title: Altered olfactory processing and increased insula activity in patients with obsessive-compulsive disorder: An fMRI study.
abstract: Obsessive-compulsive disorder (OCD) patients show increased insula activation to disgust-inducing images compared to healthy controls (HC). We explored whether this disgust reactivity was also present in the olfactory domain by conducting the first fMRI study of olfaction in OCD. Neural activation in response to pleasant and unpleasant odors (vs. unscented air) was investigated in 15 OCD and 15 HC participants using fMRI. OCD participants (vs. HC) had increased left anterior insula activation to unpleasant odors (vs. unscented air), which positively correlated with their disgust sensitivity and ratings of the unpleasantness and intensity of those odors. OCD participants (vs. HC) showed increased activation of caudate nucleus and left anterior and posterior insula to pleasant odors (vs. unscented air), which positively correlated with their OCD symptom severity, trait anxiety, frequency of feeling disgust, and odor intensity ratings. OCD participants had increased anterior insula activation to both pleasant and unpleasant odors, which correlated with their OCD symptoms, anxiety, disgust sensitivity, and frequency of feeling disgust. OCD patients might have a negative cognitive bias and experience all stimuli, regardless of valence, as being more unpleasant than healthy people. These findings further elucidate the neural underpinnings of OCD and may contribute to more effective treatments.
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: heather.berlin@mssm.edu.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Berlin
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Stern
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Johnny
authors.initials: J
authors.lastname: Ng
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Sam
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: David
authors.initials: D
authors.lastname: Rosenthal
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Turetzky
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Cheuk
authors.initials: C
authors.lastname: Tang
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Wayne
authors.initials: W
authors.lastname: Goodman
mesh_terms: D000293:Adolescent; D000328:Adult; D002421:Caudate Nucleus / Q000000981:diagnostic imaging / Q000503:physiopathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055696:Olfactory Perception / Q000502:physiology*; D055815:Young Adult
keywords: Anxiety; Disgust; Emotion; OCD; Odor; Olfaction; Sensory