The School of Life, Health and Chemical Sciences, Open University, Milton Keynes, United Kingdom (Koorenhof); and the Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London (Dommett).
J Neuropsychiatry Clin Neurosci. 2019 Summer;31(3):228-238. doi: 10.1176/appi.neuropsych.18070166. Epub 2019 Mar 19.
Response inhibition has been frequently studied in obsessive-compulsive disorder (OCD) with mixed results. The inconsistent findings may stem in part from failure to consider the heterogeneity of the disorder.
The authors examined behavioral and event-related potential (ERP) components (N2 and P3) during a simple response inhibition go/nogo task in a sample of patients with OCD (N=48) and control subjects (N=53). Comparisons in behavioral and electrophysiological measures were made between groups (OCD compared with control) and within the OCD group in terms of symptom clusters (symmetry, forbidden thoughts, and cleaning) and comorbidity status (OCD only and OCD with depression).
In the OCD group, the N2 component appeared more frontally localized compared with the control group. Participants with OCD demonstrated longer N2 latency and a larger difference in N2 between the nogo and go conditions, suggesting slower but greater conflict monitoring. P3 had a larger amplitude in the OCD group compared with the control group, indicative of greater response inhibition, but was also reduced in the nogo compared with go condition, suggesting suppressed response inhibition. No significant differences were found between symptom clusters, but patients with OCD only made more omission errors compared with patients with OCD and comorbid depression. The latter cohort also had faster P3 latencies, which, combined with the behavioral data, indicates slightly improved response inhibition when comorbid depression is found.
On the basis of these results, it would seem unlikely that symptom clusters have contributed to previous inconsistencies in the literature. Comorbid depression, which may have affected previous results, should be considered in future research.
在强迫症(OCD)中,反应抑制已被频繁研究,但结果不一。不一致的发现可能部分源于未能考虑到疾病的异质性。
作者在 OCD 患者(n=48)和对照组(n=53)样本中,使用简单的反应抑制 go/nogo 任务,检查了行为和事件相关电位(ERP)成分(N2 和 P3)。在 OCD 组中,根据症状群(对称、禁止思维和清洁)和合并症状态(仅 OCD 和 OCD 伴抑郁),在组间(OCD 与对照组)和组内(OCD 组)比较了行为和电生理测量。
与对照组相比,OCD 组的 N2 成分表现出更明显的额部定位。OCD 患者的 N2 潜伏期较长,且在 nogo 和 go 条件之间的 N2 差异更大,表明冲突监测较慢但更强。与对照组相比,OCD 组的 P3 波幅更大,表明反应抑制更强,但在 nogo 条件下比 go 条件下更小,表明反应抑制受到抑制。在症状群之间未发现显著差异,但仅 OCD 患者的遗漏错误比 OCD 伴合并症抑郁的患者更多。后一组的 P3 潜伏期也更快,这与行为数据结合表明,当合并症抑郁时,反应抑制略有改善。
基于这些结果,似乎不太可能是症状群导致了文献中的先前不一致。应在未来的研究中考虑合并症抑郁,这可能影响了以前的结果。