No abstract

Objective: This study aims to evaluate the process of decision-making in patients with obsessive-compulsive disorder (OCD) using the Iowa Gambling Task (IGT). In addition, we intend to expand the understanding of clinical and demographic characteristics that influence decision-making. Method: Our sample consisted of 214 subjects (107 diagnosed with OCD and 107 healthy controls) who were evaluated on their clinical, demographic and neuropsychological features. Moreover, the Iowa Gambling Task (IGT), a task that detects and measures decision-making impairments, was used. Results: We found that OCD patients performed significantly worse on the IGT. Furthermore, features such as symptoms of anxiety did not influence IGT performance. Conclusion: Impaired decision-making seems to be a key feature of OCD. Given that OCD is a complex heterogeneous disorder, homogeneous groups are necessary for an accurate characterization of our findings. Key words: behavior, obsessive-compulsive disorder, cognition, serotonin.Prejuízo no processo de tomada de decisão mensurado pelo Iowa Gambling Task no transtorno obsessivo-compulsivo RESUMO Objetivo: Avaliar o processo de tomada de decisão em pacientes com transtorno obsessivo-compulsivo (TOC) utilizando o Iowa Gambling Task. Pretende-se, também, avaliar características demográficas e clínicas que possam influenciar essa função executiva. Método: Nossa amostra é composta de 214 sujeitos (107 pacientes com diagnóstico de TOC e 107 controles) que foram avaliados do ponto de vista clínico, demográfico e neuropsicológico. O Iowa Gambling Task, um teste que avalia o processo de tomada de decisão, foi aplicado. Resultados: Observamos um prejuízo no desempenho dos pacientes com TOC no IGT. Características como sintomas depressivos e ansiosos não foram responsáveis por esse prejuízo. Conclusão: O prejuízo no processo de tomada de decisão parece ser um componente importante na fisiopatologia do TOC. Como o TOC é um transtorno heterogêneo, grupos mais homogêneos são necessários para uma melhor caracterização e confirmação dos nossos achados. Palavras-chave: comportamento, transtorno obsessivo-compulsivo, cognição, serotonina. CorrespondenceFelipe Filardi da Rocha Rua Sapucaia 83 35460-000 Brumadinho MG -Brasil

No abstract

Brain-derived neurotrophic factor (BDNF) gene has an important link to neurotransmitter systems, including serotonin, and seems to play a major role in emotional decision making. Impairment of decision making is an important feature of psychiatric disorders such as obsessive-compulsive disorder (OCD). We explore the link between decision making and the BDNF Val66Met polymorphism, which results in a reduction of BDNF activity, in a sample of Caucasian OCD patients. We used the Iowa Gambling Task (IGT) to measure decision making in 122 OCD patients. All patients were assessed using the Yale-Brown Obsessive-Compulsive Scale, the Beck Depression Inventory, the Beck Anxiety Inventory and the Raven Progressive Matrices. Patients also performed the Continuous Performance Task (CPT-II) and the Trail Making Test (TMT). We grouped Met-allele carriers because these act in a dominant way. Metallele carries exhibited low performance on both halves of the IGT (first half -F = −2.51, df = 120, P = 0.01; second half -F = −2.32, df = 120, P = 0.02). However, logistic regression analyses showed that the influence of the Met allele seemed to be restricted to the first half of the IGT [first half -β = 0.55, df = 1, P < 0.01, odds ratio (OR) = 5.62; second half -β = 0.32, df = 1, P = 0.15, OR = 2.30]. No differences were observed in tests used to evaluate executive functions associated with the dorsolateral prefrontal cortices (TMT and CPT-II, df = 120, P > 0.05 for both). Met-allele impairment may only be related to decisions made under ambiguous conditions. The null results involving TMT and CPT-II are possibly related to the dysfunction of the orbitofrontal cortices that is associated with OCD.

No abstract