TY - JOUR
T1 - An fMRI study of cognitive planning before and after symptom provocation in pediatric obsessive–compulsive disorder
AU - Jaspers-Fayer, Fern
AU - Yao Lin, Sarah
AU - Best, John R.
AU - Thorsen, Anders Lillevik
AU - Negreiros, Juliana
AU - Chan, Elaine
AU - Ellwyn, Rhonda
AU - Lin, Boyee
AU - de Wit, Stella
AU - van den Heuvel, Odile A.
AU - Stewart, S. Evelyn
N1 - Funding Information: Acknowledgements: This work was supported by the British Columbia Funding Information: Competing interests: F. Jaspers-Fayer and E. Stewart received support from the British Columbia Children’s Hospital Research Institute and the Michael Smith Foundation for Health Research. O.A. van den Heuvel has received grants from the Netherlands Organization for Health Research (project number: 91717306) and the National Institute of Mental Health (awarded to Blair Simpson with O.A. van den Heuvel as co-applicant; project number MH113250); consultation fees from Lundbeck and honoraria from Benecke de Tijdstroom; and has participated in an advisory board for the International OCD Foundation. E. Stewart received BC Provincial Health Services Authority research funding; and served on the scientific and clinical advisory board of the International OCD Foundation, the medical advisory board of the International Tourette Association of America, the Youth Development Instrument Provincial Practice and Policy Advisory Board and the scientific advisory committee for Anxiety Canada. No other competing interests declared. Funding Information: This work was supported by the British Columbia Children’s Hospital (BCCH), the Michael Smith Foundation for Health Research, the British Columbia Provincial Health Services Authority and the Canadian Institutes of Health Research. Publisher Copyright: © 2022 CMA Impact Inc. or its licensors.
PY - 2022/11/22
Y1 - 2022/11/22
N2 - Background: Pediatric obsessive–compulsive disorder (OCD) has been associated with poorer planning in laboratory, school and home settings. It is unclear whether this impairment is a standalone cognitive issue or the result of OCD symptoms. No study has examined the influence of provoked distress on planning performance and neural correlates in pediatric OCD. Methods: Before and after a symptom provocation task, youth with OCD (n = 23; 9 boys; mean age ± standard deviation 15.1 ± 2.6 years) and matched healthy controls (n = 23) completed the Tower of London task during functional MRI scanning. Results: During planning, participants with OCD recruited the left superior frontal gyrus to a greater extent than healthy controls after symptom provocation (group × time point interaction; t 44 = 5.22, p < 0.001). In a seeded, region of interest–constrained, functional connectivity analysis, we identified greater connectivity between the left superior frontal gyrus and the right middle frontal gyrus, left precuneus and left inferior parietal lobule in participants with OCD than healthy controls. We also identified greater connectivity between the right amygdala and right medial frontal gyrus in patients with OCD than healthy controls, but only before symptom provocation. Limitations: The fixed-order design of the study and the number of participants taking medication (n = 20) should be noted. Conclusion: Participants with OCD demonstrated greater amygdalar–cortical connectivity before symptom provocation, while sustaining greater recruitment and connectivity of task-related planning areas throughout the task. These results suggest that brain activity and connectivity is altered after symptom provocation, in the absence of impaired planning performance.
AB - Background: Pediatric obsessive–compulsive disorder (OCD) has been associated with poorer planning in laboratory, school and home settings. It is unclear whether this impairment is a standalone cognitive issue or the result of OCD symptoms. No study has examined the influence of provoked distress on planning performance and neural correlates in pediatric OCD. Methods: Before and after a symptom provocation task, youth with OCD (n = 23; 9 boys; mean age ± standard deviation 15.1 ± 2.6 years) and matched healthy controls (n = 23) completed the Tower of London task during functional MRI scanning. Results: During planning, participants with OCD recruited the left superior frontal gyrus to a greater extent than healthy controls after symptom provocation (group × time point interaction; t 44 = 5.22, p < 0.001). In a seeded, region of interest–constrained, functional connectivity analysis, we identified greater connectivity between the left superior frontal gyrus and the right middle frontal gyrus, left precuneus and left inferior parietal lobule in participants with OCD than healthy controls. We also identified greater connectivity between the right amygdala and right medial frontal gyrus in patients with OCD than healthy controls, but only before symptom provocation. Limitations: The fixed-order design of the study and the number of participants taking medication (n = 20) should be noted. Conclusion: Participants with OCD demonstrated greater amygdalar–cortical connectivity before symptom provocation, while sustaining greater recruitment and connectivity of task-related planning areas throughout the task. These results suggest that brain activity and connectivity is altered after symptom provocation, in the absence of impaired planning performance.
UR - http://www.scopus.com/inward/record.url?scp=85142365240&partnerID=8YFLogxK
U2 - https://doi.org/10.1503/jpn.220064
DO - https://doi.org/10.1503/jpn.220064
M3 - Article
C2 - 36414328
SN - 1180-4882
VL - 47
SP - E409-E420
JO - Journal of Psychiatry and Neuroscience
JF - Journal of Psychiatry and Neuroscience
IS - 6
ER -