Cognitive and Neural Correlates in Obsessive Compulsive Disorder

强迫症的认知和神经相关性

基本信息

批准号：
7687531
负责人：
Emily R Stern
金额：
$ 5.17万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-28 至 2010-09-27
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7687531
关键词：
Affect Affective Anterior Anxiety Automobile Driving Behavior Behavioral Biological Brain Brain region Burn injury Characteristics Clinical Cognitive Community Healthcare Corpus striatum structure Decision Making Detection Development Disease Dorsal Emotional Emotions Ensure Epidemiologic Studies Event Exhibits Face Fright Functional Magnetic Resonance Imaging Functional disorder Genetic Genetic Predisposition to Disease Goals Hyperactive behavior Impairment Individual Investigation Lead Link Magnetic Resonance Medial Modeling Nature Obsession Obsessive-Compulsive Disorder Pathology Patients Pattern Performance Prefrontal Cortex Preventive Intervention Probability Process Proxy Quality of life Relative (related person)Research Resistance Risk Role Series Severities Susceptibility Gene Symptoms Techniques Testing Therapeutic Time Translations Uncertainty Update Work base caudate nucleus cingulate cortex cognitive behavior therapy cognitive neuroscience cost design disability disorder prevention emotional distress endophenotype experience neuromechanism psychologic relating to nervous system research study response reward processing stem trait treatment strategy

项目摘要

DESCRIPTION (provided by applicant): Pathological uncertainty is a key feature of obsessive compulsive disorder (OCD), impairing everyday decision-making in addition to driving specific obsessions and compulsions. As a potential core process in OCD, increased uncertainty may be a trait characteristic that occurs independently of symptom provocation and could be the focus of research into treatment and prevention of the disorder. Although previous research has shown that OCD patients acquire more information in order to reach a decision than healthy controls, little work has focused on elucidating the cognitive and neural mechanisms associated with abnormal decision-making in OCD. In our preliminary study, sequential pieces of evidence were requested in order to reduce uncertainty and reach a decision. Results revealed that the cost of acquiring new information and the ambiguity of the context in which information was presented were important factors influencing subjective uncertainty and evidence accumulation among control subjects. In three studies, we will test a series of hypotheses predicting that prolonged information acquisition in OCD is driven by a relative insensitivity to these factors. In the first behavioral study, we predict that increasing OC symptom severity will be associated with greater uncertainty and increased evidence accumulation, regardless of the context and cost of information search. In the second and third studies, neural activity will be examined in healthy controls and OCD patients using functional magnetic resonance imagining (fMRI), with the aim of identifying the neural mechanisms underlying the abnormal cognitive experience or emotional appraisal of uncertainty. In particular, hyperactivity in frontal regions implicated in the pathology of OCD, such as dorsomedial prefrontal cortex/anterior cingulate cortex and orbitofrontal cortex, may underlie increases in distinct cognitive and affective aspects of uncertainty processing, respectively. Results from these studies will provide a thorough characterization of OC-related decision-making behavior, enabling clinicians to refine therapeutic techniques for treatment-resistant patients. Moreover, investigation into the neural substrates of these processes may lead to the identification of biological endophenotypes of OCD and further research on genetic susceptibilities of the disorder. The significant disability and emotional distress resulting from pathological indecisiveness in OCD constitutes an important concern for the patient as well as the health care community. The investigation of uncertainty as a core process in OCD is a promising step toward advancing treatment strategies and identifying genetic factors influencing the development of the disorder.

描述（由申请人提供）：病理不确定性是强迫症（OCD）的关键特征，除了推动特定的痴迷和强迫性外，还损害了日常决策。作为强迫症中潜在的核心过程，不确定性增加可能是一个独立于症状挑衅的特征，并且可能是研究和预防该疾病的治疗和预防的重点。尽管先前的研究表明，强迫症患者比健康控制措施获得了更多信息以做出决定，但很少的工作重点是阐明与OCD中异常决策相关的认知和神经机制。在我们的初步研究中，请求顺序的证据，以减少不确定性并做出决定。结果表明，获取新信息的成本以及提供信息的上下文的歧义是影响主观不确定性和对照对象之间积累的证据的重要因素。在三项研究中，我们将检验一系列假设，预测OCD中的延长信息采集是由对这些因素的相对不敏感的驱动的。在第一项行为研究中，我们预测，不管信息搜索的上下文和成本如何，增加的OC症状严重程度增加将与更大的不确定性和增加的证据积累有关。在第二项和第三项研究中，将使用功能性磁共振想象（fMRI）在健康对照和强迫症患者中检查神经活动，以识别认知异常认知经验或不确定情绪评估的神经机制。特别是，与强迫症的病理有关的额叶区域的多动症，例如背部前额叶皮层/前扣带回皮质和眶额皮质，可能分别增加不确定性处理的不同认知和情感方面。这些研究的结果将对与OC相关的决策行为进行彻底的特征，从而使临床医生能够完善对治疗耐药患者的治疗技术。此外，对这些过程的神经底物的研究可能会导致OCD生物内表型的鉴定，并进一步研究该疾病的遗传敏感性。强迫症的病理优柔寡断造成的严重残疾和情绪困扰构成了患者以及医疗保健社区的重要问题。将不确定性作为强迫症的核心过程的调查是朝着推进治疗策略和确定影响疾病发展的遗传因素的有前途的一步。