Clinical Cognitive Neuroscience Center, Neuroscience Institute, SNU-MRC, Seoul, South Korea.
Acta Psychiatr Scand. 2011 May;123(5):376-86. doi: 10.1111/j.1600-0447.2010.01659.x. Epub 2010 Dec 22.
Obsessive-compulsive disorder (OCD) is characterized by the dysfunction of control and reward mechanisms. However, only few neuroimaging studies of OCD have examined the reward processing. We examined the neural responses during incentive processing in OCD.
Twenty unmedicated patients with OCD and 20 age-, sex-, and IQ-matched healthy controls underwent functional magnetic resonance imaging while performing a modified monetary incentive delay task.
Compared with controls, patients with OCD showed increased ventral striatal activation in the no-loss minus loss outcome contrast and a significant positive correlation between the ventral striatal activation and compulsion symptom severity. In addition, patients with OCD showed increased activations in the frontostriatal regions in the gain minus no-gain outcomes contrast. During loss anticipation, patients with OCD showed less activations in the lateral prefrontal and inferior parietal cortices. However, during gain anticipation, patients with OCD and healthy controls did not differ in the ventral striatal activation.
These findings provide neural evidence for altered incentive processing in unmedicated patients with OCD, suggesting an elevated sensitivity to negatively affect stimuli as well as dysfunction of the ventral striatum.
强迫症（OCD）的特征是控制和奖励机制的功能障碍。然而，只有少数关于 OCD 的神经影像学研究检查了奖励处理。我们研究了 OCD 患者在激励处理过程中的神经反应。
20 名未用药的 OCD 患者和 20 名年龄、性别和智商匹配的健康对照者在执行改良的货币奖励延迟任务时接受了功能磁共振成像。
与对照组相比，强迫症患者在无损失减去损失结果对比中表现出腹侧纹状体激活增加，并且腹侧纹状体激活与强迫症状严重程度之间存在显著正相关。此外，强迫症患者在获得减去无获得结果对比中表现出额纹状体区域的激活增加。在损失预期期间，强迫症患者的外侧前额叶和下顶叶皮质的激活减少。然而，在获得预期期间，强迫症患者和健康对照组在腹侧纹状体的激活上没有差异。
这些发现为未用药的强迫症患者的激励处理提供了神经学证据，表明对负性刺激的敏感性增加以及腹侧纹状体功能障碍。
