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Reward-based spatial learning in unmedicated adults with obsessive-compulsive disorder.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Marsh, Rachel Tau, Gregory Z. Wang, Zhishun Huo, Yuankai Liu, Ge Hao, Xuejun Packard, Mark G. Peterson, Bradley S. Simpson, H. Blair
Description	Author Affiliation: Marsh R ( From the Division of Child and Adolescent Psychiatry in the Department of Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York)
Abstract	OBJECTIVE: The authors assessed the functioning of mesolimbic and striatal areas involved in reward-based spatial learning in unmedicated adults with obsessive-compulsive disorder (OCD). METHOD: Functional MRI blood-oxygen-level-dependent response was compared in 33 unmedicated adults with OCD and 33 healthy, age-matched comparison subjects during a reward-based learning task that required learning to use extramaze cues to navigate a virtual eight-arm radial maze to find hidden rewards. The groups were compared in their patterns of brain activation associated with reward-based spatial learning versus a control condition in which rewards were unexpected because they were allotted pseudorandomly to experimentally prevent learning. RESULTS: Both groups learned to navigate the maze to find hidden rewards, but group differences in neural activity during navigation and reward processing were detected in mesolimbic and striatal areas. During navigation, the OCD group, unlike the healthy comparison group, exhibited activation in the left posterior hippocampus. Unlike healthy subjects, participants in the OCD group did not show activation in the left ventral putamen and amygdala when anticipating rewards or in the left hippocampus, amygdala, and ventral putamen when receiving unexpected rewards (control condition). Signal in these regions decreased relative to baseline during unexpected reward receipt among those in the OCD group, and the degree of activation was inversely associated with doubt/checking symptoms. CONCLUSIONS: Participants in the OCD group displayed abnormal recruitment of mesolimbic and ventral striatal circuitry during reward-based spatial learning. Whereas healthy comparison subjects exhibited activation in this circuitry in response to the violation of reward expectations, unmedicated OCD participants did not and instead over-relied on the posterior hippocampus during learning. Thus, dopaminergic innervation of reward circuitry may be altered, and future study of anterior/posterior hippocampal dysfunction in OCD is warranted.
File Format	HTM / HTML
ISSN	0002953X
e-ISSN	15357228
DOI	10.1176/appi.ajp.2014.13121700
Journal	American Journal of Psychiatry
Issue Number	4
Volume Number	172
Language	English
Publisher	American Psychiatric Association
Publisher Date	2015-04-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Psychiatry Brain Physiopathology Obsessive-compulsive Disorder Spatial Learning Physiology Amygdala Brain Mapping Case-control Studies Cues Functional Neuroimaging Hippocampus Magnetic Resonance Imaging Neostriatum Putamen Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health

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