title: Common limbic and frontal-striatal disturbances in patients with obsessive compulsive disorder, panic disorder and hypochondriasis.
abstract: BACKGROUND
  Direct comparisons of brain function between obsessive compulsive disorder (OCD) and other anxiety or OCD spectrum disorders are rare. This study aimed to investigate the specificity of altered frontal-striatal and limbic activations during planning in OCD, a prototypical anxiety disorder (panic disorder) and a putative OCD spectrum disorder (hypochondriasis).
  
  
  METHODS
  The Tower of London task, a 'frontal-striatal' task, was used during functional magnetic resonance imaging measurements in 50 unmedicated patients, diagnosed with OCD (n=22), panic disorder (n=14) or hypochondriasis (n=14), and in 22 healthy subjects. Blood oxygen level-dependent (BOLD) signal changes were calculated for contrasts of interest (planning versus baseline and task load effects). Moreover, correlations between BOLD responses and both task performance and state anxiety were analysed.
  
  
  RESULTS
  Overall, patients showed a decreased recruitment of the precuneus, caudate nucleus, globus pallidus and thalamus, compared with healthy controls. There were no statistically significant differences in brain activation between the three patient groups. State anxiety was negatively correlated with dorsal frontal-striatal activation. Task performance was positively correlated with dorsal frontal-striatal recruitment and negatively correlated with limbic and ventral frontal-striatal recruitment. Multiple regression models showed that adequate task performance was best explained by independent contributions from dorsolateral prefrontal cortex (positive correlation) and amygdala (negative correlation), even after controlling for state anxiety.
  
  
  CONCLUSIONS
  Patients with OCD, panic disorder and hypochondriasis share similar alterations in frontal-striatal brain regions during a planning task, presumably partly related to increased limbic activation.
authors.affiliation: Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. oa.vandenheuvel@vumc.nl
authors.forename: O A
authors.initials: OA
authors.lastname: van den Heuvel
authors.forename: D
authors.initials: D
authors.lastname: Mataix-Cols
authors.forename: G
authors.initials: G
authors.lastname: Zwitser
authors.forename: D C
authors.initials: DC
authors.lastname: Cath
authors.forename: Y D
authors.initials: YD
authors.lastname: van der Werf
authors.forename: H J
authors.initials: HJ
authors.lastname: Groenewegen
authors.forename: A J L M
authors.initials: AJ
authors.lastname: van Balkom
authors.forename: D J
authors.initials: DJ
authors.lastname: Veltman
mesh_terms: D000293:Adolescent; D000328:Adult; D001931:Brain Mapping; D016022:Case-Control Studies; D054022:Cerebrum / Q000098:blood supply / Q000503:physiopathology*; D003342:Corpus Striatum / Q000098:blood supply / Q000503:physiopathology; D005625:Frontal Lobe / Q000098:blood supply / Q000503:physiopathology; D006801:Humans; D006998:Hypochondriasis / Q000503:physiopathology*; D008032:Limbic System / Q000098:blood supply / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology*; D016584:Panic Disorder / Q000503:physiopathology*; D012044:Regression Analysis; D013788:Thalamus / Q000098:blood supply / Q000503:physiopathology*