Riesel Anja, Kathmann Norbert, Endrass Tanja
Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
Eur Arch Psychiatry Clin Neurosci. 2014 Dec;264(8):707-17. doi: 10.1007/s00406-014-0499-3. Epub 2014 Mar 28.
Overactive performance monitoring has been consistently reported in obsessive-compulsive disorder (OCD). OCD is a clinically heterogeneous disorder and is characterized by several symptom dimensions that may have partially distinct neural correlates. We examined whether performance-monitoring alterations are related to symptom severity and symptom dimensions. Electrocortical correlates of performance monitoring were assessed in 72 OCD patients and 72 matched healthy comparison participants during a flanker task. Amplitudes of the error- and correct-related negativity as well as delta and theta power were used to quantify performance-monitoring activity, and a composite measure was derived using factor analysis. Symptom dimension scores were obtained from the Yale-Brown Obsessive Compulsive Scale symptom checklist. OCD patients showed increased electrocortical responses associated with correct and erroneous responses compared to healthy comparison participants. In patients, no correlations were obtained between performance monitoring and global symptom severity as well as lifetime symptom dimension scores. Only a statistical trend was found that higher symmetry/hoarding scores were associated with reduced performance-monitoring activity. For present symptom dimensions scores, an association with rituals/superstitious symptoms was obtained such that higher scores were associated with greater performance-monitoring activity. However, for both dimensions, subjects with low scores or high scores on each dimension were characterized by overactive performance monitoring compared to healthy controls. Overactive brain processes during performance monitoring are a neural correlate of OCD that is independent of global symptom severity and can be observed for all symptom dimensions. This supports the notion of overactive performance monitoring being a candidate endophenotype for OCD.
在强迫症（OCD）中，过度活跃的绩效监测一直有报道。强迫症是一种临床异质性疾病，其特征在于几个症状维度，这些维度可能具有部分不同的神经相关性。我们研究了绩效监测改变是否与症状严重程度和症状维度相关。在一项侧翼任务中，对72名强迫症患者和72名匹配的健康对照参与者进行了绩效监测的皮层电相关评估。使用错误相关负波和正确相关负波的幅度以及δ波和θ波功率来量化绩效监测活动，并通过因子分析得出一个综合指标。症状维度得分来自耶鲁-布朗强迫症量表症状清单。与健康对照参与者相比，强迫症患者在正确和错误反应时表现出增强的皮层电反应。在患者中，绩效监测与总体症状严重程度以及终生症状维度得分之间没有相关性。仅发现一个统计学趋势，即较高的对称性/囤积得分与降低的绩效监测活动相关。对于当前症状维度得分，发现与仪式/迷信症状存在关联，即较高得分与更大的绩效监测活动相关。然而，对于这两个维度，与健康对照相比，每个维度得分低或高的受试者均表现出过度活跃的绩效监测。绩效监测期间过度活跃的脑过程是强迫症的一种神经相关性，它独立于总体症状严重程度，并且在所有症状维度中均可观察到。这支持了过度活跃的绩效监测是强迫症候选内表型的观点。
