Cognitive control of a simple mental image in patients with obsessive--compulsive disorder

The nature of obsessions has led researchers to try to determine if the main problem in obsessive-compulsive disorder (OCD) is impaired inhibitory control. Previous studies report that the effort to suppress is one of the factors that increase the frequency of obsessive thoughts. Based on these results and those of the present study that suggest inferior parietal lobe (IPL) abnormality in OCD and findings of a recent study that reported the importance of the right posterior parietal cortex in cognitive control of a simple mental image, the present cognitive control paradigm study aimed to determine whether there is a difference in brain dynamics between OCD patients and non-obsessive controls while performing tasks that necessitate cognitive control of a simple mental image, and whether the right posterior parietal region is one of the regions in which a difference in activity between the OCD patients and controls would be observed. Functional brain imaging was performed while the participants attempted to suppress, imagine, or manipulate a mental image. The general linear model showed that there was a main effect of group and main effect of task. Accordingly, in all contrasts (suppression minus free-imagination, erasing minus free-imagination, and imagination minus free-imagination), the right IPL, right posterior cingulate cortex, and right superior frontal gyrus activity were lower in the OCD patients than in the healthy controls. These results and the observed correlations between activity levels, and symptom and subjective performance scores are discussed. In conclusion, the results of the present study and those of previous studies suggest that the main problem in OCD might be difficulty activating the right frontoparietal networks during tasks that require cognitive control, which might result in the intrusiveness of obsessive thoughts.