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Khedr EM, Elbeh K, Saber M, Abdelrady Z, Abdelwarith A. A double blind randomized clinical trial of the effectiveness of low frequency rTMS over right DLPFC or OFC for treatment of obsessive-compulsive disorder. J Psychiatr Res 2022; 156:122-131. [PMID: 36244200 DOI: 10.1016/j.jpsychires.2022.10.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022]
Abstract
We compared the effectiveness of low frequency repetitive transcranial magnetic stimulation over right dorsolateral prefrontal cortex (DLPFC), right orbitofrontal cortex (OFC) and sham for treatment of obsessive-compulsive disorder (OCD) and sought to determine possible predictors of effective treatment. Sixty OCD patients participated and were randomly allocated to one of the 3 treatment groups. Treatment was administered daily for 10 days. Assessments were made at the beginning and end of therapy as well as three months later using the Yale-Brown obsessive compulsive scale (Y-BOCS), Hamilton Anxiety Rating Scale (HAM-A), Beck Depression Inventory (BDI), and Clinical Global Impression - Severity scale (CGI-S). There were no significant demographic or clinical differences between the groups at baseline. One-way repeated measures ANOVA showed that participants in all 3 groups improved their scores on all rating scales following treatment. A two-way repeated measures ANOVA revealed a significant time and group interaction due to the fact that both active treatment groups outperformed the sham group, although there was no significant difference between the two. Percent improvement had significant negative correlations with the following factors: duration of illness, baseline Y-BOCS, HAM-A, and BDI. We conclude that rTMS over either right DLPFC or OFC has a therapeutic effect on OCD symptoms. Patients with lower Y-BOCS and fewer comorbidities responded best to rTMS.
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Affiliation(s)
- Eman M Khedr
- Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt; Department of Neuropsychiatry, Aswan University, Aswan, Egypt.
| | - Khaled Elbeh
- Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt
| | - Mostafa Saber
- Department of Neuropsychiatry, Aswan University, Aswan, Egypt
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Dispositional Negative Emotionality in Childhood and Adolescence Predicts Structural Variation in the Amygdala and Caudal Anterior Cingulate During Early Adulthood: Theoretically and Empirically Based Tests. Res Child Adolesc Psychopathol 2021; 49:1275-1288. [PMID: 33871795 DOI: 10.1007/s10802-021-00811-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
Substantial evidence implicates the amygdala and related structures in the processing of negative emotions. Furthermore, neuroimaging evidence suggests that variations in amygdala volumes are related to trait-like individual differences in neuroticism/negative emotionality, although many questions remain about the nature of such associations. We conducted planned tests of the directional prediction that dispositional negative emotionality measured at 10-17 years using parent and youth ratings on the Child and Adolescent Dispositions Scale (CADS) would predict larger volumes of the amygdala in adulthood and conducted exploratory tests of associations with other regions implicated in emotion processing. Participants were 433 twins strategically selected for neuroimaging during wave 2 from wave 1 of the Tennessee Twins Study (TTS) by oversampling on internalizing and/or externalizing psychopathology risk. Controlling for age, sex, race-ethnicity, handedness, scanner, and total brain volume, youth-rated negative emotionality positively predicted bilateral amygdala volumes after correction for multiple testing. Each unit difference of one standard deviation (SD) in negative emotionality was associated with a .12 SD unit difference in larger volumes of both amygdalae. Parent-rated negative emotionality predicted greater thickness of the left caudal/dorsal anterior cingulate cortex (β = 0.28). Associations of brain structure with negative emotionality were not moderated by sex. These results are striking because dispositions assessed at 10-17 years of age were predictive of grey matter volumes measured 12-13 years later in adulthood. Future longitudinal studies should examine the timing of amygdala/cingulate associations with dispositional negative emotionality to determine when these associations emerge during development.
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Xu Y, Qin W, Zhuo C, Xu L, Zhu J, Liu X, Yu C. Selective functional disconnection of the orbitofrontal subregions in schizophrenia. Psychol Med 2017; 47:1637-1646. [PMID: 28183367 DOI: 10.1017/s0033291717000101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND As a disconnection syndrome, schizophrenia has shown impaired resting-state functional connectivity (rsFC) in the orbitofrontal cortex (OFC); however, the OFC is a rather heterogeneous region and the rsFC changes in the OFC subregions remain unknown. METHOD A total of 98 schizophrenia patients and 102 healthy controls underwent resting-state functional MRI using a sensitivity-encoded spiral-in imaging sequence (SENSE-SPIRAL) to reduce susceptibility-induced signal loss and distortion. The OFC subregions were defined according to a previous parcellation study that divided the OFC into the anterior (OFCa), medial (OFCm), posterior (OFCp), intermediate (OFCi), and lateral (OFCl) subregions. The rsFC was compared using two-way repeated-measures ANOVA. RESULTS Whether or not global signal regression, compared with healthy controls, schizophrenia patients consistently exhibited decreased rsFC between the left OFCi and the left middle temporal gyrus and the right middle frontal gyrus (MFG), between the right OFCi and the right MFG and the left inferior frontal gyrus, between the right OFCm and the middle cingulate cortex and the left Rolandic operculum. These rsFC changes still remained significant even after cortical atrophy correction. CONCLUSIONS These findings suggest a selective functional disconnection of the OFC subregions in schizophrenia, and provide more precise information about the functional disconnections of the OFC in this disorder.
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Affiliation(s)
- Y Xu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - W Qin
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - C Zhuo
- Tianjin Anning Hospital,Tianjin,China
| | - L Xu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - J Zhu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - X Liu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
| | - C Yu
- Department of Radiology,Tianjin Key Laboratory of Functional Imaging,Tianjin Medical University General Hospital,Tianjin,China
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Mishra A, Anand M, Umesh S. Neurobiology of eating disorders - an overview. Asian J Psychiatr 2017; 25:91-100. [PMID: 28262179 DOI: 10.1016/j.ajp.2016.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/03/2016] [Accepted: 10/09/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Anand Mishra
- Central Institute of Psychiatry, Ranchi, Jharkhand, India.
| | - Manu Anand
- Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | - Shreekantiah Umesh
- K.S. Mani Centre for Cognitive Neurosciences, Central Institute of Psychiatry, Ranchi, Jharkhand, India
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Brosey EA, Woodward ND. Neuroanatomical correlates of perceptual aberrations in psychosis. Schizophr Res 2017; 179:125-131. [PMID: 27729190 DOI: 10.1016/j.schres.2016.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/27/2016] [Accepted: 10/01/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Aberrations in body perception are common in psychotic disorders. The insula and temporoparietal junction (TPJ) are involved in body ownership and spatial perception suggesting that abnormal structure of these regions might be related to the expression of perceptual aberrations in psychosis. METHODS 58 individuals with a primary psychotic disorder and 40 healthy subjects completed the Chapman Perceptual Aberration Scale (PAS) and underwent structural magnetic resonance imaging (MRI). Grey matter volume was extracted from a-priori defined TPJ, whole insula, and insula sub-division regions-of-interest (ROIs) and correlated with PAS scores. Additionally, a voxel-based morphometry (VBM) analysis examining the correlation between voxel-wise grey matter volume and PAS scores was conducted. RESULTS PAS scores in psychosis patients correlated with bilateral whole insula (right: r=-0.30, p=0.026; left: r=-0.35, p=0.011) and right TPJ (r=-0.27, p=0.024) volumes. The correlation between grey matter volume and PAS was strongest for the posterior sub-division of the insula (right: r=-0.32, p=0.017; left: r=-0.37, p=0.006). VBM analyses confirmed the ROI results: negative correlations with PAS were identified in clusters within the posterior and dorsal anterior insula, and the right TPJ. An exploratory, whole-brain analysis also revealed two additional regions located in the left middle orbitofrontal gyrus and left inferior temporal gyrus that inversely correlated with PAS scores. CONCLUSIONS Perceptual aberrations in individuals with psychosis are related to lower grey matter volume in the insula and TPJ. This relationship was strongest in the posterior region of the insula and right TPJ; brain areas that have been implicated in interoception and somesthesis.
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Affiliation(s)
- Erin A Brosey
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN 37212, USA
| | - Neil D Woodward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Nashville, TN 37212, USA.
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Han HJ, Jung WH, Yun JY, Park JW, Cho KK, Hur JW, Shin NY, Lee TY, Kwon JS. Disruption of effective connectivity from the dorsolateral prefrontal cortex to the orbitofrontal cortex by negative emotional distraction in obsessive-compulsive disorder. Psychol Med 2016; 46:921-932. [PMID: 26619965 DOI: 10.1017/s0033291715002391] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has been associated with abnormal cognitive and emotional functions and these dysfunctions may be dependent on the disruption of dynamic interactions within neuronal circuits associated with emotion regulation. Although several studies have shown the aberrant cognitive-affective processing in OCD patients, little is known about how to characterize effective connectivity of the disrupted neural interactions. In the present study, we applied effective connectivity analysis using dynamic causal modeling to explore the disturbed neural interactions in OCD patients. METHOD A total of 20 patients and 21 matched healthy controls performed a delayed-response working memory task under emotional or non-emotional distraction while undergoing functional magnetic resonance imaging. RESULTS During the delay interval under negative emotional distraction, both groups showed similar patterns of activations in the amygdala. However, under negative emotional distraction, the dorsolateral prefrontal cortex (DLPFC) and the orbitofrontal cortex (OFC) exhibited significant differences between groups. Bayesian model averaging indicated that the connection from the DLPFC to the OFC was negatively modulated by negative emotional distraction in patients, when compared with healthy controls (p < 0.05, Bonferroni-corrected). CONCLUSIONS Exaggerated recruitment of the DLPFC may induce the reduction of top-down prefrontal control input over the OFC, leading to abnormal cortico-cortical interaction. This disrupted cortico-cortical interaction under negative emotional distraction may be responsible for dysfunctions of cognitive and emotional processing in OCD patients and may be a component of the pathophysiology associated with OCD.
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Affiliation(s)
- H J Han
- Department of Brain and Cognitive Sciences,College of Natural Sciences,Seoul National University,Seoul,South Korea
| | - W H Jung
- Medical Research Center,Seoul National University Hospital,Seoul,South Korea
| | - J-Y Yun
- Medical Research Center,Seoul National University Hospital,Seoul,South Korea
| | - J W Park
- Department of Psychiatry,Seoul National University College of Medicine,Seoul,South Korea
| | - K K Cho
- Department of Brain and Cognitive Sciences,College of Natural Sciences,Seoul National University,Seoul,South Korea
| | - J-W Hur
- Department of Brain and Cognitive Sciences,College of Natural Sciences,Seoul National University,Seoul,South Korea
| | - N Y Shin
- Medical Research Center,Seoul National University Hospital,Seoul,South Korea
| | - T Y Lee
- Medical Research Center,Seoul National University Hospital,Seoul,South Korea
| | - J S Kwon
- Department of Brain and Cognitive Sciences,College of Natural Sciences,Seoul National University,Seoul,South Korea
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Emotion regulation and trait anxiety are predicted by the microstructure of fibers between amygdala and prefrontal cortex. J Neurosci 2015; 35:6020-7. [PMID: 25878275 DOI: 10.1523/jneurosci.3659-14.2015] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Diffusion tensor imaging revealed that trait anxiety predicts the microstructural properties of a prespecified fiber tract between the amygdala and the perigenual anterior cingulate cortex. Besides this particular pathway, it is likely that other pathways are also affected. We investigated white matter differences in persons featuring an anxious or a nonanxious personality, taking into account all potential pathway connections between amygdala and anxiety-related regions of the prefrontal cortex (PFC). Diffusion-weighted images, measures of trait anxiety and of reappraisal use (an effective emotion-regulation style), were collected in 48 females. With probabilistic tractography, pathways between the amygdala and the dorsolateral PFC, dorsomedial PFC, ventromedial PFC, and orbitofrontal cortex (OFC) were delineated. The resulting network showed a direct ventral connection between amygdala and PFC and a second limbic connection following the fornix and the anterior limb of the internal capsule. Reappraisal use predicted the microstructure of pathways to all calculated PFC regions in the left hemisphere, indicating stronger pathways for persons with high reappraisal use. Trait anxiety predicted the microstructure in pathways to the ventromedial PFC and OFC, indexing weaker connections in trait-anxious persons. These effects appeared in the right hemisphere, supporting lateralization and top-down inhibition theories of emotion processing. Whereas a specific microstructure is associated with an anxious personality, a different structure subserves emotion regulation. Both are part of a broad fiber tract network between amygdala and PFC.
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Torrado M, Ouakinin S. Maturação Orbitofrontal, Marcadores Somáticos e Vulnerabilidade Precoce: para uma Hipótese Compreensiva de "Miopia Emocional" na Toxicodependência. PSICOLOGIA: TEORIA E PESQUISA 2015. [DOI: 10.1590/0102-37722015011713097104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A hipótese de “miopia emocional” constitui uma reflexão teórica de compreensão da vulnerabilidade psicológica identificada em muitos toxicodependentes. Propõe-se uma cooperação, mas não incorporação, de níveis de conhecimento em torno dos determinantes do neurodesenvolvimento, de perspectivas psicanalíticas e de vinculação e de modelos psicobiológicos das toxicodependências. Salientam-se influências ambientais sobre as mudanças na morfologia cerebral, não apenas o trauma precoce ou a privação de cuidados, mas também as decorrentes de consumos abusivos como cernes de vulnerabilidade. Propõe-se que a hipótese Damasiana dos marcadores somáticos participe nessa formulação. A parca qualidade das interações precoces pode sustentar o desligamento afetivo progressivo, a hipomaturação do cérebro social, o incremento de um padrão alexitímico e a procura urgente de sensações, todos potenciais propiciadores da busca do prazer nas drogas.
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Medial frontal white and gray matter contributions to general intelligence. PLoS One 2014; 9:e112691. [PMID: 25551572 PMCID: PMC4281236 DOI: 10.1371/journal.pone.0112691] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/09/2014] [Indexed: 11/19/2022] Open
Abstract
The medial orbitofrontal cortex (mOFC) and rostral anterior cingulate cortex (rACC) are part of a wider neural network that plays an important role in general intelligence and executive function. We used structural brain imaging to quantify magnetic resonance gray matter volume and diffusion tensor white matter integrity of the mOFC-rACC network in 26 healthy participants who also completed neuropsychological tests of intellectual abilities and executive function. Stochastic tractography, the most effective Diffusion Tensor Imaging method for examining white matter connections between adjacent gray matter regions, was employed to assess the integrity of mOFC-rACC pathways. Fractional anisotropy (FA), which reflects the integrity of white matter connections, was calculated. Results indicated that higher intelligence correlated with greater gray matter volumes for both mOFC and rACC, as well as with increased FA for left posterior mOFC-rACC connectivity. Hierarchical regression analyses revealed that DTI-derived FA of left posterior mOFC-rACC uniquely accounted for 29%–34% of the variance in IQ, in comparison to 11%–16% uniquely explained by gray matter volume of the left rACC. Together, left rACC gray matter volume and white matter connectivity between left posterior mOFC and rACC accounted for up to 50% of the variance in general intelligence. This study is to our knowledge the first to examine white matter connectivity between OFC and ACC, two gray matter regions of interests that are very close in physical proximity, and underscores the important independent contributions of variations in rACC gray matter volume and mOFC-rACC white matter connectivity to individual differences in general intelligence.
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Zald DH, McHugo M, Ray KL, Glahn DC, Eickhoff SB, Laird AR. Meta-analytic connectivity modeling reveals differential functional connectivity of the medial and lateral orbitofrontal cortex. ACTA ACUST UNITED AC 2012; 24:232-48. [PMID: 23042731 DOI: 10.1093/cercor/bhs308] [Citation(s) in RCA: 117] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The orbitofrontal cortex (OFC) is implicated in a broad range of behaviors and neuropsychiatric disorders. Anatomical tracing studies in nonhuman primates reveal differences in connectivity across subregions of the OFC, but data on the connectivity of the human OFC remain limited. We applied meta-analytic connectivity modeling in order to examine which brain regions are most frequently coactivated with the medial and lateral portions of the OFC in published functional neuroimaging studies. The analysis revealed a clear divergence in the pattern of connectivity for the medial OFC (mOFC) and lateral OFC (lOFC) regions. The lOFC showed coactivations with a network of prefrontal regions and areas involved in cognitive functions including language and memory. In contrast, the mOFC showed connectivity with default mode, autonomic, and limbic regions. Convergent patterns of coactivations were observed in the amygdala, hippocampus, striatum, and thalamus. A small number of regions showed connectivity specific to the anterior or posterior sectors of the OFC. Task domains involving memory, semantic processing, face processing, and reward were additionally analyzed in order to identify the different patterns of OFC functional connectivity associated with specific cognitive and affective processes. These data provide a framework for understanding the human OFC's position within widespread functional networks.
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Melloni M, Urbistondo C, Sedeño L, Gelormini C, Kichic R, Ibanez A. The extended fronto-striatal model of obsessive compulsive disorder: convergence from event-related potentials, neuropsychology and neuroimaging. Front Hum Neurosci 2012; 6:259. [PMID: 23015786 PMCID: PMC3449438 DOI: 10.3389/fnhum.2012.00259] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Accepted: 08/30/2012] [Indexed: 11/09/2022] Open
Abstract
In this work, we explored convergent evidence supporting the fronto-striatal model of obsessive-compulsive disorder (FSMOCD) and the contribution of event-related potential (ERP) studies to this model. First, we considered minor modifications to the FSMOCD model based on neuroimaging and neuropsychological data. We noted the brain areas most affected in this disorder -anterior cingulate cortex (ACC), basal ganglia (BG), and orbito-frontal cortex (OFC) and their related cognitive functions, such as monitoring and inhibition. Then, we assessed the ERPs that are directly related to the FSMOCD, including the error-related negativity (ERN), N200, and P600. Several OCD studies present enhanced ERN and N2 responses during conflict tasks as well as an enhanced P600 during working memory (WM) tasks. Evidence from ERP studies (especially regarding ERN and N200 amplitude enhancement), neuroimaging and neuropsychological findings suggests abnormal activity in the OFC, ACC, and BG in OCD patients. Moreover, additional findings from these analyses suggest dorsolateral prefrontal and parietal cortex involvement, which might be related to executive function (EF) deficits. Thus, these convergent results suggest the existence of a self-monitoring imbalance involving inhibitory deficits and executive dysfunctions. OCD patients present an impaired ability to monitor, control, and inhibit intrusive thoughts, urges, feelings, and behaviors. In the current model, this imbalance is triggered by an excitatory role of the BG (associated with cognitive or motor actions without volitional control) and inhibitory activity of the OFC as well as excessive monitoring of the ACC to block excitatory impulses. This imbalance would interact with the reduced activation of the parietal-DLPC network, leading to executive dysfunction. ERP research may provide further insight regarding the temporal dynamics of action monitoring and executive functioning in OCD.
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Affiliation(s)
- Margherita Melloni
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO) and Institute of Neuroscience, Favaloro University Buenos Aires, Argentina
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Abramovitch A, Mittelman A, Henin A, Geller D. Neuroimaging and neuropsychological findings in pediatric obsessive–compulsive disorder: a review and developmental considerations. ACTA ACUST UNITED AC 2012. [DOI: 10.2217/npy.12.40] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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The root of all value: a neural common currency for choice. Curr Opin Neurobiol 2012; 22:1027-38. [PMID: 22766486 DOI: 10.1016/j.conb.2012.06.001] [Citation(s) in RCA: 666] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 05/30/2012] [Accepted: 06/10/2012] [Indexed: 11/23/2022]
Abstract
How do humans make choices between different types of rewards? Economists have long argued on theoretical grounds that humans typically make these choices as if the values of the options they consider have been mapped to a single common scale for comparison. Neuroimaging studies in humans have recently begun to suggest the existence of a small group of specific brain sites that appear to encode the subjective values of different types of rewards on a neural common scale, almost exactly as predicted by theory. We have conducted a meta analysis using data from thirteen different functional magnetic resonance imaging studies published in recent years and we show that the principle brain area associated with this common representation is a subregion of the ventromedial prefrontal cortex (vmPFC)/orbitofrontal cortex (OFC). The data available today suggest that this common valuation path is a core system that participates in day-to-day decision making suggesting both a neurobiological foundation for standard economic theory and a tool for measuring preferences neurobiologically. Perhaps even more exciting is the possibility that our emerging understanding of the neural mechanisms for valuation and choice may provide fundamental insights into pathological choice behaviors like addiction, obesity and gambling.
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Ray RD, Zald DH. Anatomical insights into the interaction of emotion and cognition in the prefrontal cortex. Neurosci Biobehav Rev 2012; 36:479-501. [PMID: 21889953 PMCID: PMC3244208 DOI: 10.1016/j.neubiorev.2011.08.005] [Citation(s) in RCA: 247] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Revised: 08/16/2011] [Accepted: 08/17/2011] [Indexed: 11/30/2022]
Abstract
Psychological research increasingly indicates that emotional processes interact with other aspects of cognition. Studies have demonstrated both the ability of emotional stimuli to influence a broad range of cognitive operations, and the ability of humans to use top-down cognitive control mechanisms to regulate emotional responses. Portions of the prefrontal cortex appear to play a significant role in these interactions. However, the manner in which these interactions are implemented remains only partially elucidated. In the present review we describe the anatomical connections between ventral and dorsal prefrontal areas as well as their connections with limbic regions. Only a subset of prefrontal areas are likely to directly influence amygdalar processing, and as such models of prefrontal control of emotions and models of emotional regulation should be constrained to plausible pathways of influence. We also focus on how the specific pattern of feedforward and feedback connections between these regions may dictate the nature of information flow between ventral and dorsal prefrontal areas and the amygdala. These patterns of connections are inconsistent with several commonly expressed assumptions about the nature of communications between emotion and cognition.
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Affiliation(s)
- Rebecca D Ray
- Department of Psychiatry, University of Wisconsin, Madison, 6001 Research Park Boulevard, Madison, WI 53711, USA
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Social deficits and perseverative behaviors, but not overt aggression, in MAO-A hypomorphic mice. Neuropsychopharmacology 2011; 36:2674-88. [PMID: 21832987 PMCID: PMC3230491 DOI: 10.1038/npp.2011.157] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Monoamine oxidase (MAO)-A is a key enzyme for the degradation of brain serotonin (5-hydroxytryptamine, 5-HT) and norepinephrine (NE). In humans and mice, total MAO-A deficiency results in high 5-HT and NE levels, as well as elevated reactive aggression. Here we report the generation of MAO-A(Neo) mice, a novel line of hypomorphic MAO-A mutants featuring the insertion of a floxed neomycin-resistance cassette in intron-12 of the Maoa gene. This construct resulted in a chimeric, non-functional variant of the Maoa-Neo transcript, with a truncated C-terminus, likely due to aberrant splicing; these deficits notwithstanding, small amounts of functional Maoa transcript were found in the brain of MAO-A(Neo) mice. In the prefrontal cortex and amygdala, MAO-A(Neo) mice showed low, yet detectable, MAO-A catalytic activity, as well as 5-HT levels equivalent to WT littermates; conversely, the hippocampus and midbrain of MAO-A(Neo) mice featured a neurochemical profile akin to MAO-A-knockout (KO) mice, with undetectable MAO-A activity and high 5-HT concentrations. MAO-A(Neo) mice showed significant increases in dendritic length in the pyramidal neurons of orbitofrontal cortex, but not basolateral amygdala, in comparison with WT littermates; by contrast, the orbitofrontal cortex of MAO-A KO mice showed significant reductions in basilar dendritic length, as well as a profound increase in apical dendritic length. MAO-A(Neo) mice showed a unique set of behavioral abnormalities, encompassing reduced open-field locomotion, perseverative responses, such as marble burying and water mist-induced grooming, and a lack of anxiety-like behaviors in the elevated plus-maze and light-dark box paradigms. Notably, whereas MAO-A(Neo) and KO mice showed significant reductions in social interaction, only the latter genotype showed increases in resident-intruder aggression. Taken together, our findings indicate that MAO A hypomorphism results in behavioral and morphological alterations distinct from those featured by MAO-A KO mice.
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Parvaz MA, Alia-Klein N, Woicik PA, Volkow ND, Goldstein RZ. Neuroimaging for drug addiction and related behaviors. Rev Neurosci 2011; 22:609-24. [PMID: 22117165 PMCID: PMC3462350 DOI: 10.1515/rns.2011.055] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In this review, we highlight the role of neuroimaging techniques in studying the emotional and cognitive-behavioral components of the addiction syndrome by focusing on the neural substrates subserving them. The phenomenology of drug addiction can be characterized by a recurrent pattern of subjective experiences that includes drug intoxication, craving, bingeing, and withdrawal with the cycle culminating in a persistent preoccupation with obtaining, consuming, and recovering from the drug. In the past two decades, imaging studies of drug addiction have demonstrated deficits in brain circuits related to reward and impulsivity. The current review focuses on studies employing positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and electroencephalography (EEG) to investigate these behaviors in drug-addicted human populations. We begin with a brief account of drug addiction followed by a technical account of each of these imaging modalities. We then discuss how these techniques have uniquely contributed to a deeper understanding of addictive behaviors.
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Affiliation(s)
- Muhammad A. Parvaz
- Medical Department, Brookhaven National Laboratory, 30 Bell Ave., Bldg. 490, Upton, NY 11973-5000, USA
| | - Nelly Alia-Klein
- Medical Department, Brookhaven National Laboratory, 30 Bell Ave., Bldg. 490, Upton, NY 11973-5000, USA
| | - Patricia A. Woicik
- Medical Department, Brookhaven National Laboratory, 30 Bell Ave., Bldg. 490, Upton, NY 11973-5000, USA
| | - Nora D. Volkow
- National Institute of Drug Abuse, Bethesda, MD 20892, USA
| | - Rita Z. Goldstein
- Medical Department, Brookhaven National Laboratory, 30 Bell Ave., Bldg. 490, Upton, NY 11973-5000, USA
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Atmaca M, Yildirim H, Koc M, Korkmaz S, Ozler S, Erenkus Z. Do defense styles of ego relate to volumes of orbito-frontal cortex in patients with obsessive-compulsive disorder? Psychiatry Investig 2011; 8:123-9. [PMID: 21852988 PMCID: PMC3149106 DOI: 10.4306/pi.2011.8.2.123] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 12/29/2010] [Accepted: 01/14/2011] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Although the importance of orbito-frontal cortex (OFC) is established in the pathogenesis of obsessive compulsive disorder (OCD), no study have evaluated its relation to the traditional psychodynamic perspective. In the present study, we aimed to evaluate the relationship between the defense styles consisting of mature, immature and neurotic defenses and OFC volumes of patients with OCD. METHODS Subjects were selected among those of our previous study, and so eighteen patients with OCD and same number of healthy controls were took into the study. The patients and controls had underwent magnetic resonance imaging (MRI). In addition, the Defense Style Questionnaire-40 was administered to obtain defense styles of patients and controls. RESULTS No significant relationship was found between the right OFC volumes of both the patient and control groups and their scores of mature, neurotic, or immature defense mechanisms. As for the left OFC volumes, the only significant relationship for the scores of immature defense mechanism was found in the patient group. CONCLUSION The results of the present study indicated that there was no significant relationship between OFC volumes of the patient group and their scores of mature, neurotic, or immature defense mechanisms, except a significant relation with the scores of immature defense mechanisms.
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Affiliation(s)
- Murad Atmaca
- Department of Psychiatry, School of Medicine, Firat University, Elazig, Turkey
| | - Hanefi Yildirim
- Department of Radiology, School of Medicine, Firat University, Elazig, Turkey
| | - Mustafa Koc
- Department of Radiology, School of Medicine, Firat University, Elazig, Turkey
| | - Sevda Korkmaz
- Department of Psychiatry, School of Medicine, Firat University, Elazig, Turkey
| | - Sinan Ozler
- Department of Psychiatry, School of Medicine, Firat University, Elazig, Turkey
| | - Zehra Erenkus
- Department of Biostatistics, School of Medicine, Hacettepe University, Ankara, Turkey
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Atmaca M, Onalan E, Yildirim H, Yuce H, Koc M, Korkmaz S, Mermi O. Serotonin transporter gene polymorphism implicates reduced orbito-frontal cortex in obsessive-compulsive disorder. J Anxiety Disord 2011; 25:680-5. [PMID: 21441009 DOI: 10.1016/j.janxdis.2011.03.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 02/26/2011] [Accepted: 03/01/2011] [Indexed: 12/16/2022]
Abstract
Although a number of magnetic resonance imaging (MRI) and genetic studies have been performed on obsessive-compulsive disorder (OCD), only limited studies in which genetic and neuroanatomical variables are evaluated concurrently have been performed. Therefore, the aim of our present study is (to understand) better understanding how genetic variation in the promoter region of the 5-HTT gene (5-HTTLPR) is associated with key brain structures in OCD, orbito-frontal cortex (OFC), thalamus and anterior cingulate. 5-HTT genotypes (SS, SL, LL) were determined for 40 patients with OCD and the same number of healthy controls. MRI-derived volumes of the OFC, thalamus, and anterior cingulate were determined by reliable tracing techniques. Volumetric measurements were made with T1-weighted coronal MRI images, with 1.5-mm-thick slices, at 1.5T, and were done blindly. In comparison with controls, OCD patients demonstrated volumes reduction in OFC, increased volumes of thalamus and total white matter volumes, but no difference in total brain volume, total gray matter volumes and anterior cingulate volumes. No significant difference was observed in allelic frequencies between the patients and controls. The stronger effects of 5-HTT polymorphism on brain morphology in OCD than those in controls were determined in the both OFC and thalamus. On the other hand, for the OCD patients, ANCOVA revealed a significant main effect of genotype for both the OFC and thalamus and a significant genotype-by-side interaction for the OFC, demonstrating that the short variants had a smaller right OFC than the long variants. In conclusion, we found a significant genotype-diagnosis interaction effects on key brain structures, with a stronger effects of 5-HTT polymorphism in OFC and thalamus of OCD patients, whereas no morphological changes related to the polymorphism were found in normal individuals.
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Affiliation(s)
- Murad Atmaca
- Firat University School of Medicine Department of Psychiatry, Elazig, Turkey.
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19
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Karadag F, Tumkaya S, Kırtaş D, Efe M, Alacam H, Oguzhanoglu NK. Neurological soft signs in obsessive compulsive disorder with good and poor insight. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1074-9. [PMID: 21396423 DOI: 10.1016/j.pnpbp.2011.03.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 01/29/2011] [Accepted: 03/03/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Obsessive compulsive disorder (OCD) is a clinically heterogeneous disorder; OCD with poor insight has been suggested to be a specific clinical subtype. Neurological soft signs (NSSs) may be helpful to identify the specific subtypes of OCD patients. METHODS In the present study, we aimed to compare OCD patients with poor insight with OCD patients having good insight, and healthy individuals. Sixty-four OCD patients (38 with good insight and 26 with poor insight), and 32 healthy subjects were enrolled in the present study. The Overvalued Ideas Scale (OVIS) was used to determine OCD patients with poor insight. NSSs were assessed by using the Neurological Evaluation Scale (NES). RESULTS Two OCD groups had significantly higher total NES scores compared to controls (p=.000). Compared to healthy controls, OCD patients with poor insight performed significantly worse on all NES subscales, and they had significantly more NSSs on motor coordination, and sensory integration subscales compared to the OCD with good insight group. CONCLUSION Our results suggested that OCD patients with poor insight exhibit more extensive neurodevelopmental impairments compared to OCD patients with good insight.
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Affiliation(s)
- Filiz Karadag
- Pamukkale University, Medicine Faculty, Psychiatry Department, Doktorlar Cd. 20100 Denizli, Turkey.
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20
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Treadway MT, Zald DH. Reconsidering anhedonia in depression: lessons from translational neuroscience. Neurosci Biobehav Rev 2010; 35:537-55. [PMID: 20603146 DOI: 10.1016/j.neubiorev.2010.06.006] [Citation(s) in RCA: 918] [Impact Index Per Article: 65.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 06/25/2010] [Accepted: 06/28/2010] [Indexed: 01/14/2023]
Abstract
Anhedonia is a core symptom of major depressive disorder (MDD), the neurobiological mechanisms of which remain poorly understood. Despite decades of speculation regarding the role of dopamine (DA) in anhedonic symptoms, empirical evidence has remained elusive, with frequent reports of contradictory findings. In the present review, we argue that this has resulted from an underspecified definition of anhedonia, which has failed to dissociate between consummatory and motivational aspects of reward behavior. Given substantial preclinical evidence that DA is involved primarily in motivational aspects of reward, we suggest that a refined definition of anhedonia that distinguishes between deficits in pleasure and motivation is essential for the purposes of identifying its neurobiological substrates. Moreover, bridging the gap between preclinical and clinical models of anhedonia may require moving away from the conceptualization of anhedonia as a steady-state, mood-like phenomena. Consequently, we introduce the term "decisional anhedonia" to address the influence of anhedonia on reward decision-making. These proposed modifications to the theoretical definition of anhedonia have implications for research, assessment and treatment of MDD.
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Affiliation(s)
- Michael T Treadway
- Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA.
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MacMaster F, Vora A, Easter P, Rix C, Rosenberg D. Orbital frontal cortex in treatment-naïve pediatric obsessive-compulsive disorder. Psychiatry Res 2010; 181:97-100. [PMID: 20074911 PMCID: PMC2830852 DOI: 10.1016/j.pscychresns.2009.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Revised: 07/13/2009] [Accepted: 08/28/2009] [Indexed: 11/15/2022]
Abstract
The orbital frontal cortex (OFC) has been implicated in obsessive-compulsive disorder (OCD). Participants comprised 28 treatment-naïve pediatric OCD patients and 21 controls, who were examined using magnetic resonance imaging. OCD patients had larger right but not left OFC white matter volume than controls. This is fresh evidence implicating white matter in OCD.
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Affiliation(s)
| | | | | | | | - David Rosenberg
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, 9B-UHC, 4201 St. Antoine, Detroit, MI 48201; fax: 313-577-5900, telephone: 313-577-9000, and
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22
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Park JY, Gu BM, Kang DH, Shin YW, Choi CH, Lee JM, Kwon JS. Integration of cross-modal emotional information in the human brain: An fMRI study. Cortex 2010; 46:161-9. [DOI: 10.1016/j.cortex.2008.06.008] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2008] [Revised: 06/01/2008] [Accepted: 06/20/2008] [Indexed: 11/15/2022]
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23
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Orbitofrontal cortex contributions to food selection and decision making. Ann Behav Med 2009; 38 Suppl 1:S18-24. [PMID: 19787309 DOI: 10.1007/s12160-009-9117-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND From a neuroeconomics perspective, decisions about what to eat are ultimately determined by basic features of how the brain codes and contrasts the values of different rewards and the potential positive or negative consequences of eating the food. Several brain regions play a role in this valuation and comparison process. Among these regions, the orbitofrontal cortex (OFC), which occupies the ventral surface of the frontal lobe, plays a critical integrative role in these processes. An examination of the influences on valuation both within the OFC and in related brain regions reveals several features that are likely to impact food selection. These include coding of rewards relative to other available rewards, general and specific satiety, and temporal discounting. The OFC also processes information about negative valuations (i.e., cost, negative health consequences), which are influenced by factors such as temporal discounting, probability and ambiguity. CONCLUSION An understanding of these influences on positive and negative valuation is critical in designing diets and public health programs aimed at promoting healthy eating.
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van Kuyck K, Gérard N, Van Laere K, Casteels C, Pieters G, Gabriëls L, Nuttin B. Towards a neurocircuitry in anorexia nervosa: evidence from functional neuroimaging studies. J Psychiatr Res 2009; 43:1133-45. [PMID: 19442986 DOI: 10.1016/j.jpsychires.2009.04.005] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2008] [Revised: 04/06/2009] [Accepted: 04/14/2009] [Indexed: 11/19/2022]
Abstract
Functional neuroimaging is widely used to unravel changes in brain functioning in psychiatric disorders. In the current study, we review single-photon emission tomography (SPECT), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) studies in anorexia nervosa (AN), a difficult-to-treat eating disorder with the highest mortality rate among psychiatric disorders. We discuss the role of the parietal cortex, anterior and subgenual cingulate cortex, frontal cortex and temporal lobe in light of the cardinal symptoms of AN. The insights of the current review may ultimately lead to the development of new treatments.
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Affiliation(s)
- Kris van Kuyck
- Laboratory for Experimental Functional Neurosurgery, Department of Neurosciences, K.U.Leuven Provisorium I, Minderbroedersstraat 17, 3000 Leuven, Belgium.
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25
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Nakao T, Nakagawa A, Nakatani E, Nabeyama M, Sanematsu H, Yoshiura T, Togao O, Tomita M, Masuda Y, Yoshioka K, Kuroki T, Kanba S. Working memory dysfunction in obsessive-compulsive disorder: a neuropsychological and functional MRI study. J Psychiatr Res 2009; 43:784-91. [PMID: 19081580 DOI: 10.1016/j.jpsychires.2008.10.013] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Revised: 10/31/2008] [Accepted: 10/31/2008] [Indexed: 11/20/2022]
Abstract
Previous neuropsychological studies indicate that OCD subtypes such as checking rituals might be associated with a working memory deficit. On the other hand, functional neuroimaging studies found functional abnormalities of the frontal cortex and subcortical structures in OCD. Combined with functional imaging method, we applied neuropsychological batteries to demonstrate a working memory deficit in OCD by comparison with normal controls. In addition, working memory and brain activation were further examined with symptom-based analysis. Forty patients with OCD and 25 normal controls were examined using neuropsychological tests including the WAIS-R, WCST, WMS-R, and R-OCFT and functional MRI (fMRI) during the N-back task including 0- and 2-back task. On fMRI, the brain regions activated during the performance and the differences in the activation between patients and controls were identified. Additional analyses of severity and subtypes were conducted by using Y-BOCS severity score, symptom-checklist and Leckman's four-factor model, respectively. On the neuropsychological tests, the OCD patients had significantly lower scores on the delayed recall section of the WMS-R and the immediate recall section of the R-OCFT compared to the controls. On fMRI, the patients showed greater activation in the right dorsolateral prefrontal cortex (DLPFC), left superior temporal gyrus (STG), left insula, and cuneus during two-back task compared to the controls. Right orbitofrontal cortex activity showed a significant positive correlation with Y-BOCS scores in OCD. Furthermore, patients with obsessions/checking rituals (n=10) showed severer memory deficits and decreased activity in the postcentral gyrus than patients with cleanliness/washing rituals (n=14). In conclusion, we found neuropsychological dysfunction and brain abnormalities in OCD. Furthermore, our results suggested that symptom severity and symptom subtype such as obsessions/checking might affect neuropsychological dysfunction and related brain activities.
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Affiliation(s)
- Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
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26
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Rotge JY, Guehl D, Dilharreguy B, Tignol J, Bioulac B, Allard M, Burbaud P, Aouizerate B. Meta-analysis of brain volume changes in obsessive-compulsive disorder. Biol Psychiatry 2009; 65:75-83. [PMID: 18718575 DOI: 10.1016/j.biopsych.2008.06.019] [Citation(s) in RCA: 213] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2008] [Revised: 06/19/2008] [Accepted: 06/24/2008] [Indexed: 11/18/2022]
Abstract
BACKGROUND Many neuroimaging studies exploring the volumes of brain structures in obsessive-compulsive disorder (OCD) have been published in the past 2 decades. In this study, we attempted to provide a complete overview of structural alterations in OCD by meta-analyzing magnetic resonance imaging (MRI) data. METHODS We conducted a systematic search of MRI studies that reported volumetric measurements in both OCD patients and healthy subjects. Data were entered into the meta-analysis through calculation of the standardized mean differences (SMDs) between the volumes of cerebral regions in OCD patients and the corresponding volumes in control subjects. We then performed a meta-regression to explore the influence of clinical covariates on effect sizes. RESULTS Although no volumetric differences were found for the whole brain, intracranial region, gray matter, or prefrontal cortex, OCD patients did show a reduced volume of the left anterior cingulate cortex (ACC) and the left and right orbitofrontal cortex (OFC). No significant volumetric differences within the basal ganglia were observed, although the left and right thalamic volumes were significantly increased in OCD patients. The severity of obsessive or compulsive symptoms correlated significantly with the effect sizes for the left and right thalamus. CONCLUSIONS Our findings indicate volumetric differences between OCD patients and control subjects in the cortical and thalamic regions, suggesting that structural alteration of the thalamocortical pathways may contribute to the functional disruptions of frontosubcortical circuits observed in OCD.
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Affiliation(s)
- Jean-Yves Rotge
- Laboratoire Mouvement Adaptation Cognition, CNRS UMR 5227, Université Bordeaux and Service Universitaire de Psychiatrie, Centre Hospitalier Charles Perrens, Bordeaux, France.
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27
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Pain-related effects of trait anger expression: neural substrates and the role of endogenous opioid mechanisms. Neurosci Biobehav Rev 2008; 33:475-91. [PMID: 19146872 DOI: 10.1016/j.neubiorev.2008.12.003] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Revised: 10/17/2008] [Accepted: 12/15/2008] [Indexed: 11/23/2022]
Abstract
Literature is reviewed indicating that greater tendency to manage anger via direct verbal or physical expression (trait anger-out) is associated with increased acute and chronic pain responsiveness. Neuroimaging data are overviewed supporting overlapping neural circuits underlying regulation of both pain and anger, consisting of brain regions including the rostral anterior cingulate cortex, orbitofrontal cortex, anterior insula, amygdala, and periaqueductal gray. These circuits provide a potential neural basis for observed positive associations between anger-out and pain responsiveness. The role of endogenous opioids in modulating activity in these interlinked brain regions is explored, and implications for understanding pain-related effects of anger-out are described. An opioid dysfunction hypothesis is presented in which inadequate endogenous opioid inhibitory activity in these brain regions contributes to links between trait anger-out and pain. A series of studies is presented that supports the opioid dysfunction hypothesis, further suggesting that gender and genetic factors may moderate these effects. Finally, possible implications of interactions between trait anger-out and state behavioral anger expression on endogenous opioid analgesic activity are described.
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28
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Ochsner KN. The social-emotional processing stream: five core constructs and their translational potential for schizophrenia and beyond. Biol Psychiatry 2008; 64:48-61. [PMID: 18549876 PMCID: PMC2453243 DOI: 10.1016/j.biopsych.2008.04.024] [Citation(s) in RCA: 226] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 03/21/2008] [Accepted: 04/21/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cognitive neuroscience approaches to translational research have made great strides toward understanding basic mechanisms of dysfunction and their relation to cognitive deficits, such as thought disorder in schizophrenia. The recent emergence of Social Cognitive and Affective Neuroscience has paved the way for similar progress to be made in explaining the mechanisms underlying the social and emotional dysfunctions (i.e., negative symptoms) of schizophrenia and that characterize virtually all DSM Axis I and II disorders more broadly. METHODS This article aims to provide a roadmap for this work by distilling from the emerging literature on the neural bases of social and emotional abilities a set of key constructs that can be used to generate questions about the mechanisms of clinical dysfunction in general and schizophrenia in particular. RESULTS To achieve these aims, the first part of this article sketches a framework of five constructs that comprise a social-emotional processing stream. The second part considers how future basic research might flesh out this framework and translational work might relate it to schizophrenia and other clinical populations. CONCLUSIONS Although the review suggests there is more basic research needed for each construct, two in particular--one involving the bottom-up recognition of social and emotional cues, the second involving the use of top-down processes to draw mental state inferences--are most ready for translational work.
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Affiliation(s)
- Kevin N Ochsner
- Department of Psychology, Columbia University, New York, New York 10027, USA.
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29
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Minagawa-Kawai Y, Matsuoka S, Dan I, Naoi N, Nakamura K, Kojima S. Prefrontal Activation Associated with Social Attachment: Facial-Emotion Recognition in Mothers and Infants. Cereb Cortex 2008; 19:284-92. [DOI: 10.1093/cercor/bhn081] [Citation(s) in RCA: 186] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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30
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Yoo SY, Roh MS, Choi JS, Kang DH, Ha TH, Lee JM, Kim IY, Kim SI, Kwon JS. Voxel-based morphometry study of gray matter abnormalities in obsessive-compulsive disorder. J Korean Med Sci 2008; 23:24-30. [PMID: 18303194 PMCID: PMC2526479 DOI: 10.3346/jkms.2008.23.1.24] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To examine regional abnormalities in the brains of patients with obsessive-compulsive disorder (OCD), we assessed the gray matter (GM) density using voxel-based morphometry (VBM). We compared magnetic resonance images (MRIs) acquired from 71 OCD patients and 71 age- and gender-matched normal controls and examined the relationship between GM density and various clinical variables in OCD patients. We also investigated whether GM density differs among the subtypes of OCD compared to healthy controls. We detected significant reduction of GM in the inferior frontal gyrus, the medial frontal gyrus, the insula, the cingulate gyrus, and the superior temporal gyrus of OCD patients. A significant increase in GM density was observed in the postcentral gyrus, the thalamus, and the putamen. Some of these regions, including the insular and postcentral gyrus, were also associated with the severity of obsessive- compulsive symptoms. These findings indicate that the frontal-subcortical circuitry is dysfunctional in OCD, and suggest that the parietal cortex may play a role in the pathophysiology of this disease.
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Affiliation(s)
- So Young Yoo
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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31
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Saito Y, Nobuhara K, Okugawa G, Takase K, Sugimoto T, Horiuchi M, Ueno C, Maehara M, Omura N, Kurokawa H, Ikeda K, Tanigawa N, Sawada S, Kinoshita T. Corpus callosum in patients with obsessive-compulsive disorder: diffusion-tensor imaging study. Radiology 2008; 246:536-42. [PMID: 18180336 DOI: 10.1148/radiol.2462061469] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively examine microstructural white matter abnormalities in the corpus callosum (CC) of patients with obsessive-compulsive disorder (OCD), as compared with control subjects, and to investigate the relationship between diffusion-tensor (DT) imaging measures of the CC region and clinical symptoms of OCD. MATERIALS AND METHODS Institutional review board approval was obtained, and each participant--or the participant's parent(s)--provided written informed consent. Sixteen patients with OCD (seven male, nine female; mean age, 28.7 years +/- 9.8 [standard deviation]) and 16 matched healthy volunteers (control subjects) (seven male, nine female; mean age, 29.9 years +/- 9.0) were examined. Mean diffusivity and fractional anisotropy (FA) were measured in five subdivisions of the CC. The paired t test was performed to compare the mean diffusivity or the FA in CC regions between the patients with OCD and the control subjects. RESULTS There were no significant differences (rostrum, P = .15; genu, P = .88; rostral body, P = .12; isthmus, P = .77; splenium, P = .88) in mean diffusivity between the patients with OCD and the healthy volunteers. A significant reduction in FA was observed in the rostrum of the CC in patients with OCD compared with the rostral FA in the control subjects (P < .001). Higher FA in only the rostrum correlated significantly with lower Yale-Brown obsessive-compulsive scale score (r = -0.72, P = .002). CONCLUSION Study results support the widely held view that the orbital prefrontal region is involved in the pathophysiology of OCD and indicate that the orbitofrontal circuit influences symptom severity in patients with OCD.
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Affiliation(s)
- Yukiko Saito
- Department of Neuropsychiatry, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi City, Osaka, 570-8506, Japan.
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Menzies L, Chamberlain SR, Laird AR, Thelen SM, Sahakian BJ, Bullmore ET. Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisited. Neurosci Biobehav Rev 2007; 32:525-49. [PMID: 18061263 DOI: 10.1016/j.neubiorev.2007.09.005] [Citation(s) in RCA: 810] [Impact Index Per Article: 47.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2007] [Revised: 09/24/2007] [Accepted: 09/28/2007] [Indexed: 12/16/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a common, heritable and disabling neuropsychiatric disorder. Theoretical models suggest that OCD is underpinned by functional and structural abnormalities in orbitofronto-striatal circuits. Evidence from cognitive and neuroimaging studies (functional and structural magnetic resonance imaging (MRI) and positron emission tomography (PET)) have generally been taken to be supportive of these theoretical models; however, results from these studies have not been entirely congruent with each other. With the advent of whole brain-based structural imaging techniques, such as voxel-based morphometry and multivoxel analyses, we consider it timely to assess neuroimaging findings to date, and to examine their compatibility with cognitive studies and orbitofronto-striatal models. As part of this assessment, we performed a quantitative, voxel-level meta-analysis of functional MRI findings, which revealed consistent abnormalities in orbitofronto-striatal and other additional areas in OCD. This review also considers the evidence for involvement of other brain areas outside orbitofronto-striatal regions in OCD, the limitations of current imaging techniques, and how future developments in imaging may aid our understanding of OCD.
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Affiliation(s)
- Lara Menzies
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.
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Way BM, Laćan G, Fairbanks LA, Melega WP. Architectonic distribution of the serotonin transporter within the orbitofrontal cortex of the vervet monkey. Neuroscience 2007; 148:937-48. [PMID: 17766046 PMCID: PMC2072994 DOI: 10.1016/j.neuroscience.2007.06.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 05/31/2007] [Accepted: 07/04/2007] [Indexed: 11/15/2022]
Abstract
To elucidate the organization of the serotoninergic innervation within the orbitofrontal cortex (OFC), serotonin transporter (SERT) density was quantified by autoradiography using [(3)H]cyanoimipramine binding. In six adult vervet monkeys, 15 architectonic areas were delineated according to cytoarchitectonic (Nissl), myeloarchitectonic (Gallyas) and chemoarchitectonic (acetylcholinesterase) criteria to assess SERT distribution at two levels of organization: cortical area and cortical type. For cortical type, the 15 areas were evenly divided into three different categories primarily based upon the degree of granularization of layer IV: agranular, dysgranular, and granular. Within agranular and dysgranular, but not granular cortical types, SERT density was area-specific and progressively decreased in a medial to lateral gradient. Across cortical types, SERT density decreased in a caudal to rostral gradient: agranular>dysgranular>granular. A similar caudal to rostral gradient was seen when serotonin content was measured (using high performance liquid chromatography) in areas representative of each cortical type. Collectively, these results suggest that the serotoninergic innervation is organized according to both cortical type and area, and is thus structured to differentially modulate information processing within the OFC.
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Affiliation(s)
- Baldwin M. Way
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California
| | - Goran Laćan
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California
| | - Lynn A. Fairbanks
- Jane and Terry Semel Institute of Neuroscience and Human Behavior at the University of California at Los Angeles, Los Angeles, California
| | - William P. Melega
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California
- Jane and Terry Semel Institute of Neuroscience and Human Behavior at the University of California at Los Angeles, Los Angeles, California
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Demarquay G, Ryvlin P, Royet JP. Olfaction et pathologies neurologiques : revue de la littérature. Rev Neurol (Paris) 2007; 163:155-67. [PMID: 17351535 DOI: 10.1016/s0035-3787(07)90387-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Olfactory disorders are often misjudged and rarely rated in the clinical setting. They are nevertheless described in a wide range of neurological disorders, and their evaluation can be useful for diagnosis. Usually irreversible olfactory dysfunction is a well-known complication after head trauma. Severe changes in olfactory tests are observed in Parkinson's disease. Dysfunction is present at disease onset and evidenced with all behavioral tests. Regarding other parkinsonian syndromes, olfactory performances are severely impaired in Lewy body disease, less pronounced in multiple system atrophy and usually preserved in corticobasal degeneration. Olfactory deficits are an early feature in Alzheimer's disease and worsen with disease progression. Rarely reported by patients, they must be searched for with olfactory tests. Though epilepsy is mainly known for its olfactory hallucinatory disorders, alterations of olfactory abilities are also described, especially in mesial temporal epilepsy. Disorders of olfactory perception are finally reported in patients with multiple sclerosis and migraine. After a reminder of anatomical data on the olfactory system, and the different methods of testing used to rate olfactory performances, the current review focuses on the type of olfactory dysfunction and damaged brain areas of the olfactory system encountered in the main neurological diseases.
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Affiliation(s)
- G Demarquay
- Unité de Neurologie Fonctionnelle et d'Epileptologie, Hôpital Neurologique Pierre Wertheimer, Lyon.
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Malhi GS, Loo C, Cahill CM, Lagopoulos J, Mitchell P, Sachdev P. "Getting physical": the management of neuropsychiatric disorders using novel physical treatments. Neuropsychiatr Dis Treat 2006; 2:165-79. [PMID: 19412461 PMCID: PMC2671781 DOI: 10.2147/nedt.2006.2.2.165] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To summarize and review the utility of physical interventions in the treatment of psychiatric disorders. METHODS A systematic review of the literature pertaining to novel physical interventions, namely, transcranial magnetic stimulation, deep brain stimulation, vagus nerve stimulation, and neurosurgery, was conducted using MEDLINE, EMBASE, and PSYCHLIT. Bibliographies of papers were scrutinized for further relevant references along with literature known to the authors. RESULTS Currently available physical interventions worldwide are reviewed with respect to efficacy, applications, and putative indications. Physical interventions have experienced a resurgence of interest for both the investigation of brain function and the treatment of neuropsychiatric disorders. The widespread availability of neuroimaging technology has advanced our understanding of brain function and allowed closer examination of the effects of physical treatments. Clinically, transcranial magnetic stimulation seems likely to have a role in the management of depression, and its use in other neuropsychiatric disorders appears promising. Following on from its success in the management of intractable epilepsy, vagus nerve stimulation is undergoing evaluation in the treatment of depression with some success in refractory cases. Deep brain stimulation has improved mood in patients with Parkinson's disease and may also relieve symptoms of obsessive-compulsive disorder. Neurosurgery has re-invented itself by way of increased technical sophistication, and although further assessment of its efficacy and clinical utility is still needed, its widespread practice reflects its increasing acceptance as a viable treatment of last resort. CONCLUSION It is clear that physical treatments are here to stay and "getting physical" offers a useful addition to the neuropsychiatrist's therapeutic armamentarium. However, like all new treatments these interventions need to remain under rigorous scientific scrutiny to determine accurately their immediate and long-term effects.
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Affiliation(s)
- Gin S Malhi
- School of Psychiatry, University of New South Wales, Australia.
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36
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Giaccio RG. The dual origin hypothesis: An evolutionary brain-behavior framework for analyzing psychiatric disorders. Neurosci Biobehav Rev 2006; 30:526-50. [PMID: 16356547 DOI: 10.1016/j.neubiorev.2005.04.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2005] [Revised: 04/12/2005] [Accepted: 04/25/2005] [Indexed: 12/13/2022]
Abstract
According to the dual origin hypothesis, the cerebral cortex of higher mammals evolved from two primordial brain structures, the amygdala and hippocampal formation. This developmental process defines the orderly principles of cortical connectivity and gives rise to functionally distinct ventral and dorsal systems within the cerebrum. This paper reviews the basic features of the dual origin theory. This model is then applied to understanding symptom production in a number of psychiatric illnesses, with particular reference to recent structural and functional imaging studies. In this paper I propose that psychiatric symptoms can be conceptualized as arising from abnormal processing within dorsal (time-space-motility) or ventral (meaning-motivation) systems, or from a disturbance in the functional interaction/balance between them. Within this framework, one can identify symptom-specific correlations that cross-traditional diagnostic boundaries, as well as potential mechanisms that may explain biologically valid diagnostic entities. Integrating evolutionary, connectional and functional bases across multiple species, the dual origin hypothesis offers a powerful neural systems model to help organize our understanding of psychiatric illness, therein suggesting novel approaches to diagnosis, prevention and treatment.
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Black DN, Althoff RR, Daye K, Pelletier CA. Lethal Obesity Associated with Sodium Valproate in a Brain-Injured Patient. Cogn Behav Neurol 2005; 18:98-101. [PMID: 15970728 DOI: 10.1097/01.wnn.0000152204.71409.2e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 34-year-old man developed posttraumatic epilepsy and a disinhibited orbitofrontal syndrome following severe head trauma at age 22. After an 11-year prison term marked by repeated impulsive aggression, he was transferred to a state psychiatric hospital. Replacement of phenytoin by valproic acid resulted in a 100-lb weight gain, exacerbation of sleep apnea, and right heart failure. Despite replacement of valproate with topiramate, he died of a cardiorespiratory arrest during a seizure. This case illustrates the potential risks associated with valproate therapy in the obese brain-damaged population.
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Affiliation(s)
- Deborah N Black
- Department of Neurology, University of Vermont, Burlington, Vermont, USA.
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Nakao T, Nakagawa A, Yoshiura T, Nakatani E, Nabeyama M, Yoshizato C, Kudoh A, Tada K, Yoshioka K, Kawamoto M, Togao O, Kanba S. Brain activation of patients with obsessive-compulsive disorder during neuropsychological and symptom provocation tasks before and after symptom improvement: a functional magnetic resonance imaging study. Biol Psychiatry 2005; 57:901-10. [PMID: 15820711 DOI: 10.1016/j.biopsych.2004.12.039] [Citation(s) in RCA: 240] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2004] [Revised: 12/13/2004] [Accepted: 12/18/2004] [Indexed: 11/30/2022]
Abstract
BACKGROUND Functional neuroimaging studies have implicated hyperactivity of the frontal cortex in obsessive-compulsive disorder (OCD); however, relationships between abnormal brain activity, clinical improvement, and neuropsychological function have not been clarified in OCD. To clarify the pathophysiology of this disorder, regional changes in brain function were examined during administration of cognitive and symptom provocation tasks in patients with OCD before and after treatment. METHODS Ten outpatients with OCD participated in the study. Functional magnetic resonance imaging (fMRI) was performed before and after treatment. Stroop and symptom provocation tasks were administered during fMRI. Each patient was randomly allocated to receive either pharmacotherapy with fluvoxamine 200 mg/day (n = 4) or behavior therapy (n = 6) for 12 weeks. RESULTS After 12-week treatment, mean (+/- SD) total score on the Yale-Brown Obsessive-Compulsive Scale decreased from 29.00 +/- 3.59 to 14.60 +/- 9.22, representing symptomatic improvement from moderate to mild. After symptom improvement, symptom provocation-related activation in the orbitofrontal, dorsolateral-prefrontal, and anterior cingulate cortices decreased. Conversely, Stroop task-related activation in the parietal cortex and cerebellum increased. CONCLUSIONS After improvement of OCD with either fluvoxamine or behavioral therapy, hyperactivation of the frontal lobe related to a symptom-provocative state decreases, and posterior brain activity related to action-monitoring function increases.
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Affiliation(s)
- Tomohiro Nakao
- Graduate School of Medical Sciences, Kyushu University, Okayama, Japan
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Boldrini M, Del Pace L, Placidi GPA, Keilp J, Ellis SP, Signori S, Placidi GF, Cappa SF. Selective cognitive deficits in obsessive-compulsive disorder compared to panic disorder with agoraphobia. Acta Psychiatr Scand 2005; 111:150-8. [PMID: 15667435 DOI: 10.1111/j.1600-0447.2004.00247.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Visual-spatial and executive functions deficits have been reported in obsessive-compulsive disorder (OCD). We investigated their specificity comparing cognitive function in OCD, panic disorder with agoraphobia (PD/A) and controls by a comprehensive neuropsychological battery. METHOD Fifty-five subjects (25 OCD, 15 PD/A, 15 controls) without current depressive episode underwent structured clinical interview for DSM-IV, Yale-Brown Obsessive Compulsive Scale, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale. Neuropsychological battery assessed: executive functions, visual discrimination, spatial memory and learning, verbal memory, general intellectual functioning. RESULTS OCD showed controlled fluency, visual-spatial construction, learning and memory deficits; PD/A spatial learning impairment. OCD was discriminated from PD/A and controls by three tests scores, predicting group membership for 76.4% of the cases. CONCLUSION Visual-constructive and controlled fluency deficits seem specific in OCD, while the spatial learning deficit, shared with PD patients, may not be disorder-specific, but anxiety-related. Results support the proposed ventral frontal-striatal circuit involvement in OCD.
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Affiliation(s)
- M Boldrini
- Department of Neuroscience, New York State Psychiatric Institute New York, NY, USA.
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40
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Kavanagh DJ, Andrade J, May J. Imaginary Relish and Exquisite Torture: The Elaborated Intrusion Theory of Desire. Psychol Rev 2005; 112:446-67. [PMID: 15783293 DOI: 10.1037/0033-295x.112.2.446] [Citation(s) in RCA: 427] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The authors argue that human desire involves conscious cognition that has strong affective connotation and is potentially involved in the determination of appetitive behavior rather than being epiphenomenal to it. Intrusive thoughts about appetitive targets are triggered automatically by external or physiological cues and by cognitive associates. When intrusions elicit significant pleasure or relief, cognitive elaboration usually ensues. Elaboration competes with concurrent cognitive tasks through retrieval of target-related information and its retention in working memory. Sensory images are especially important products of intrusion and elaboration because they simulate the sensory and emotional qualities of target acquisition. Desire images are momentarily rewarding but amplify awareness of somatic and emotional deficits. Effects of desires on behavior are moderated by competing incentives, target availability, and skills. The theory provides a coherent account of existing data and suggests new directions for research and treatment.
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Affiliation(s)
- David J Kavanagh
- School of Medicine, Faculty of Health Sciences, University of Queensland, Herston, QLD, Australia.
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Kim JH, Cho SY, Byun HJ, Kang UG, Ahn YM, Kim YS. Multidimensional sensory phenomena in antipsychotic-induced akathisia. J Clin Psychopharmacol 2004; 24:618-23. [PMID: 15538123 DOI: 10.1097/01.jcp.0000145343.76288.f7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The primary distinguishing features of akathisia in comparison with other extrapyramidal syndromes are the prominent subjective manifestations, which include various sensory symptoms. The sensory symptoms are multidimensional in nature and encompass various forms of bodily and mental sensations. The purpose of the present study was to elucidate the multidimensional aspects of the sensory phenomena associated with antipsychotic-induced akathisia. Seventy stable and chronic schizophrenic subjects receiving maintenance antipsychotic treatment were evaluated for akathisia and other extrapyramidal side effects. Subjective sensory phenomena were evaluated in 3 dimensions (ie, bodily sensations, mental sensations, and autonomic sensations). The frequency of each dimension of these sensory phenomena was compared between the groups with and without akathisia using chi test with Bonferroni correction. The akathisia group (n = 29) reported significantly more frequent focal or generalized bodily sensations than the non-akathisia group (n = 41) (P < 0.001). The akathisia group also showed significantly more frequent mental sensations such as mental urge and a feeling of inner tension/pressure (P < 0.001). In autonomic phenomena, there was a trend for the akathisia group to show more frequent autonomic sensations. The most common autonomic phenomena associated with akathisia were palpitation and difficulty breathing. The results of the present study suggest that the sensory phenomena of antipsychotic-induced akathisia are characterized by multidimensional features such as bodily sensations, mental sensations, and several autonomic sensations. The assessment of these multidimensional sensory phenomena would be useful in evaluating the important phenotypic features of akathisia.
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Affiliation(s)
- Jong-Hoon Kim
- Department of Psychiatry, Gil Medical Center, Gachon Medical School, Incheon, Korea
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42
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Lamar M, Yousem DM, Resnick SM. Age differences in orbitofrontal activation: an fMRI investigation of delayed match and nonmatch to sample. Neuroimage 2004; 21:1368-76. [PMID: 15050562 DOI: 10.1016/j.neuroimage.2003.11.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2003] [Revised: 11/22/2003] [Accepted: 11/25/2003] [Indexed: 10/26/2022] Open
Abstract
Several investigations have suggested that the orbitofrontal cortex (OFC) may be particularly vulnerable to the effects of age-related changes. We recently reported behavioral data indicating greater age differences in orbitofrontal tasks when directly compared to tasks tapping dorsolateral prefrontal functions. The present study was designed to investigate the neural underpinnings of age differences in OFC functioning. Event-related functional magnetic resonance imaging (fMRI) was performed during delayed match and nonmatch to sample tasks, previously shown to differentially activate medial and lateral OFC in young adults. Sixteen healthy younger [age = 26.7(5.6)] and 16 healthy older individuals [age = 69.1 + 5.6] with similar levels of education and general cognitive functioning participated in the experiment. Participants chose the stimulus from a pair of stimuli matching a previously viewed target (match to sample) or chose the nontarget item (nonmatch to sample) depending upon a trial-specific instruction word. Consistent with previous studies, SPM99 analyses of the younger age group revealed activation for medial OFC regions during the match task compared to the nonmatch task and lateral OFC activation during the nonmatch task compared to the match task. In contrast, older adults showed prefrontal activation only during the match relative to the nonmatch task and posterior temporal and limbic involvement during the nonmatch relative to the match task. Between-group analyses confirmed within-group results suggesting differential age-related recruitment of prefrontal regions when performing match and nonmatch tasks. Results suggest that OFC recruitment during these cognitive tasks changes with age and should be evaluated within the context of other prefrontal subregions to further define differential age effects on frontal functions.
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Affiliation(s)
- Melissa Lamar
- Laboratory of Personality and Cognition, Gerontology Research Center, National Institute on Aging, Baltimore, MD 21224, USA.
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Choi JS, Kang DH, Kim JJ, Ha TH, Lee JM, Youn T, Kim IY, Kim SI, Kwon JS. Left anterior subregion of orbitofrontal cortex volume reduction and impaired organizational strategies in obsessive-compulsive disorder. J Psychiatr Res 2004; 38:193-9. [PMID: 14757334 DOI: 10.1016/j.jpsychires.2003.08.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The orbitofrontal cortex (OFC) may be involved in the clinical and cognitive expressions of obsessive-compulsive disorder (OCD) and is a heterogenous region with respect to its cytoarchitecture, function and connectivity. This study was designed to examine the morphological abnormality of the anterior subregion of OFC and its relationship to clinical symptoms and cognitive performance in patients with OCD. We divided the OFC into anterior and posterior subregions using an external landmark and measured the gray matter volumes of each by three-dimensional magnetic resonance imaging in age- and sex-matched groups, which consisted of 34 OCD and 34 normal volunteers. Clinical and cognitive evaluations were completed using Yale-Brown Obsessive Compulsive Scale (YBOCS) and four sets of neuropsychological tests that assessed executive functions and visual memory. Volume reduction of the left anterior OFC was observed in patients with OCD versus normal controls. Also, a significant positive correlation was found between left anterior OFC gray matter volume and the copy score of the Rey-Osterrieth Complex Figure Test in patients with OCD. These results suggest that left anterior subregion volume reduction of the OFC may be related to impaired organizational strategies in patients with OCD.
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Affiliation(s)
- Jung-Seok Choi
- Department of Psychiatry, Seoul National University College of Medicine, 28 Yeongon-dong, Chongno-gu, 110-744, Seoul, South Korea
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Vasa RA, Grados M, Slomine B, Herskovits EH, Thompson RE, Salorio C, Christensen J, Wursta C, Riddle MA, Gerring JP. Neuroimaging correlates of anxiety after pediatric traumatic brain injury. Biol Psychiatry 2004; 55:208-16. [PMID: 14744460 DOI: 10.1016/s0006-3223(03)00708-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Anxiety disorders are common after traumatic brain injury (TBI). Data on the neural correlates of these conditions are lacking. This study examines the relationship between brain damage, particularly to the orbitofrontal cortex (OFC) and temporal lobe, and anxiety symptoms and disorders. METHODS Ninety-five children and adolescents were followed for one year postinjury. Preinjury and one-year postinjury anxiety status were obtained from the parent. Magnetic resonance imaging was performed to evaluate brain lesions. The primary analysis used regression models to determine relationships between brain lesions and anxiety outcomes. As a secondary analysis, previously reported posttraumatic stress disorder (PTSD) data were reanalyzed using similar methods for purposes of comparison. RESULTS The primary analysis showed that greater volume and number of OFC lesions correlated with decreased risk for anxiety, whereas lesions in other brain areas did not correlate with anxiety. Consistent with prior data, the secondary analysis showed an inverse correlation between OFC damage and PTSD; temporal lobe damage was positively correlated with PTSD. CONCLUSIONS After pediatric TBI, greater damage to the OFC is associated with decreased risk for anxiety outcomes. Similar to adult data, these findings implicate OFC dysfunction in childhood anxiety. Temporal lobe damage did not correlate with anxiety, in contrast to the findings for PTSD.
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Affiliation(s)
- Roma A Vasa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Royet JP, Plailly J, Delon-Martin C, Kareken DA, Segebarth C. fMRI of emotional responses to odors: influence of hedonic valence and judgment, handedness, and gender. Neuroimage 2003; 20:713-28. [PMID: 14568446 DOI: 10.1016/s1053-8119(03)00388-4] [Citation(s) in RCA: 240] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2003] [Revised: 06/10/2003] [Accepted: 06/26/2003] [Indexed: 01/28/2023] Open
Abstract
Previous positron emission tomography studies of right-handed individuals show that the left orbitofrontal cortex is dominant during emotional processing of odors. We collected functional magnetic resonance imaging data from 28 subjects to study this network as a function of odor hedonic valence (pleasant vs. unpleasant), active hedonic judgments versus passive sensation of hedonically charged odors, handedness, and gender. Two functional runs were performed, with pleasant and unpleasant odors presented in different epochs. In the first run, subjects passively smelled odorants, whereas in the second run they rated degree of odor pleasantness or unpleasantness by using a "finger-span" technique that simulated a visual rating scale. Electrodermal and plethysmography responses were simultaneously recorded to control for covert, physiological manifestations of the emotional response. The piriform-amygdala area and ventral insula were activated more for unpleasant than pleasant odors. More extreme ratings were also associated with higher electrodermal amplitude, suggesting that activation stemmed more from emotional or hedonic intensity than valence, and that unpleasant odors induced more arousal than pleasant odors. Unpleasant odors activated the left ventral insula in right-handers and the right ventral insula in left-handers, suggesting lateralized processing of emotional odors as a function of handedness. Active decisions about odor pleasantness induced specific left orbitofrontal cortex activation, implicating the role of this area in the conscious assessment of the emotional quality of odors. Finally, left orbitofrontal cortex was more active in women than men, potentially in relation to women's well-documented advantage in odor identification.
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Affiliation(s)
- Jean-P Royet
- Neurosciences and Sensory Systems, CNRS UMR 5020, Claude-Bernard University Lyon1, 69007, Lyon, France.
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Lee SH, Payne ME, Steffens DC, McQuoid DR, Lai TJ, Provenzale JM, Krishnan KRR. Subcortical lesion severity and orbitofrontal cortex volume in geriatric depression. Biol Psychiatry 2003; 54:529-33. [PMID: 12946881 DOI: 10.1016/s0006-3223(03)00063-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Previous studies have shown a reduction of orbital frontal cortex volume and an increase in magnetic resonance imaging signal hyperintensities in geriatric depression. We aimed to assess the relationship between subcortical gray- and deep white-matter lesions and orbital frontal cortex volume in elderly depressives and controls. The study included 41 elderly depressed patients and 41 age-matched control subjects. The orbital frontal cortex volume was measured in both hemispheres using a standardized MRI procedure. Signal hyperintensities were rated on (T2)-weighted MRI with qualitative lesion analyses performed according to an established hyperintensity classification system. After controlling for total cerebral hemisphere, age and sex, the geriatric depressed subjects had significant reduction in orbital frontal cortex volume and compared with the control group. Multiple linear regression modeling indicated that reduced orbital frontal cortex volumes were significantly associated with increased subcortical gray-matter lesions. Our study confirmed the reduction of OFC volume in geriatric depressed subjects. We also suggest that subcortical lesions may decrease OFC volume. Further studies are needed to understand how subcortical lesions may be related to OFC volume changes.
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Affiliation(s)
- Shwu-Hua Lee
- Neuropsychiatric Imaging Research Laboratory and Department of Psychiatry and Social Behavior, Duke University Medical Center, Durham, North Carolina 27710, USA
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Kang DH, Kwon JS, Kim JJ, Youn T, Park HJ, Kim MS, Lee DS, Lee MC. Brain glucose metabolic changes associated with neuropsychological improvements after 4 months of treatment in patients with obsessive-compulsive disorder. Acta Psychiatr Scand 2003; 107:291-7. [PMID: 12662252 DOI: 10.1034/j.1600-0447.2003.00070.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The study was designed to elucidate regional brain metabolic changes according to a treatment and their relationship with neuropsychological performance changes in obsessive-compulsive disorder (OCD). METHOD Cerebral glucose metabolic rates were repeatedly measured before and after treatment in 10 patients with OCD using [18F]-2-fluoro-deoxyglucose positron emission tomography (PET). They were compared on a voxel-basis, and the correlations were counted between the regional metabolic changes and the degree to improvement on the neuropsychological assessments. RESULTS After treatment, the patients showed significant (P < 0.005, two-tailed) regional metabolic changes in multiple brain areas involving frontal-subcortical circuits and parietal-cerebellar networks. Especially, the metabolic changes of the putamen, the cerebellum, and the hippocampus were significantly correlated with the improvement of the immediate- and delayed-recall scores of the Rey-Osterrieth Complex Figure Test (RCFT). CONCLUSION These results suggest a possibility that metabolic changes of frontal-subcortical and parietal-cerebellar circuit changes may underlie cognitive improvements in patients with OCD.
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Affiliation(s)
- D-H Kang
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
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48
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Kwon JS, Kim JJ, Lee DW, Lee JS, Lee DS, Kim MS, Lyoo IK, Cho MJ, Lee MC. Neural correlates of clinical symptoms and cognitive dysfunctions in obsessive-compulsive disorder. Psychiatry Res 2003; 122:37-47. [PMID: 12589881 DOI: 10.1016/s0925-4927(02)00104-x] [Citation(s) in RCA: 151] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Although results from neuropsychological and neuroimaging studies have postulated the involvement of the frontal lobe and the subcortical brain regions in the pathophysiology of obsessive-compulsive disorder (OCD), neuroimaging studies have provided little evidence that cognitive abnormalities in patients with OCD are related to dysfunctions in these areas. This study was designed to determine whether the clinical features and cognitive deficits of OCD might be taken to reflect frontal-subcortical dysfunction. Fourteen patients with OCD and 14 case-matched normal subjects completed clinical and cognitive evaluation, including four sets of neuropsychological tests that assessed the executive functions and visual memory. Cerebral glucose metabolic rates were measured by using positron emission tomography (PET) with 18F-fluorodeoxyglucose. Behavioral and PET data were analyzed using statistical parametric mapping for group differences and behavioral-metabolic correlates. The right orbitofrontal cortex showed increased metabolic activity and the left parieto-occipital junction showed decreased metabolic activity in patients. Metabolism in the right hippocampus, the left putamen and the right parietal region was associated with the severity of obsessive-compulsive symptoms. Correlations between metabolic rates and neuropsychological test scores in the prefrontal cortex and the putamen occurred only in the patient group. These results suggest that patients with OCD have distinct features of brain metabolic activities for performing cognitive tasks as well as presenting obsessive-compulsive symptoms. In particular, the frontal-subcortical circuits might mediate not only symptomatic expression but also cognitive expression in patients with OCD.
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Affiliation(s)
- Jun Soo Kwon
- BK 21 Human Life Sciences, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea
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Abstract
This paper conceptualizes shame as an acute stress response to an unacceptable view of oneself mediated through another's perspective. After reviewing the developmental antecedents and ontogenetic role of shame, the author first illustrates how shame may induce a depressive paralysis and self-hurtful intent when the goal of reconciliation is thwarted. She then addresses how shame ignited by narcissistic injury can mobilize aggressive behavior toward others, motivated by a need to restore the self. The goals of this paper are to demonstrate that the configurations of shame are manifestations of interpersonal traumatization, to define them as predictable stress responses that activate specific goal-directed behaviors, and to propose the use of these conceptualizations in the empirical study of interpersonal traumatization.
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Affiliation(s)
- Dianne Trumbull
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV 26506, USA.
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Frank GK, Kaye WH, Meltzer CC, Price JC, Greer P, McConaha C, Skovira K. Reduced 5-HT2A receptor binding after recovery from anorexia nervosa. Biol Psychiatry 2002; 52:896-906. [PMID: 12399143 DOI: 10.1016/s0006-3223(02)01378-1] [Citation(s) in RCA: 152] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Several lines of evidence suggest that a disturbance of serotonin neuronal pathways may contribute to the pathogenesis of anorexia nervosa (AN). This study applied positron emission tomography (PET) to investigate the brain serotonin 2A (5HT2A) receptor, which could contribute to disturbances of appetite and behavior in AN. METHODS To avoid the confounding effects of malnutrition, we studied 16 women recovered from AN (REC AN, >1 year normal weight, regular menstrual cycles, no bingeing or purging) compared with 23 healthy control women (CW) using [18F]altanserin, a specific 5-HT2A receptor antagonist on PET imaging. RESULTS REC AN women had significantly reduced [18F]altanserin binding relative to CW in mesial temporal (amygdala and hippocampus), as well as cingulate cortical regions. In a subset of subjects (11 CW and 16 REC AN), statistical parametric mapping (SPM) confirmed reduced mesial temporal cortex 5HT2A receptor binding and, in addition, showed reduced occipital and parietal cortex binding. CONCLUSIONS This study extends research suggesting that altered 5-HT neuronal system activity persists after recovery from AN and may be related to disturbances of mesial temporal lobe function. Altered 5-HT neurotransmission after recovery also supports the possibility that this may be a trait-related disturbance that contributes to the pathophysiology of AN.
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Affiliation(s)
- Guido K Frank
- Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA
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