title: Switching between internally and externally focused attention in obsessive-compulsive disorder: Abnormal visual cortex activation and connectivity.
abstract: Obsessive-compulsive disorder (OCD) is characterized by excessive absorption with internally-generated distressing thoughts and urges, with difficulty incorporating external information running counter to their fears and concerns. In the present study, we experimentally probed this core feature of OCD through the use of a novel attention switching task that investigates transitions between internally focused (IF) and externally focused (EF) attentional states. Eighteen OCD patients and 18 controls imagined positive and negative personal event scenarios (IF state) or performed a color-word Stroop task (EF state). The IF/EF states were followed by a target detection (TD) task requiring responses to external stimuli. Compared to controls, OCD patients made significantly more errors and showed reduced activation of superior and inferior occipital cortex, thalamus, and putamen during TD following negative IF, with the inferior occipital hypoactivation being significantly greater for TD following negative IF compared to TD following the other conditions. Patients showed stronger functional connectivity between the inferior occipital region and dorsomedial prefrontal cortex. These findings point to an OCD-related impairment in the visual processing of external stimuli specifically when they follow a period of negative internal focus, and suggest that future treatments may wish to target the transition between attentional states.
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Fishberg Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States. Electronic address: emily.stern@mssm.edu.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Stern
authors.affiliation: Department of Psychology, Drexel University, Philadelphia, PA, United States.
authors.forename: Alexandra F
authors.initials: AF
authors.lastname: Muratore
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.
authors.forename: Stephan F
authors.initials: SF
authors.lastname: Taylor
authors.affiliation: Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States.
authors.forename: James L
authors.initials: JL
authors.lastname: Abelson
authors.affiliation: Fishberg Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Hof
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Fishberg Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
authors.forename: Wayne K
authors.initials: WK
authors.lastname: Goodman
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology*; D003071:Cognition / Q000502:physiology; D005260:Female; D006801:Humans; D007092:Imagination; D008297:Male; D009415:Nerve Net / Q000503:physiopathology*; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000503:physiopathology*; D009778:Occipital Lobe / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000503:physiopathology; D011699:Putamen / Q000503:physiopathology; D013788:Thalamus / Q000503:physiopathology; D014793:Visual Cortex / Q000503:physiopathology*; D055815:Young Adult
keywords: Default mode; Negative thought; Occipital; Rumination; Task positive network