TY - JOUR
T1 - Amygdala activity in obsessive-compulsive disorder with contamination fear
T2 - A study with oxygen-15 water positron emission tomography
AU - Van Den Heuvel, Odile A.
AU - Veltman, Dick J.
AU - Groenewegen, Henk J.
AU - Dolan, Raymond J.
AU - Cath, Danielle C.
AU - Boellaard, Ronald
AU - Mesina, Catalina T.
AU - Van Balkom, Anton J.L.M.
AU - Van Oppen, Patricia
AU - Witter, Menno P.
AU - Lammertsma, Adriaan A.
AU - Van Dyck, Richard
PY - 2004/12/30
Y1 - 2004/12/30
N2 - Previous imaging studies of obsessive-compulsive symptom states have implicated frontal-striatal and limbic regions in the pathophysiology of obsessive-compulsive disorder (OCD). Functional imaging studies, however, have yielded inconsistent results, presumably due to methodological differences (patient inclusion criteria, stimulus paradigm, imaging technique, and absence of control groups). In the present study, randomized presentation of contamination-related and neutral visual stimuli was used to investigate the neurophysiological correlates of contamination fear in a group of medication-free OCD patients with washing behaviors and healthy controls. A total of 21 subjects (11 OCD patients and 10 healthy controls) were scanned using H215O positron emission tomography (PET). Subjects were presented with pictures of clean and dirty surroundings and were requested to make indoor/outdoor decisions to control for attention differences. State anxiety and obsessionality were rated after each scan using visual analogue scales. Main effects of stimulus type (contamination vs. neutral) were found in bilateral occipital cortex in both groups. A significant group interaction effect was observed in the left amygdala reflecting enhanced activity in response to contamination stimuli in OCD patients. Sensitization effects were observed in the right amygdala in the OCD group; these paralleled an increase in levels of distress and obsessionality as well as a decrease in dorsolateral prefrontal activity. The findings of the present study are consistent with the hypothesis of decreased frontal-striatal control of limbic structures, specifically the amygdala, resulting in an inadequate fear response in OCD patients with contamination fear.
AB - Previous imaging studies of obsessive-compulsive symptom states have implicated frontal-striatal and limbic regions in the pathophysiology of obsessive-compulsive disorder (OCD). Functional imaging studies, however, have yielded inconsistent results, presumably due to methodological differences (patient inclusion criteria, stimulus paradigm, imaging technique, and absence of control groups). In the present study, randomized presentation of contamination-related and neutral visual stimuli was used to investigate the neurophysiological correlates of contamination fear in a group of medication-free OCD patients with washing behaviors and healthy controls. A total of 21 subjects (11 OCD patients and 10 healthy controls) were scanned using H215O positron emission tomography (PET). Subjects were presented with pictures of clean and dirty surroundings and were requested to make indoor/outdoor decisions to control for attention differences. State anxiety and obsessionality were rated after each scan using visual analogue scales. Main effects of stimulus type (contamination vs. neutral) were found in bilateral occipital cortex in both groups. A significant group interaction effect was observed in the left amygdala reflecting enhanced activity in response to contamination stimuli in OCD patients. Sensitization effects were observed in the right amygdala in the OCD group; these paralleled an increase in levels of distress and obsessionality as well as a decrease in dorsolateral prefrontal activity. The findings of the present study are consistent with the hypothesis of decreased frontal-striatal control of limbic structures, specifically the amygdala, resulting in an inadequate fear response in OCD patients with contamination fear.
KW - Amygdala
KW - Contamination
KW - Frontal-striatal
KW - HO
KW - OCD
KW - PET
UR - http://www.scopus.com/inward/record.url?scp=19944430471&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.pscychresns.2004.06.007
DO - https://doi.org/10.1016/j.pscychresns.2004.06.007
M3 - Article
C2 - 15664794
SN - 0925-4927
VL - 132
SP - 225
EP - 237
JO - Psychiatry Research - Neuroimaging
JF - Psychiatry Research - Neuroimaging
IS - 3
ER -