Trade-off between speed and accuracy: associations between obsessive-compulsive symptoms and meticulousness in PANS

Area of Science:

• Neuroscience
• Pediatric Psychiatry
• Cognitive Psychology

Background:

• Pediatric acute-onset neuropsychiatric syndrome (PANS) is increasingly recognized but its neuropsychological basis, especially concerning obsessive-compulsive disorder (OCD) symptoms, is not well understood.
• PANS presents with abrupt OCD and/or eating restrictions, plus other neuropsychiatric symptoms, causing significant distress and functional impairment.

Purpose of the Study:

• To investigate the relationship between neurocognitive performance and OCD symptom severity in pediatric patients diagnosed with PANS.
• To explore the specific neurocognitive mechanisms underlying OCD symptomatology in the context of PANS.

Main Methods:

• A cohort of twelve children and adolescents with PANS underwent assessment using a novel touchscreen-based button-choice reaction time task across 39 sessions.
• The task was designed to measure attentional focus, motor precision, and response speed.
• Statistical analyses correlated OCD symptom severity with performance metrics from the reaction time task.

Main Results:

• Higher OCD symptom severity correlated with increased attentiveness and more precise touch positioning on the touchscreen.
• No direct association was found between OCD symptom severity and reaction time.
• An interaction revealed that heightened attentiveness and precision were linked to slower reaction times, suggesting a speed-perfectionism trade-off.

Conclusions:

• OCD symptom severity in PANS significantly influences response monitoring and motor control, rather than simply reaction speed.
• The findings suggest a neurocognitive profile in PANS characterized by elevated self-monitoring and meticulousness, potentially underlying OCD symptoms.
• Digital assessment tools can reveal complex interactions between neurocognition and symptom severity in PANS, enhancing understanding of the condition.