Department of Biomedical Engineering, Keimyung University, Daegu, Republic of Korea.
Institute of Behavioral Science in Medicine and Department of Psychiatry, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, Seoul 03722, Republic of Korea.
Psychiatry Res Neuroimaging. 2020 Oct 30;304:111154. doi: 10.1016/j.pscychresns.2020.111154. Epub 2020 Jul 29.
Studies about social functioning in obsessive-compulsive disorder (OCD) are lacking, even though neuroimaging studies and metacognition evaluation results suggest abnormal neural responses during social interactions. This study examined neural responses of OCD patients during handshakes with a virtual avatar. Because of the nature of the handshaking task, we expected that OCD patients with predominantly contamination/washing symptoms (CON) would show different neural responses compared to healthy controls (HCs) and to disease-controlled (NCON) patients. Thirteen CON, 13 NCON, and 18 HC participants performed handshake tasks with clean or dirty virtual avatars while undergoing functional magnetic resonance imaging. During handshakes with a clean avatar, deactivation in the left anterior cingulate cortex was found in CON patients compared to NCON and HC subjects. This cortical deactivation also occurred with dirty-avatar handshakes, but the difference was significant only between the two OCD groups and HC patients. Deactivation in the left anterior cingulate cortex was correlated with both OCD symptom severity and social anxiety traits. This cortical deactivation in OCD, especially in CON patients, suggests that social dysfunction in OCD may be due to interactions between OCD symptoms and impairment in social cognition, including emotional processing.
强迫症（OCD）患者的社会功能研究较少，尽管神经影像学研究和元认知评估结果表明其在社交互动过程中存在异常的神经反应。本研究通过虚拟现实技术考察了强迫症患者与虚拟化身握手时的神经反应。由于握手任务的性质，我们预计以污染/洗涤症状为主的强迫症患者（CON）与健康对照（HC）和疾病对照（NCON）患者相比，会表现出不同的神经反应。13 名 CON 患者、13 名 NCON 患者和 18 名 HC 参与者在接受功能磁共振成像的同时与干净或脏污的虚拟化身进行握手任务。与 NCON 和 HC 参与者相比，CON 患者在与干净虚拟化身握手时，其左前扣带皮层出现了去激活现象。在与脏污虚拟化身握手时也出现了这种皮层去激活现象，但这种差异仅在 OCD 患者的两个组别与 HC 患者之间具有统计学意义。左前扣带皮层的去激活现象与 OCD 症状严重程度和社交焦虑特质均呈正相关。强迫症患者，尤其是 CON 患者的这种皮层去激活现象表明，强迫症的社会功能障碍可能是 OCD 症状与社交认知（包括情绪处理）损害之间相互作用的结果。
