Neurocognitive risk markers in pediatric obsessive–compulsive disorder

Abstract

Background: Obsessive-compulsive disorder (OCD) has complex genetic underpinnings, particularly in its earlyonset form, which places siblings at a 10-fold increased risk of developing the disorder. Examination for neurocognitive markers preceding pediatric OCD onset has not been conducted, although markers have been identified in adult OCD. This study compared neurocognition across groups of OCD-affected youth (n = 87), unaffected siblings of those with early-onset OCD (n = 67), and healthy controls (HC; n = 79). Methods: A total of 233 participants aged 6-18 years old completed standardized neurocognitive tests of cognitive flexibility, decision making, planning, response inhibition, spatial working memory, attention, recognition nonverbal memory, and intelligence. They were administered the Anxiety Disorders Interview Schedule-Parent version (ADIS-P) and completed self-report anxiety and OCD questionnaires. Linear mixed-effects models tested for differences between groups, adjusting for age, gender, IQ, state anxiety, and ethnicity, and accounting for random effects of family membership. Results: OCD-affected youth and unaffected siblings performed significantly worse on planning in comparison to HCs (Cohen's d = 0.74; 95% CI = [0.11, 1.36]; Cohen's d = 0.75; 95% CI = [0.12, 1.38], respectively; omnibus group effect p = .007). No other significant between-group differences were identified. Conclusions: Neurocognitive performance differences between groups identified planning as a preexisting trait marker of pediatric OCD, while no other domain presented as a preceding marker of pediatric OCD. This differs from adult OCD, which is associated with broader cognitive impairments. Investigating longitudinal trajectories and predictive significance of neurocognition in those affected by, and at risk for, early-onset OCD is warranted. Ideally, this will enhance individualized risk stratification and inform future prevention and early intervention strategies.

Visuomotor Activation of Inhibition-Processing in Pediatric Obsessive Compulsive Disorder: A Magnetoencephalography Study

“…We did not find significant differences in Go/No-Go task performance in our medication-naïve OCD sample compared to TDC. This is consistent with previous literature indicating that response inhibition performance on lab-based measures appears to be intact in children and youth with OCD ( 12 , 14 , 23 , 52 ). Despite intact behavioral performance, the amplitude of neural response while engaging in the Go/No-Go task differed in OCD vs. TDC participants.…”

Towards a computational psychiatry of juvenile obsessive-compulsive disorder

“…Such deficits have been found both in adult (Chamberlain, Fineberg, Blackwell, Robbins, & Sahakian, 2006;Gu et al, 2008) and juvenile OCD patients Drechsler et al, 2015;Gottwald et al, 2018;Kim et al, 2019;Wolff, Buse, Tost, Roessner, & Beste, 2017;Wolff, Giller, Buse, Roessner, & Beste, 2018), although not ubiquitously (Beers et al, 1999;Hybel et al, 2017;Ornstein et al, 2010). Most recent work showed that planning seems to be a pre-existing trait COMPUTATIONAL PSYCHIATRY OF JUVENILE OCD 7 marker for paediatric OCD (Negreiros et al, 2020), which underpins the hypothesis that models may not be used or constructed adequately by patients. Moreover, deficiencies in adult OCD have mainly been found in the most challenging aspects of learning processes (e.g.…”

Cognitive performance in children and adolescents at high-risk for obsessive-compulsive disorder

“…Associations between pediatric OCD and impairments in nonverbal memory have been inconsistently reported [ 30 – 32 , 71 , 72 ]. Likewise, the only study, to our knowledge, which investigated neuropsychological dysfunction among pediatric FDRs of patients with OCD found no impairments in spatial working memory [ 34 ]. Nonetheless, accumulating evidence supports the association between deficits in nonverbal memory and adult OCD [ 55 , 73 – 82 ].…”

“…Moreover, the assessment of cognitive function in pediatric FDRs of individuals with OCD has been largely unexplored. To our knowledge, only one study so far has assessed the cognitive performance of pediatric patients with OCD, their unaffected FDRs, and healthy individuals [34]. Both patients with OCD and their FDRs exhibited underperformance in planning tasks.…”

“…Indeed, a meta-analysis revealed no significant impairments in cognitive functions associated with pediatric OCD, possibly due to the small number of studies included [ 31 ]. Conversely, deficits in visual memory, visual organization, processing speed, cognitive flexibility, and planning have been reported for pediatric OCD [ 30 , 32 – 34 ]. Moreover, the assessment of cognitive function in pediatric FDRs of individuals with OCD has been largely unexplored.…”