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Brain activation in paediatric obsessive–compulsive disorder during tasks of inhibitory control

Section of Neuroimaging

Isobel Heyman, PhD, MRCPsych

Child and Adolescent Psychiatry

Mick Brammer, PhD

Brain Image Analysis Unit

Ian Frampton, DClinPsych

Child and Adolescent Psychiatry

Philip K. McGuire, MD, PhD, FRCPsych

Section of Neuroimaging

Katya Rubia, PhD

Child and Adolescent Psychiatry, Institute of Psychiatry, London, UK

Correspondence: Dr Katya Rubia, Child and Adolescent Psychiatry (PO 46), Institute of Psychiatry, Denmark Hill, London SE5 8AF, UK. Email: k.rubia{at}iop.kcl.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Obsessive–compulsive disorder (OCD) may be related to a dysfunction in frontostriatal pathways mediating inhibitory control. However, no functional magnetic resonance imaging (fMRI) study has tested this in children.

Aims

To test whether adolescents with OCD in partial remission would show abnormal frontostriatal brain activation during tasks of inhibition.

Method

Event-related fMRI was used to compare brain activation in 10 adolescent boys with OCD with that of 9 matched controls during three different tasks of inhibitory control.

Results

During a ‘stop’ task, participants with OCD showed reduced activation in right orbitofrontal cortex, thalamus and basal ganglia; inhibition failure elicited mesial frontal underactivation. Task switching and interference inhibition were associated with attenuated activation in frontal, temporoparietal and cerebellar regions.

Conclusions

These preliminary findings support the hypothesis that paediatric OCD is characterised by a dysregulation of frontostriatothalamic brain regions necessary for motor inhibition, and also demonstrate dysfunction of temporoparietal and frontocerebellar attention networks during more cognitive forms of inhibition.