Switching between internally and externally focused attention in obsessive-compulsive disorder: Abnormal visual cortex activation and connectivity.
Switching between internally and externally focused attention in obsessive-compulsive disorder: Abnormal visual cortex activation and connectivity.
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DOI：
10.1016/j.pscychresns.2016.08.006
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发表时间：
2017-07-30
期刊：
影响因子：
--
通讯作者：
Goodman WK
中科院分区：
文献类型：
--
作者：
Stern ER;Muratore AF;Taylor SF;Abelson JL;Hof PR;Goodman WK
强迫症（OCD）的特征是过度吸收内部产生的痛苦想法和冲动，难以吸收与他们的恐惧和担忧相反的外部信息。在本研究中，我们通过实验探索强迫症的这一核心特征，通过使用一种新的注意力转换任务来研究内部聚焦（IF）和外部聚焦（EF）注意状态之间的转换。18名强迫症患者和18名对照组分别想象积极和消极的个人事件情景（IF状态）或执行颜色词Stroop任务（EF状态）。在IF/EF状态之后是需要对外部刺激作出反应的目标检测（TD）任务。与对照组相比，强迫症患者在负IF后的TD过程中出现了更多的错误，并表现出枕上、下皮层、丘脑和壳核的激活减少，且与其他条件下的TD相比，负IF后TD的枕下低激活明显更大。患者表现出较强的枕下区与背内侧前额叶皮层之间的功能连通性。这些发现指出了强迫症在外部刺激的视觉处理过程中的相关损害，特别是当它们在一段时间的负面内部焦点之后，并建议未来的治疗可能希望针对注意力状态之间的转换。
Obsessive-compulsive disorder (OCD) is characterized by excessive absorption with internally-generated distressing thoughts and urges, with difficulty incorporating external information running counter to their fears and concerns. In the present study, we experimentally probed this core feature of OCD through the use of a novel attention switching task that investigates transitions between internally focused (IF) and externally focused (EF) attentional states. Eighteen OCD patients and 18 controls imagined positive and negative personal event scenarios (IF state) or performed a color-word Stroop task (EF state). The IF/EF states were followed by a target detection (TD) task requiring responses to external stimuli. Compared to controls, OCD patients made significantly more errors and showed reduced activation of superior and inferior occipital cortex, thalamus, and putamen during TD following negative IF, with the inferior occipital hypoactivation being significantly greater for TD following negative IF compared to TD following the other conditions. Patients showed stronger functional connectivity between the inferior occipital region and dorsomedial prefrontal cortex. These findings point to an OCD-related impairment in the visual processing of external stimuli specifically when they follow a period of negative internal focus, and suggest that future treatments may wish to target the transition between attentional states.