Cerebral Glucose Metabolism in Obsessive-Compulsive Hoarding

Saxena, Sanjaya; Brody, Arthur L.; Maidment, Karron M.; Smith, Erlyn C.; Zohrabi, Narineh; Katz, Elyse; Baker, Stephanie K; Baxter, Lewis R.

doi:10.1176/appi.ajp.161.6.1038

Cited by 317 publications

(202 citation statements)

References 88 publications

(91 reference statements)

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“…Interestingly, in the resting state PET study by Saxena et al, 14 the severity of compulsive hoarding also correlated with increased metabolism in sensorimotor cortex. This brain region has a crucial role in the visual processing of emotional material.…”

Section: Discussionmentioning

confidence: 90%

“…Saxena et al 14 found that 12 OCD patients with predominant hoarding symptoms showed reduced glucose metabolism in the dorsal anterior cingulate cortex and increased metabolism in the right sensorimotor cortex, compared with 33 non-hoarding OCD patients. In addition, across all OCD patients (n = 45), the severity of hoarding was negatively correlated with metabolism in the former region and positively correlated with metabolism in the latter region.…”

Section: Introductionmentioning

confidence: 99%

“…To achieve this, we recruited new samples of OCD patients with (n = 13) and without (n = 16) prominent hoarding symptoms and healthy volunteers (n = 21) and studied their patterns of brain activity during the provocation of both hoarding-related and symptomunrelated anxiety using a previously validated symptom provocation paradigm. 13,15,20 Based on previous animal and human lesion studies, and the above functional neuroimaging and neuropsychological studies, we hypothesized that compared with healthy controls and non-hoarding OCD patients, OCD hoarders would show greater subjective anxiety, greater activation in VMPFC and limbic regions 13,15 and reduced activation in dorsal prefrontal regions 14 during symptom provocation. We also predicted that the three groups would show comparable subjective anxiety and neural responses during the generally aversive control experiment.…”

Section: Introductionmentioning

confidence: 99%

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To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder

et al. 2008

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Preliminary neuroimaging studies suggest that patients with the 'compulsive hoarding syndrome' may be a neurobiologically distinct variant of obsessive-compulsive disorder (OCD) but further research is needed. A total of 29 OCD patients (13 with and 16 without prominent hoarding symptoms) and 21 healthy controls of both sexes participated in two functional magnetic resonance imaging experiments consisting of the provocation of hoarding-related and symptom-unrelated (aversive control) anxiety. In response to the hoarding-related (but not symptom-unrelated) anxiety provocation, OCD patients with prominent hoarding symptoms showed greater activation in bilateral anterior ventromedial prefrontal cortex (VMPFC) than patients without hoarding symptoms and healthy controls. In the entire patient group (n = 29), provoked anxiety was positively correlated with activation in a frontolimbic network that included the anterior VMPFC, medial temporal structures, thalamus and sensorimotor cortex. Negative correlations were observed in the left dorsal anterior cingulate gyrus, bilateral temporal cortex, bilateral dorsolateral/medial prefrontal regions, basal ganglia and parieto-occipital regions. These results were independent from the effects of age, sex, level of education, state anxiety, depression, comorbidity and use of medication. The findings are consistent with the animal and lesion literature and several landmark clinical features of compulsive hoarding, particularly decision-making difficulties. Whether the results are generalizable to hoarders who do not meet criteria for OCD remains to be investigated.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder

et al. 2008

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“…All patients completed a measure of depression and anxiety levels using Beck Depression Inventory (BDI) (Beck et al, 1961) and Beck Anxiety Inventory (BAI) (Beck et al, 1988), respectively. We classified the OCD patients according to the five clinical dimensions (Mataix-Cols et al, 1999) and excluded patients with hoarding symptoms due to their different neural involvement from non-hoarding OCD patients (Lochner et al, 2005, Saxena et al, 2004. Predominant obsession/compulsions were as follows: contamination/cleaning (N = 9), aggressive/checking (N = 3), miscellaneous (N = 6), and symmetry/ordering (N = 2).…”

Section: Participantsmentioning

confidence: 99%

Disruption of effective connectivity from the dorsolateral prefrontal cortex to the orbitofrontal cortex by negative emotional distraction in obsessive–compulsive disorder

et al. 2015

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BackgroundObsessive–compulsive disorder (OCD) has been associated with abnormal cognitive and emotional functions and these dysfunctions may be dependent on the disruption of dynamic interactions within neuronal circuits associated with emotion regulation. Although several studies have shown the aberrant cognitive–affective processing in OCD patients, little is known about how to characterize effective connectivity of the disrupted neural interactions. In the present study, we applied effective connectivity analysis using dynamic causal modeling to explore the disturbed neural interactions in OCD patients.MethodA total of 20 patients and 21 matched healthy controls performed a delayed-response working memory task under emotional or non-emotional distraction while undergoing functional magnetic resonance imaging.ResultsDuring the delay interval under negative emotional distraction, both groups showed similar patterns of activations in the amygdala. However, under negative emotional distraction, the dorsolateral prefrontal cortex (DLPFC) and the orbitofrontal cortex (OFC) exhibited significant differences between groups. Bayesian model averaging indicated that the connection from the DLPFC to the OFC was negatively modulated by negative emotional distraction in patients, when compared with healthy controls (p < 0.05, Bonferroni-corrected).ConclusionsExaggerated recruitment of the DLPFC may induce the reduction of top-down prefrontal control input over the OFC, leading to abnormal cortico-cortical interaction. This disrupted cortico-cortical interaction under negative emotional distraction may be responsible for dysfunctions of cognitive and emotional processing in OCD patients and may be a component of the pathophysiology associated with OCD.

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“…14,15 In one factor analytic study of neuropsychological functioning, three major subsets of patients were observed with differential patterns of association between OCS subtypes and performance on the WCST and Part B of the Trail Making Test. 16 One subset of patients was impaired on both tests and had prominent contamination obsessions and compulsive washing.…”

mentioning

confidence: 99%

Nonclinical Obsessive-Compulsive Symptoms and Executive Functions in Schizophrenia

Kumbhani¹,

Roth²,

Kruck³

et al. 2010

Journal of Neuropsychiatry

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The impact of non-clinical obsessive compulsive symptoms (OCS) on neuropsychological functioning in schizophrenia has received little investigation. We evaluated whether severity and subtype of OCS are associated with executive functioning in schizophrenia. Twenty-nine patients with schizophrenia and 32 healthy subjects completed questionnaire and performance-based measures of executive functioning Overall OCS severity in patients was associated with poorer monitoring and cognitive flexibility per a questionnaire. Obsessing, hoarding, and checking were related to poorer executive functioning in daily life. Performance-based scores showed few correlations with OCS. Findings indicate that severity of non-clinical OCS subtypes contribute to the heterogeneity of executive functions in schizophrenia.

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Cerebral Glucose Metabolism in Obsessive-Compulsive Hoarding

Cited by 317 publications

References 88 publications

To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder

To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder

Disruption of effective connectivity from the dorsolateral prefrontal cortex to the orbitofrontal cortex by negative emotional distraction in obsessive–compulsive disorder

Nonclinical Obsessive-Compulsive Symptoms and Executive Functions in Schizophrenia

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