a systematic review and meta-analysis

ABSTRACT Disease from nicotine dependency continues to be a leading cause of preventable death worldwide, and therefore research that elucidates potential correlates of tobacco use may facilitate the advancement of research, clinical practice, and policy in this area to target this public health challenge. One potential tobacco use correlate is obsessive-compulsive disorder (OCD) phenomena. The growing research evidence on the association between tobacco use and OCD phenomena is mixed, making it difficult to synthesize extant findings into meaningful conclusions. Indeed, there has never been a systematic review or meta-analysis of this area of research. To this end, a systematic review was carried out with studies between 1988 and 2021, and from this review, 71 independent estimations (n = 10,475; Females = 51.95%; mean age = 37.29, SD = 13.78) were extracted for meta-analysis. We found that about three in ten participants with OCD are likely to use tobacco, which is higher than the general population. The prevalence was the same among OCD participants at all levels (those with symptomology but no confirmed diagnosis, those surpassing a clinical cutoff for OCD but no confirmed diagnosis, and those with a confirmed OCD diagnosis). The results also indicated considerable variability across study results and a wide confidence interval associated with the tobacco use prevalence rate among those with OCD phenomena. The findings provide support for continued study of this comorbidity, perhaps with longitudinal and experimental designs to test for reciprocal associations between tobacco use and OCD phenomena in the service of targeting nicotine dependence as a substantial global public health concern.

Are people with obsessive-compulsive disorder under-confident in their memory and perception? A review and meta-analysis.

People with obsessive-compulsive disorder (OCD) tend to distrust their memory, perception, and other cognitive functions, and many OCD symptoms can be traced to diminished confidence in one's cognitive processes. For example, poor confidence in recall accuracy can cause doubt about one's memory and motivate repeated checking. At the same time, people with OCD also display performance deficits in a variety of cognitive tasks, so their reduced confidence must be evaluated in relation to their actual performance. To that end, we conducted an exhaustive review and meta-analysis of studies in which OCD participants and non-clinical control participants performed cognitive tasks and reported their confidence in their performance. Our search resulted in 19 studies that met criteria for inclusion in the quantitative analysis, with all studies addressing either memory or perception. We found that both performance and reported confidence were lower in OCD than in control participants. Importantly, however, confidence was more impaired than performance in participants with OCD. These findings suggest that people with OCD are less confident in their memory and perception than they should be, indicating a genuine under-confidence in this population. We discuss potential mechanisms that might account for this finding and suggest avenues for further research into under-confidence and related meta-cognitive characteristics of OCD.

Cross-disorder comparison of sensory over-responsivity in chronic tic disorders and obsessive-compulsive disorder

BackgroundSensory over-responsivity (SOR) refers to excessively intense and/or prolonged behavioral responses to environmental stimuli typically perceived as non-aversive. SOR is prevalent in several neurodevelopmental disorders, including chronic tic disorders (CTDs) and obsessive-compulsive disorder (OCD). Few studies have examined the extent and clinical correlates of SOR across disorders, limiting insights into the phenomenon's transdiagnostic clinical and biological relevance. Such cross-disorder comparisons are of particular interest for CTDs and OCD given their frequent co-occurrence. ObjectiveWe sought to compare the magnitude of SOR between adults with CTD and adults with OCD and to identify the clinical factors most strongly associated with SOR across these disorders. MethodsWe enrolled 207 age- and sex-matched participants across four diagnostic categories: CTD without OCD (designated “CTD/OCD-”; n = 37), CTD with OCD (“CTD/OCD+”; n = 32), OCD without tic disorder (“OCD”; n = 69), and healthy controls (n = 69). Participants completed a self-report battery of rating scales assessing SOR (Sensory Gating Inventory, SGI), obsessive-compulsive symptoms (Dimensional Obsessive-Compulsive Scale, DOCS), inattention and hyperactivity (Adult ADHD Self-Report Screening Scale for DSM-5, ASRS-5), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9). CTD participants were also administered the Yale Global Tic Severity Scale (YGTSS). To examine between-group differences in SOR, we compared SGI score across all groups and between pairs of groups. To examine the relationship of SOR with other clinical factors, we performed multivariable linear regression. ResultsCTD/OCD-, CTD/OCD+, and OCD participants were 86.7%, 87.6%, and 89.5%, respectively, more likely to have higher SGI total scores than healthy controls. SGI total score did not differ between CTD/OCD-, CTD/OCD+, and OCD groups. In the regression model of log-transformed SGI total score, OCD diagnosis, DOCS score, and ASRS-5 score each contributed significantly to model goodness-of-fit, whereas CTD diagnosis and YGTSS total tic score did not. ConclusionSOR is prevalent in adults with CTD and in adults with OCD but does not significantly differ in magnitude between these disorders. Across CTD, OCD, and healthy control adult populations, SOR is independently associated with both obsessive-compulsive and ADHD symptoms, suggesting a transdiagnostic relationship between these sensory and psychiatric manifestations. Future cross-disorder, longitudinal, and translational research is needed to clarify the role and prognostic import of SOR in CTDs, OCD, and other neurodevelopmental disorders.

Spatial working memory performance in people with obsessive–compulsive disorder, their unaffected first-degree relatives and healthy controls

Summary Studies have shown that people with obsessive–compulsive disorder (OCD) have impairments in spatial working memory (SWM) performance. However, it remains unclear whether this deficit represents a cognitive endophenotype preceding symptoms or a correlate of OCD. We investigated SWM in 69 people with OCD, 77 unaffected first-degree relatives of people with OCD and 106 healthy control participants. Taking age effects into account, SWM performance was best in healthy controls, intermediate in relatives and worst in OCD participants. However, since performance did not differ significantly between healthy controls and relatives, our study does not fully support SWM performance as a core cognitive endophenotype of OCD.

Cross-diagnostic cognitive heterogeneity in body dysmorphic disorder and obsessive-compulsive disorder

Background and objectivesPrevious research has indicated that body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD) often demonstrate similar cognitive impairments across multiple domains. However, findings for both disorders have not consistently shown impaired cognition. As such, BDD and OCD might share an overlapping pattern of cognitive heterogeneity, characterised by subgroups with different cognitive profiles. MethodsTo evaluate this possibility, we compared 26 BDD, 24 OCD, and 26 healthy control participants on a comprehensive eight-domain cognitive battery. Then, cluster analysis was performed on the BDD and OCD participants’ combined data to explore for cognitive subgroups. ResultsNo significant differences were found between the three groups’ cognitive functioning, except for poorer visual learning in OCD relative to healthy controls. Cluster analysis produced two cognitive subgroups within the combined BDD and OCD data, characterised by intact cognition (52%) and broadly impaired cognition (48%). Each subgroup comprised both BDD and OCD participants, in similar proportions. The subgroups did not differ in clinical or demographic features. LimitationsSample sizes were moderate. Future research should investigate clustering patterns both in larger groups and separately in BDD and OCD samples to determine replicability. ConclusionsThese findings suggest that BDD and OCD may involve similar patterns of cognitive heterogeneity, and further imply that individuals with either disorder can show a wide range of cognitive profiles, thus necessitating a nuanced approach to future cognitive research in BDD and OCD.

Continuous Theta-Burst Stimulation Over the Right Orbitofrontal Cortex in Treatment-Resistant Obsessive-Compulsive Disorder Treatment: A Randomized Sham-Controlled Trial.

PurposeExamining whether modulation of right orbitofrontal cortex (OFC) activity by continuous theta-burst stimulation (cTBS) affects obsessive-compulsive disorder (OCD) symptoms.Patients and MethodsA total of 28 treatment-resistant OCD participants were treated with either active or sham cTBS of the OFC twice per day, for five days a week, for 2 weeks, in a double-blinded manner. Clinical response to treatment was determined using the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS).ResultsThere were no statistically significant differences between the 2 groups after two weeks of treatment in the Yale–Brown Obsessive-Compulsive Scale score (group*time interaction, F2,20=0.996, p=0.387) and other secondary outcome measures, including anxiety symptoms and responder rates. Depressive symptoms improved significantly in the active group (p=0.027), but the significant difference disappeared at 6 weeks (p=0.089).ConclusionThis is the first randomized controlled study using cTBS in the right OFC to observe the improvement of treatment-resistant OCD symptoms. It is safe to use cTBS, but 2 weeks of treatment is not enough to achieve a curative effect. Future studies are needed to explore more advanced stimulation parameters suitable for the treatment of OCD.Clinical Trial Registrationwww.chictr.org.cn, identifier ChiCTR2000034814.

Attenuated Access to Emotions in Obsessive-Compulsive Disorder

The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) posits that OCD is associated with attenuated access to internal states. Here we explored the implications of this model in the realm of emotions. Participants with OCD, anxiety disorders, and nonclinical control participants completed the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), assessing two domains of emotional intelligence: Experiential emotional intelligence (EI), reflecting the ability to perceive and feel emotions accurately, and Strategic EI, reflecting the ability to understand and manage emotions correctly. As only Experiential EI requires accurate perception of one’s emotions for adequate performance, we predicted an interaction between group and EI area. Specifically, we predicted that compared to both anxiety disorders and healthy control participants, OCD participants would show a larger deficit in Experiential area of the MSCEIT relative to the Strategic area. Results were fully in line with this prediction. Moreover, supporting the specificity of the hypothesized deficit to OCD, participants with anxiety disorders did not differ from nonclinical control participants in their performance, and findings were not attributable to anxiety or depression levels. These results replicate and extend previous findings obtained with analogue samples and suggest that OCD is associated with attenuated access to emotional states, which may be partially compensated for by reliance on semantic knowledge of emotion.

Severity related neuroanatomical alteration across symptom dimensions in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a symptomatically heterogeneous disease. Symptoms of OCD can be grouped into a six-factor structure including washing, checking, neutralizing, obsessing, ordering and hoarding. These different symptom profiles might be one of the critical factors contributing to the inconsistent neuroanatomical findings in OCD according to the literature. In this study, whole-brain voxel-based morphometry was used to examine neuroanatomical alterations in gray matter (GM) for OCD compared to healthy controls, and the variations associated with differing symptoms of OCD. The high-quality structural imaging data from 39 OCD individuals and 42 age-matched healthy controls were recruited. First, we found increased cortical GM volume in the left postcentral gyrus in OCD participants compared to healthy controls. Next, six independent regression analyses were conducted to examine the correlation between OCD symptom dimensions and inter-individual variation in neuroanatomy. After a rigorous multiple comparison correction, greater hoarding symptom was robustly found associated with greater GM volumes at various frontotemporal regions (including orbitofrontal, middle frontal and superior temporal GMs). Additionally, greater washing symptoms were associated with increased GM volume at the superior temporal cortex. The symptom-specific GM alterations observed here support the notion that OCD is an etiologically heterogeneous disorder, with both overlapping and distinct neuroanatomical structure across symptom dimensions.

Cognitive control in obsessive-compulsive disorder (OCD): Proactive control adjustments or consistent performance?

Cognitive control is often parsed into proactive and reactive control components. In proactive control, task- and goal-relevant information is utilized in a top-down manner to improve performance, while reactive control is a late-response corrective mechanism that occurs after conflict or errors. We tested whether people with obsessive-compulsive disorder (OCD) would show specific proactive control dysfunction in 31 individuals with OCD and 30 psychiatrically-healthy controls. We employed two tasks that differentiate proactive and reactive cognitive control processes: the cued-Stroop and the AX version of a continuous performance task (AX-CPT). There was a 1s or 5s delay between the cue and probe for both tasks to allow for implementation of proactive control processes. Participants also completed a neuropsychological test battery and mood and symptom severity self-report questionnaires. Although there were group-level differences in OCD severity and depression/anxiety symptoms, there were no significant differences in response times (RT) and error rates between groups for delay or condition for the cued-Stroop or for the AX-CPT, indicating similar performance in implementing proactive control strategies. There were also no significant differences between OCD and control participants on neuropsychological test performance. Results suggest a convergence of evidence wherein individuals with OCD are not showing disproportionately altered proactive control abilities.

Network-based functional connectivity predicts response to exposure therapy in unmedicated adults with obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) is associated with alterations in cortico-striato-thalamo-cortical brain networks, but some resting-state functional magnetic resonance imaging studies report more diffuse alterations in brain connectivity. Few studies have assessed functional connectivity within or between networks across the whole brain in unmedicated OCD patients or how patterns of connectivity predict response to exposure and ritual prevention (EX/RP) therapy, a first-line treatment for OCD. Herein, multiband resting-state functional MRI scans were collected from unmedicated, adult patients with OCD (n = 41) and healthy participants (n = 36); OCD patients were then offered twice weekly EX/RP (17 sessions). A whole-brain-network-based statistic approach was used to identify group differences in resting-state connectivity. We detected altered pre-treatment functional connectivity between task-positive regions in the temporal gyri (middle and superior) and regions of the cingulo-opercular and default networks in individuals with OCD. Signal extraction was performed using a reconstruction independent components analysis and isolated two independent subcomponents (IC1 and IC2) within this altered connectivity. In the OCD group, linear mixed-effects models tested whether IC1 or IC2 values predicted the slope of change in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores across EX/RP treatment. Lower (more different from controls) IC2 score significantly predicted greater symptom reduction with EX/RP (Bonferroni-corrected p = 0.002). Collectively, these findings suggest that an altered balance between task-positive and task-negative regions centered around temporal gyri may contribute to difficulty controlling intrusive thoughts or urges to perform ritualistic behaviors.

Frontoparietal hyperconnectivity during cognitive regulation in obsessive-compulsive disorder followed by reward valuation inflexibility

Obsessive-compulsive disorder (OCD) is characterized by cognitive deficits and altered reward processing systems. An imbalance between cognitive and reward pathways may explain the lack of control over obsessions followed by rewarding compulsive behaviors. While the processes of emotional cognitive regulation are widely studied in OCD, the mechanisms of cognitive regulation of reward are poorly described. Our goal was to investigate the OCD impact on cognitive regulation of reward at behavioral and neural functioning levels. OCD and control participants performed a functional magnetic resonance imaging task where they cognitively modulated their craving for food pictures under three cognitive regulation conditions: indulge/increase craving, distance/decrease craving, and natural/no regulation of craving. After regulation, the participants gave each picture a monetary value. We found that OCD patients had fixed food valuation scores while the control group modulated these values accordingly to the regulation conditions. Moreover, we observed frontoparietal hyperconnectivity during cognitive regulation. Our results suggest that OCD is characterized by deficits in cognitive regulation of internal states associated with inflexible behavior during reward processing. These findings bring new insights into the nature of compulsive behaviors in OCD.

Examining subjective sleep quality in adults with hoarding disorder

Hoarding disorder (HD), characterized by difficulty parting with possessions and functionally impairing clutter, affects 2–6% of the population. Originally considered part of Obsessive-Compulsive Disorder (OCD), HD became a distinct diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. While sleep impacts OCD, little is known about sleep in HD. As HD patients often report poor sleep in clinical settings, understanding global subjective sleep quality and disturbances may lead to novel therapeutic targets. To address this gap, the authors used a sample of convenience: an existing data set designed to screen research study eligibility and explore the psychopathology and phenomenology of OCD and HD. The data set included information collected from individuals with HD (n = 38), OCD (n = 26), and healthy participants (n = 22) about insomnia, sleep quality, and mood using interviews and structured instruments including the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scales (DASS). In this data set, HD and OCD groups reported significantly greater insomnia symptoms and poorer sleep quality compared with healthy controls while controlling for depression, age, and gender. A sizable minority of HD and OCD individuals met criteria for comorbid sleep disorders. OCD and HD groups differed in delayed sleep phase prevalence. To our knowledge, this is the first study examining subjective sleep quality and insomnia in HD as compared to healthy individuals and those with OCD, while controlling for relevant clinical characteristics. Given that there are evidence-based treatments for insomnia and other sleep disorders, our study raises the possibility that treatment interventions targeting sleep may improve HD outcomes.