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Functional and biochemical alterations of the medial frontal cortex in obsessive-compulsive disorder

Yucel, Murat , Harrison, Ben J. , Wood, Stephen J. , Fornito, Alex , Wellard, R. Mark, Pujol, Jesus , Clarke, Kerrie , Phillips, Mary L. , Kyrios, Michael , Velakoulis, Dennis , & Pantelis, Christos (2007) Functional and biochemical alterations of the medial frontal cortex in obsessive-compulsive disorder. Archives of General Psychiatry, 64(8), pp. 946-955.

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Abstract

Context: The medial frontal cortex (MFC), including the dorsal anterior cingulate (dAC) and supplementary motor area (SMA), is critical for adaptive and inhibitory control of
behaviour. Abnormally high MFC activity has been a consistent finding in functional
neuroimaging studies of obsessive-compulsive disorder (OCD). However, the precise
regions and the neural alterations associated with this abnormality remain unclear.

Objective:
To examine the functional and biochemical properties of the MFC in patients with OCD.
Design: Cross-sectional design combining volume localized proton magnetic resonance spectroscopy (1H-MRS) and functional MRI (fMRI) with an inhibitory control paradigm (the Multi-Source Interference Task; MSIT) designed to activate the MFC.
Setting: Healthy control participants and OCD patients recruited from the general community. Participants: Nineteen OCD patients (10 male, and 9 female) and nineteen age, gender, education and intelligence-matched healthy control participants. Main Outcome Measures: Psychometric measures of symptom severity, MSIT behavioural performance, blood-oxygen-level-dependent (BOLD) activation and 1H-MRS brain metabolite concentrations.
Results:
MSIT behavioural performance did not differ between OCD patients and control subjects.
Reaction-time interference and response errors were correlated with BOLD activation in
the dAC region in both groups. Relative to control subjects, OCD patients showed hyper- activation of the SMA during high response-conflict (incongruent > congruent) trials and hyper-activation of the rostral anterior cingulate (rAC) region during low response- conflict (incongruent < congruent) trials. OCD patients also showed reduced levels of
neuronal N-acetylaspartate in the dAC region, which was negatively correlated with their BOLD activation of the region.

Conclusions: Our findings suggest that hyper-activation of the medial frontal cortex in OCD patients may be a compensatory response to neural pathology in the region. This relationship may partly explain the nature of inhibitory control deficits that are frequently seen in this group and may serve as a focus of future treatment studies.

Impact and interest:

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ID Code: 6749
Item Type: Journal Article
Additional URLs:
Keywords: cingulate, functional MRI, spectroscopy, OCD, obsessive, compulsive
ISSN: 0003-990X
Subjects: Australian and New Zealand Standard Research Classification > TECHNOLOGY (100000) > MEDICAL BIOTECHNOLOGY (100400) > Medical Biotechnology not elsewhere classified (100499)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Psychiatry (incl. Psychotherapy) (110319)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > MEDICAL PHYSIOLOGY (111600) > Systems Physiology (111603)
Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > PSYCHOLOGY (170100) > Biological Psychology (Neuropsychology Psychopharmacology Physiological Psychology) (170101)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NEUROSCIENCES (110900) > Central Nervous System (110903)
Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > COGNITIVE SCIENCE (170200) > Neurocognitive Patterns and Neural Networks (170205)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Mental Health (111714)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NEUROSCIENCES (110900) > Neurology and Neuromuscular Diseases (110904)
Divisions: Past > QUT Faculties & Divisions > Faculty of Science and Technology
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2007 American Medical Association
Deposited On: 28 Mar 2007
Last Modified: 01 Mar 2012 05:11

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