title: Contextual and behavioral influences on uncertainty in obsessive-compulsive disorder.
abstract: BACKGROUND
  Behavioral adaptation generally follows the contextual changes arising from the consequences (rewards and punishments) of an action. According to the reciprocal determinism model, there is a mutual influence between external context, cognitive processes and behavior. The maladaptive behaviors observed in obsessive-compulsive disorder (OCD) have been hypothesized to result from the disruption of the interactions between these three entities. For this, we assessed the influence of error signals and checking behavior on prefrontal cortical functions during decision-making in 14 OCD patients and 14 matched healthy participants.
  
  
  METHODS
  We used a behavioral task designed to elicit intolerance of uncertainty (IU) followed by the free expression of checking behaviors, which was coupled with functional magnetic resonance imaging.
  
  
  RESULTS
  At the behavioral level, IU intensity was correlated to the number of checking behaviors in both checking OCD patients and healthy controls during decision-making. However, external error signals did not influence checking behaviors in OCD patients, whereas they appeared to trigger checking behaviors in healthy subjects. At the neural level, IU intensity was positively correlated with activation in the orbitofrontal cortex (OFC) in both the OCD and control groups. At the region of interest (ROI) level, error signals increased IU-related OFC activations; in contrast, checking behaviors contributed to decreasing these neural activations in the healthy subjects, but no such modulation was observed in the OCD patients.
  
  
  CONCLUSIONS
  Our results show that IU-related OFC dysfunctions are not under the influence of the context and the behavioral response in OCD, suggesting that alterations of the dynamic features for this neural network may contribute to the expression of OCD symptoms.
authors: Institut des Maladies Neurodégénératives, CNRS UMR 5293, Bordeaux, France; Université Victor Segalen Bordeaux 2, Bordeaux, France; Pôle Universitaire de Psychiatrie Adulte, Hôpital Charles Perrens, Bordeaux, France. Electronic address: jeanyves.rotge@mac.com.
authors: Jean-Yves
authors: JY
authors: Rotge
authors: Institut des Maladies Neurodégénératives, CNRS UMR 5293, Bordeaux, France; Université Victor Segalen Bordeaux 2, Bordeaux, France.
authors: Nicolas
authors: N
authors: Langbour
authors: Université Victor Segalen Bordeaux 2, Bordeaux, France; Institut des Neurosciences Cognitives et Intégratives d'Aquitaine, CNRS UMR 5287, Bordeaux, France.
authors: Bixente
authors: B
authors: Dilharreguy
authors: Université Victor Segalen Bordeaux 2, Bordeaux, France; Institut des Neurosciences Cognitives et Intégratives d'Aquitaine, CNRS UMR 5287, Bordeaux, France; Service de Médecine Nucléaire, Hôpital Pellegrin, Bordeaux, France.
authors: Martine
authors: M
authors: Bordessoulles
authors: Institut des Maladies Neurodégénératives, CNRS UMR 5293, Bordeaux, France; Université Victor Segalen Bordeaux 2, Bordeaux, France; Service de Neurophysiologie, Hôpital Pellegrin, Bordeaux, France.
authors: Dominique
authors: D
authors: Guehl
authors: Institut des Maladies Neurodégénératives, CNRS UMR 5293, Bordeaux, France; Université Victor Segalen Bordeaux 2, Bordeaux, France; Service de Neurophysiologie, Hôpital Pellegrin, Bordeaux, France.
authors: Bernard
authors: B
authors: Bioulac
authors: Université Victor Segalen Bordeaux 2, Bordeaux, France.
authors: Corinne
authors: C
authors: Martin-Guehl
authors: Centre d'Investigation Clinique, INSERM U 802, Poitiers, France; INSERM U 1084, Laboratoire de Neurosciences Expérimentales et Cliniques, Equipe AVENIR ≪ Psychobiologie des Troubles Compulsifs ≫, Poitiers, France; Université de Poitiers, Poitiers, France; Centre Hospitalier Universitaire, Poitiers, France; Unité de Recherche Clinique Intersectorielle en Psychiatrie, Hôpital Henri Laborit, Poitiers, France.
authors: Nematollah
authors: N
authors: Jaafari
authors: Université Victor Segalen Bordeaux 2, Bordeaux, France; Pôle Universitaire de Psychiatrie Adulte, Hôpital Charles Perrens, Bordeaux, France.
authors: Bruno
authors: B
authors: Aouizerate
authors: Université Victor Segalen Bordeaux 2, Bordeaux, France; Institut des Neurosciences Cognitives et Intégratives d'Aquitaine, CNRS UMR 5287, Bordeaux, France; Service de Médecine Nucléaire, Hôpital Pellegrin, Bordeaux, France.
authors: Michele
authors: M
authors: Allard
authors: Institut des Maladies Neurodégénératives, CNRS UMR 5293, Bordeaux, France; Université Victor Segalen Bordeaux 2, Bordeaux, France; Service de Neurophysiologie, Hôpital Pellegrin, Bordeaux, France.
authors: Pierre
authors: P
authors: Burbaud
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D016022:Case-Control Studies; D003192:Compulsive Behavior / Q000503:physiopathology* / Q000523:psychology; D003657:Decision Making; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology* / Q000523:psychology; D009778:Occipital Lobe / Q000503:physiopathology*; D010296:Parietal Lobe / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000503:physiopathology*; D035501:Uncertainty; D055815:Young Adult
keywords: Decision-making; Functional magnetic resonance imaging; Intolerance of uncertainty; Obsessive-compulsive disorder; Orbitofrontal cortex