Cognitive and Neural Correlates in Obsessive Compulsive Disorder

强迫症的认知和神经相关性

• 批准号: 7509174
• 负责人: Emily R Stern
• 金额: $ 4.96万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-28 至 2010-09-27
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7509174
• 关键词: Affect; Affective; Anterior; Anxiety; Automobile Driving; Behavior; Behavioral; Biological; Brain; Brain region; Burn injury; Characteristics; Clinical; Cognitive; Cognitive Therapy; Community Healthcare; Corpus striatum structure; Decision Making; Decision Modeling; Detection; Development; Disease; Dorsal; Emotional; Emotions; Ensure; Epidemiologic Studies; Event; Exhibits; Face; Fright; Functional Magnetic Resonance Imaging; Functional disorder; Genetic; Genetic Predisposition to Disease; Goals; Hyperactive behavior; Impairment; Individual; Investigation; Lead; Link; MFC; Magnetic Resonance; Medial; Nature; Obsession; Obsessive-Compulsive Disorder; Pathology; Patients; Pattern; Performance; Prefrontal Cortex; Preventive Intervention; Probability; Process; Proxy; Quality of life; Rate; Relative (related person); Research; Resistance; Risk; Role; Series; Severities; Susceptibility Gene; Symptoms; Techniques; Testing; Therapeutic; Time; Translations; Uncertainty; Update; Work; base; caudate nucleus; cingulate cortex; cognitive neuroscience; concept; cost; design; disability; disorder prevention; emotional distress; endophenotype; experience; neuromechanism; psychologic; relating to nervous system; research study; response; reward processing; stem; trait

DESCRIPTION (provided by applicant): Pathological uncertainty is a key feature of obsessive compulsive disorder (OCD), impairing everyday decision-making in addition to driving specific obsessions and compulsions. As a potential core process in OCD, increased uncertainty may be a trait characteristic that occurs independently of symptom provocation and could be the focus of research into treatment and prevention of the disorder. Although previous research has shown that OCD patients acquire more information in order to reach a decision than healthy controls, little work has focused on elucidating the cognitive and neural mechanisms associated with abnormal decision-making in OCD. In our preliminary study, sequential pieces of evidence were requested in order to reduce uncertainty and reach a decision. Results revealed that the cost of acquiring new information and the ambiguity of the context in which information was presented were important factors influencing subjective uncertainty and evidence accumulation among control subjects. In three studies, we will test a series of hypotheses predicting that prolonged information acquisition in OCD is driven by a relative insensitivity to these factors. In the first behavioral study, we predict that increasing OC symptom severity will be associated with greater uncertainty and increased evidence accumulation, regardless of the context and cost of information search. In the second and third studies, neural activity will be examined in healthy controls and OCD patients using functional magnetic resonance imagining (fMRI), with the aim of identifying the neural mechanisms underlying the abnormal cognitive experience or emotional appraisal of uncertainty. In particular, hyperactivity in frontal regions implicated in the pathology of OCD, such as dorsomedial prefrontal cortex/anterior cingulate cortex and orbitofrontal cortex, may underlie increases in distinct cognitive and affective aspects of uncertainty processing, respectively. Results from these studies will provide a thorough characterization of OC-related decision-making behavior, enabling clinicians to refine therapeutic techniques for treatment-resistant patients. Moreover, investigation into the neural substrates of these processes may lead to the identification of biological endophenotypes of OCD and further research on genetic susceptibilities of the disorder. The significant disability and emotional distress resulting from pathological indecisiveness in OCD constitutes an important concern for the patient as well as the health care community. The investigation of uncertainty as a core process in OCD is a promising step toward advancing treatment strategies and identifying genetic factors influencing the development of the disorder.

描述（由申请人提供）：病理性不确定性是强迫症（OCD）的一个关键特征，除了驱动特定的强迫症和强迫症外，还会损害日常决策。作为强迫症的一个潜在的核心过程，增加的不确定性可能是一个独立于症状激发的特质特征，并可能成为治疗和预防该疾病的研究重点。虽然以前的研究表明，强迫症患者获得更多的信息，以达到比健康对照组的决定，很少有工作集中在阐明认知和神经机制与强迫症的异常决策。在我们的初步研究中，为了减少不确定性并做出决定，要求提供连续的证据。结果表明，获取新信息的成本和信息呈现的背景的模糊性是影响控制对象的主观不确定性和证据积累的重要因素。在三项研究中，我们将测试一系列假设，预测强迫症中长时间的信息获取是由对这些因素的相对不敏感性驱动的。在第一个行为研究中，我们预测，增加OC症状的严重程度将与更大的不确定性和增加的证据积累，无论信息搜索的背景和成本。在第二和第三项研究中，将使用功能性磁共振成像（fMRI）检查健康对照组和强迫症患者的神经活动，目的是确定异常认知体验或不确定性情绪评估的神经机制。特别是，过度活跃的额叶区域涉及的病理强迫症，如背内侧前额叶皮层/前扣带皮层和眶额皮层，可能是增加不同的认知和情感方面的不确定性处理，分别。这些研究的结果将提供OC相关决策行为的全面表征，使临床医生能够改进治疗耐药患者的治疗技术。此外，对这些过程的神经基质的调查可能会导致OCD的生物学内表型的鉴定和对该疾病的遗传易感性的进一步研究。强迫症患者的病理性犹豫不决所导致的严重残疾和情绪困扰是患者和医疗保健界的重要关注点。对不确定性作为强迫症核心过程的研究是朝着推进治疗策略和确定影响疾病发展的遗传因素迈出的有希望的一步。