Reduced Orbitofrontal-Striatal Activity on a Reversal Learning Task in Obsessive-Compulsive Disorder

SynopsisForty patients with obsessive–compulsive disorder (OCD) were compared to matched healthy controls on neuropsychological tests which are sensitive to frontal lobe dysfunction. On a computerized version of the Tower of London test of planning, the patients were no different from healthy controls in the accuracy of their solutions. However, when they made a mistake, they spent more time than the controls in generating alternative solutions or checking that the next move would be correct. The results suggest that OCD patients have a selective deficit in generating alternative strategies when they make a mistake. In a separate attentional set-shifting task, OCD patients were impaired in a simple discrimination learning task and showed a continuous cumulative increase in the number who failed at each stage of the task, including the crucial extra-dimensional set shifting stage. This suggests that OCD patients show deficits in both acquiring and maintaining cognitive sets.The cognitive deficits in OCD may be summarized as: (i) being easily distracted by other competing stimuli; (ii) excessive monitoring and checking of the response to ensure a mistake does not occur; and (iii) when a mistake does occur, being more rigid at setting aside the main goal and planning the necessary subgoals. Both studies support the evidence of fronto-striatal dysfunction in OCD and the results are discussed in terms of an impaired Supervisory Attentional System.

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Compulsivity and probabilistic reversal learning in OCD and cocaine addiction

European Psychiatry ◽

10.1016/j.eurpsy.2015.09.210 ◽

2015 ◽

Vol 30 (S2) ◽

pp. S110-S111 ◽

Cited By ~ 1

Author(s):

P. Smith ◽

N. Benzina ◽

F. Vorspan ◽

L. Mallet ◽

K. N’Diaye

Keyword(s):

Reversal Learning ◽

A Priori ◽

Behavioral Flexibility ◽

Learning Task ◽

Repetitive Behaviors ◽

Cocaine Addiction ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Cocaine Users ◽

Probabilistic Reversal Learning

Compulsive behavior is a core symptom of both obsessive compulsive disorder (OCD) and cocaine addiction (CA). Across both pathologies, one can identify a priori goal-directed actions (purportedly anxiolytic checking or washing in OCD and pleasure-seeking drug use in addiction) that turn into rigid, ritualized and repetitive behaviors over which the patient loose control. One possible psychopathological mechanism underlying compulsivity is behavioral inflexibility, namely a deficit in the aptitude to dynamically adapt to novel contexts and changing reward rules. The probabilistic reversal learning paradigm allows to objectively assess behavioral flexibility by challenging participants with a task where they have to learn through trials-and-errors which of two stimuli is the most-often rewarded one, while adjusting to sudden inconspicuous contingency reversals. We therefore hypothesized that both OCD and CA would be associated with impaired cognitive flexibility, as measured through perseverative response rate following contingency reversals in this task. Interestingly, impulsivity may also be assessed within this task via the tendency of participants to switch from one stimulus to the other following probabilistic errors. To investigate cognitive inflexibility in relation to CA and OCD respectively, we first compared the performance in a probabilistic reversal learning task of cocaine users, ex cocaine users (abstinent for 2 months or more), and controls, as well as that of participants from the general population whose obsessive-compulsive traits were assessed using the OCI-R, a well-validated self-questionnaire. Our task yielded results similar to those found in the literature: cocaine addicts changed their responses more often, and learned less effectively. Ex-cocaine addicts performed better than addicts but worse than controls, suggesting that addicts’ poor results may be in part explained by reversible cognitive consequences of addiction. Addicts with less cognitive impairments may also be less likely to relapse. Regarding the relationship of flexibility to subclinical OCD traits, we found no link between OCI-R score and perseveration, or between impulsiveness and excessive switching.

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Probing striatal function in obsessive compulsive disorder using PET and a sequence learning task

NeuroImage ◽

10.1016/s1053-8119(96)80509-x ◽

1996 ◽

Vol 3 (3) ◽

pp. S507 ◽

Cited By ~ 4

Author(s):

S.L. Rauch ◽

C.R. Savage ◽

N.M. Alpert ◽

D. Dougherty ◽

A. Kendrick ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Sequence Learning ◽

Learning Task ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Striatal Function

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Differential frontal–striatal and paralimbic activity during reversal learning in major depressive disorder and obsessive–compulsive disorder

Psychological Medicine ◽

10.1017/s0033291708005072 ◽

2009 ◽

Vol 39 (9) ◽

pp. 1503-1518 ◽

Cited By ~ 81

Author(s):

P. L. Remijnse ◽

M. M. A. Nielen ◽

A. J. L. M. van Balkom ◽

G.-J. Hendriks ◽

W. J. Hoogendijk ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Obsessive Compulsive Disorder ◽

Reversal Learning ◽

Anterior Insula ◽

Healthy Controls ◽

Obsessive Compulsive ◽

Major Depressive ◽

Compulsive Disorder ◽

Imaging Results

BackgroundSeveral lines of research suggest a disturbance of reversal learning (reward and punishment processing, and affective switching) in patients with major depressive disorder (MDD). Obsessive–compulsive disorder (OCD) is also characterized by abnormal reversal learning, and is often co-morbid with MDD. However, neurobiological distinctions between the disorders are unclear. Functional neuroimaging (activation) studies comparing MDD and OCD directly are lacking.MethodTwenty non-medicated OCD-free patients with MDD, 20 non-medicated MDD-free patients with OCD, and 27 healthy controls performed a self-paced reversal learning task in an event-related design during functional magnetic resonance imaging (fMRI).ResultsCompared with healthy controls, both MDD and OCD patients displayed prolonged mean reaction times (RTs) but normal accuracy. In MDD subjects, mean RTs were correlated with disease severity. Imaging results showed MDD-specific hyperactivity in the anterior insula during punishment processing and in the putamen during reward processing. Moreover, blood oxygen level-dependent (BOLD) responses in the dorsolateral prefrontal cortex (DLPFC) and the anterior PFC during affective switching showed a linear decrease across controls, MDD and OCD. Finally, the OCD group showed blunted responsiveness of the orbitofrontal (OFC)–striatal loop during reward, and in the OFC and anterior insula during affective switching.ConclusionsThis study shows frontal–striatal and (para)limbic functional abnormalities during reversal learning in MDD, in the context of generic psychomotor slowing. These data converge with currently influential models on the neuropathophysiology of MDD. Moreover, this study reports differential neural patterns in frontal–striatal and paralimbic structures on this task between MDD and OCD, confirming previous findings regarding the neural correlates of deficient reversal learning in OCD.

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Acquisition and maintenance of disgust reactions in an OCD analogue sample: efficiency of extinction strategies through a counter conditioning procedure

10.21203/rs.3.rs-29170/v1 ◽

2020 ◽

Author(s):

caroline Novara ◽

Cindy Lebrun ◽

Alexandra MacGregor ◽

Bruno Vivet ◽

Pierre Therouanne ◽

...

Keyword(s):

Anxiety Disorder ◽

Conditioned Stimulus ◽

Associative Learning ◽

Obsessive Compulsive Disorder ◽

Emotional Responses ◽

Learning Task ◽

Conditioning Procedure ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Highly Correlated

Abstract Background If obsessive-compulsive disorder (OCD) has long been considered as an anxiety disorder, disgust is the dominant emotion in contamination-based OCD. However, disgust seems resistant to exposure with response prevention partly due to the fact that disgust is acquired through evaluative conditioning. The present research investigates a counter-conditioning intervention in treating disgust-related emotional responses in two groups of individuals with high (HDCC, n = 25) and low (LDCC, n = 23) contamination concerns. Methods The two groups completed a differential associative learning task in which neutral images were followed by disgusting images (conditioned stimulus; CS+), or not (CS-). Following this acquisition phase, there was a counterconditioning procedure in which CS + was followed by a very pleasant US, while CS- remained unreinforced. Results Following counterconditioning, both groups reported significant reduction in their expectancy of US occurrence and reported less disgust with CS+. For both expectancy and valence, reduction was lower in the HDCC group than in the LDCC group. Disgust sensitivity was highly correlated with both acquisition and maintenance of the response acquired, while US expectation was predicted by anxiety. Conclusion Desensitization to disgust handled by counter-conditioning procedure reduces both expectations and conditioned valence.

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Reversal Learning as a Neuropsychological Indicator for the Neuropathology of Obsessive Compulsive Disorder? A Behavioral Study

Journal of Neuropsychiatry ◽

10.1176/jnp.2008.20.2.210 ◽

2008 ◽

Vol 20 (2) ◽

pp. 210-218 ◽

Cited By ~ 19

Author(s):

Gabriele Valerius ◽

Anne Lumpp ◽

Anne-Katrin Kuelz ◽

Tobias Freyer ◽

Ulrich Voderholzer

Keyword(s):

Obsessive Compulsive Disorder ◽

Reversal Learning ◽

Behavioral Study ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Dysfunction of Orbitofrontal GABAergic Interneurons Leads to Impaired Reversal Learning in a Mouse Model of Obsessive-Compulsive Disorder

Current Biology ◽

10.1016/j.cub.2020.10.045 ◽

2020 ◽

Author(s):

Zicheng Yang ◽

Geming Wu ◽

Min Liu ◽

Xiaohong Sun ◽

Qunyuan Xu ◽

...

Keyword(s):

Mouse Model ◽

Obsessive Compulsive Disorder ◽

Reversal Learning ◽

Gabaergic Interneurons ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Patients with obsessive–compulsive disorder are impaired in associative learning based on external feedback

Psychological Medicine ◽

10.1017/s0033291709005297 ◽

2009 ◽

Vol 39 (9) ◽

pp. 1519-1526 ◽

Cited By ~ 36

Author(s):

M. M. Nielen ◽

J. A. den Boer ◽

H. G. O. M. Smid

Keyword(s):

Associative Learning ◽

Obsessive Compulsive Disorder ◽

Response Selection ◽

Learning Task ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

External Feedback ◽

Selection Processes ◽

Initial Learning ◽

Gains And Losses

BackgroundPatients with obsessive–compulsive disorder (OCD) have to repeat their actions before feeling satisfied that the action reached its intended goal. Learning theory predicts that this may be due to a failure in the processing of external feedback.MethodWe examined the performance of 29 OCD patients and 28 healthy volunteers on an associative learning task, in which initial learning is based solely on external feedback signals. Feedback valence was manipulated with monetary gains and losses.ResultsAs predicted, OCD patients were impaired during initial, external feedback-driven learning but not during later learning stages. The emotional salience of the feedback modulated learning during the initial stage in patients and controls alike. During later learning stages, however, patients approached near-normal performance with rewarding feedback but continued to produce deficient learning with punishing feedback.ConclusionOCD patients have a fundamental impairment in updating behavior based on the external outcome of their actions, possibly mediated by faulty error signals in response selection processes.

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