Hoarding disorder and obsessive-compulsive disorder show different patterns of neural activity during response
David F Tolin1, Suzanne T Witt1, Michael C Stevens1
1The Institute of Living and Yale University School of Medicine, 200 Retreat Avenue, Hartford, CT 06106, USA.
Insights
Hoarding disorder (HD) and obsessive-compulsive disorder (OCD) show distinct brain activity during response inhibition tasks. HD patients exhibit unique right precentral gyrus activation, while OCD patients show altered orbitofrontal activity, supporting their biological separation.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Hoarding disorder (HD) is often considered alongside obsessive-compulsive disorder (OCD).
- Emerging evidence suggests distinct neural mechanisms differentiate HD and OCD.
- Understanding these differences is crucial for accurate diagnosis and treatment.
Purpose of the Study:
- To compare brain hemodynamic responses between HD patients, OCD patients, and healthy controls (HC).
- To investigate neural underpinnings of response inhibition in these groups using a high-conflict Go/NoGo task.
- To elucidate the biological distinctions between HD and OCD.
Main Methods:
- Functional magnetic resonance imaging (fMRI) was employed.
- Participants included 24 HD patients, 24 OCD patients, and 24 HCs.
- A high-conflict Go/NoGo task assessed response inhibition.
Main Results:
- Behavioral performance on the Go/NoGo task did not differ significantly across groups.
- During successful response inhibition (correct rejects), HD patients showed greater right precentral gyrus activation.
- OCD patients exhibited greater right orbitofrontal activation during correct rejects and excessive bilateral orbitofrontal activation during errors of commission.
Conclusions:
- The findings support a biological distinction between hoarding disorder and obsessive-compulsive disorder.
- Observed brain activity patterns during response inhibition are specific to each disorder.
- Results align with prior research indicating frontal hypoactivity in HD patients during non-hoarding related tasks.
Abstract:
Although hoarding disorder (HD) has been historically conceptualized as a subtype or dimension of obsessive-compulsive disorder (OCD), preliminary evidence suggests that these two disorders have distinct neural underpinnings. The aim of the present study was to compare the hemodynamic responses of HD patients, OCD patients, and healthy controls (HC) during response inhibition on a high-conflict Go/NoGo task that has previously proved sensitive to OCD. Participants comprised 24 HD patients, 24 OCD patients, and 24 HCs who completed a Go/NoGo task during functional magnetic resonance imaging (fMRI). Although behavioral data showed no difference among the groups in Go/NoGo task performance, significant differences in hemodynamic activity were noted. During correct rejects (successful response inhibition), HD patients showed greater right precentral gyrus activation, whereas OCD patients exhibited greater right orbitofrontal activation, as assessed using a region of interest approach. During errors of commission (response inhibition failures), OCD patients, but not HD patients, were characterized by excessive activity in left and right orbitofrontal gyrus. The present results lend further support to the biological distinction between HD and OCD, and they are consistent with previous research suggesting frontal hypoactivity in HD patients during hoarding-unrelated tasks.
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