title: Role of medial cortical networks for anticipatory processing in obsessive-compulsive disorder.
abstract: Recurrent anticipation of ominous events is central to obsessions, the core symptom of obsessive-compulsive disorder (OCD), yet the neural basis of intrinsic anticipatory processing in OCD is unknown. We studied nonmedicated adults with OCD and case matched healthy controls in a visual-spatial working memory task with distractor. Magnetoencephalography was used to examine the medial cortex activity during anticipation of to-be-inhibited distractors and to-be-facilitated retrieval stimuli. In OCD anticipatory activation to distractors was abnormally reduced within the posterior cingulate and fusiform gyrus compared to prominent activation in controls. Conversely, OCD subjects displayed significantly increased activation to retrieval stimuli within the anterior cingulate and supplementary motor cortex. This previously unreported discordant pattern of medial anticipatory activation in OCD was accompanied by normal performance accuracy. While increased anterior cortex activation in OCD is commonly viewed as failure of inhibition, the current pattern of data implicates the operation of an anterior compensatory mechanism amending the posterior medial self-regulatory networks disrupted in OCD.
authors: Department of Radiology, MGH/MIT/HMS A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and McLean Hospital, Harvard Medical School, Charlestown, Massachusetts, USA. ktc@nmr.mgh.harvard.edu
authors: Kristina T
authors: KT
authors: Ciesielski
authors: Scott L
authors: SL
authors: Rauch
authors: Seppo P
authors: SP
authors: Ahlfors
authors: Mark E
authors: ME
authors: Vangel
authors: Sabine
authors: S
authors: Wilhelm
authors: Bruce R
authors: BR
authors: Rosen
authors: Matti S
authors: MS
authors: Hämäläinen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D059031:Anticipation, Psychological / Q000502:physiology*; D001519:Behavior / Q000502:physiology; D001931:Brain Mapping; D003265:Contingent Negative Variation; D003627:Data Interpretation, Statistical; D005260:Female; D006179:Gyrus Cinguli / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D009044:Motor Cortex / Q000502:physiology; D009415:Nerve Net / Q000502:physiology*; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology* / Q000523:psychology*; D010775:Photic Stimulation; D011569:Psychiatric Status Rating Scales