Objective
To assess the functioning of mesolimbic and striatal areas involved in reward-based spatial learning in unmedicated adults with Obsessive-Compulsive Disorder (OCD).
Methods
We compared fMRI BOLD response in 33 unmedicated adults with OCD to 33 healthy, age-matched control participants during a reward-based learning task that required learning to use extra-maze cues to navigate a virtual 8-arm radial maze to find hidden rewards. We compared groups in their patterns of brain activation associated with reward-based spatial learning versus a control condition in which rewards were unexpected because they were allotted pseudo-randomly to experimentally prevent learning.
Results
Both groups learned to navigate the maze to find hidden rewards, but group differences in neural activity during navigation and reward processing were detected in mesolimbic and striatal areas. During navigation, OCD participants, unlike healthy participants, activated left posterior hippocampus. Unlike healthy participants, OCD participants did not activate left ventral putamen and amygdala when anticipating rewards or left hippocampus, amygdala, and ventral putamen when receiving unexpected rewards (control condition). Signal in these regions decreased relative to baseline during unexpected reward receipt in OCD participants and the degree of activation was inversely associated with doubt/checking symptoms.
Conclusion
OCD participants displayed abnormal recruitment of mesolimbic and ventral striatal circuitry during reward-based spatial learning. Whereas healthy participants activate this circuitry in response to the violation of reward expectations, unmedicated OCD participants do not and instead overrely on posterior hippocampus during learning. Thus, dopaminergic innervation of reward circuitry may be altered and future study of anterior/posterior hippocampal dysfunction in OCD is warranted.