Atypical cerebellar activity and connectivity during affective touch in adults with skin-picking disorder

Excessive touching and picking of one's skin are core symptoms of skin-picking disorder (SPD). Previous research has shown that patients with SPD display difficulties in motor control and show altered reward responsivity. Considering the limited knowledge about neuronal mechanisms in SPD, particularly concerning the cerebellum, the analysis focused on this brain region due to its involvement in sensorimotor and affective functions. The participants of the present study received affective (caress-like), which is typically perceived as pleasant and can be passively enjoyed. A total of 132 female participants (70 patients with SPD, 62 healthy controls) received affective and nonaffective touch to their forearms (slow vs. fast brushing) during functional magnetic resonance imaging. This tactile stimulation was rated according to pleasure, arousal, and the urge to pick one's skin. Being touched was perceived as more negative and arousing by the SPD group, and elicited a greater urge to perform skin-picking. During affective touch, those participants with SPD were characterized by reduced activity in lobule VIII, reduced functional connectivity of lobule VIII with the hippocampus, and increased connectivity with the superior parietal lobule. Since VIII is involved in the inhibition of movement, the present findings point to deficient motor control in SPD in the context of affective-sensory processing.