Abstract
Background
Compulsive behaviors in Obsessive-Compulsive Disorder (OCD) are posited to be negatively reinforced via short-term negation of distress-inducing triggers, but neural activity during negative reinforcement in the context of OCD remains poorly understood.
Methods
In 18 people with OCD and 16 healthy matched comparison subjects completing functional MRI, we tested the effect of a novel negative reinforcement behavioral paradigm. Three visual stimulus types (Compulsion-Related, Negative, Neutral) were displayed in the scanner and removed by participants pressing a button, yielding two analysis epochs: image presentation and image removal.
Results
OCD patients showed a larger increase in medial orbitofrontal cortex (mOFC; BA11) activation after image removal that was specific to compulsion-related images. People with OCD also showed altered patterns of deactivation following compulsion-related and negative image removal in the right and left amygdala, respectively. People with OCD also showed larger deactivations in the ventral tegmental area (VTA) after removal of all image types, and increased overall activation to negative images in the right nucleus accumbens (NAcc).
Conclusion
We provide initial data demonstrating altered neural activity during negative reinforcement in OCD patients, providing empirical support for dominant behavioral models emphasizing the role of negative reinforcement in etiology and maintenance of pathological compulsive behaviors.
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Acknowledgements
This study was funded by a pilot seed grant from the University of Pittsburgh Brain Institute. We gratefully acknowledge Mary Phillips, MD for her assistance with the IRB protocols.
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SA designed the study. AW, BP, and RBP conducted experiments and acquired data. BP and RBP analyzed data and performed statistical analysis. All authors contributed to writing the manuscript.
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Panny, B., Price, R.B., Wears, A. et al. Altered Neural Activity during Negative Reinforcement in People with Obsessive-Compulsive Disorder. Cogn Ther Res (2024). https://doi.org/10.1007/s10608-024-10475-z
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DOI: https://doi.org/10.1007/s10608-024-10475-z