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Neural mechanisms of persistent avoidance in OCD: A novel avoidance devaluation study.

Henry W Chase1, Simona Graur1, Amelia Versace1

  • 1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

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|September 11, 2020
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Summary

Obsessive-Compulsive Disorder (OCD) patients show impaired goal-directed learning, favoring habits over flexible responses. Longer illness duration in OCD correlates with poorer devaluation performance and altered brain activity, particularly in the premotor cortex.

Keywords:
CompulsivityGoal-directed behaviorInhibitionObsessive-Compulsive DisorderfMRI

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Science

Background:

  • Obsessive-Compulsive Disorder (OCD) is characterized by repetitive avoidance behaviors causing distress and functional impairment.
  • Recent research suggests OCD avoidance may align with habit formation, moving away from goal-directed control.

Purpose of the Study:

  • To investigate the hypothesis that avoidance behavior in OCD is consistent with habit formation using a devaluation paradigm.
  • To examine behavioral performance and neural correlates of devaluation in individuals with OCD and healthy controls using functional MRI.

Main Methods:

  • Employed a rule-based avoidance task incorporating a devaluation paradigm.
  • Utilized functional magnetic resonance imaging (fMRI) to analyze neural activity in 44 participants with OCD and 46 healthy controls.
  • Analyzed neuroimaging data using a general linear model (GLM) to model valued, devalued, and control cues, as well as feedback events.

Main Results:

  • No overall difference in devaluation performance between OCD patients and controls, but longer illness duration in OCD correlated with poorer performance.
  • Reduced devaluation was linked to impaired learning and enhanced feedback activation in the caudate and parietal lobe during retraining across all participants.
  • Observed significant interaction effects in the premotor cortex, with divergent activations between OCD patients and controls regarding responses to devalued cues.
  • Medial orbitofrontal cortex activation for valued cues was reduced in OCD patients compared to controls.

Conclusions:

  • Findings suggest diminished goal-directed control in favor of habitual behavior in OCD, potentially influenced by illness duration.
  • Illness duration may be a key factor in variations of impaired goal-directed learning in OCD, explaining discrepancies across studies.
  • Conceptual replication using devaluation paradigms offers valuable insights into compulsive behavior and the neural circuitry of OCD.