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Study Shows Why Children with OCD Might not be Able to 'Move On'

A new study by scientists at the Wayne State University School of Medicine sheds significant light on our understanding of how brain networks contribute to obsessive-compulsive disorder in youth. Led by David Rosenberg, M.D., and Vaibhav Diwadkar, Ph.D., of the Department of Psychiatry and Behavioral Neurosciences, the research demonstrates that communication between some of the brain’s most important centers is altered in the disorder.

by Wayne State University School of Medicine
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The study included youth with a diagnosis of OCD and a comparison group free of psychiatric illness. The investigators used functional magnetic resonance imaging, or fMRI, to collect brain responses while participants engaged in a basic working memory task. The difficulty of the task was varied to evoke activity in a core brain sub-network. This sub-network is responsible for implementing complex processes such as cognitive control. Then, using sophisticated network analyses, the investigators quantified differences in brain network function between the two groups.

Vaibhav Diwadkar, PhDVaibhav Diwadkar, PhDWayne State University“Most fundamentally, we show that the dorsal anterior cingulate cortex, a key region of the brain associated with cognitive control, exerts exaggerated brain network effects in OCD,” said Dr. Diwadkar, an associate professor. “This result provides a putative scientific framework for what clinicians have noted about OCD-related behaviors. These network-based effects have been suggested, but not explicitly demonstrated before in brain imaging data in the disorder. Our studies are perfectly aligned with the renewed emphasis of the National Institute of Mental Health to discover mechanisms of neuropsychiatric disease in the brain. If you can discover a reliable mechanism underlying disease, you have the promise of improved pathways toward treatment.”

The results are highly consistent with observations in the clinic, said Dr. Rosenberg, who is a professor and the department’s chair. “Children with OCD are beset by preoccupations and can’t easily move on from certain tasks and behaviors. As all complex behavior arises from brain networks, being trapped in this mode must arise from impaired brain network interactions in OCD. In our previous studies we had focused on assessing the structure and the neurochemistry of the anterior cingulate. We had long suspected that brain network interactions originating in this region are impaired in the disorder. But this is the first study to clearly demonstrate this.”

The full paper, “Dysfunctional activation and brain network profiles in youth with obsessive-compulsive disorder: a focus on the dorsal anterior cingulate during working memory,” appears in a special issue of the journal Frontiers in Human Neuroscience, and is available to the public online at the journal’s website. The special issue is devoted to the use of complex techniques to map psychopathology in the brain, a question of increased interest in the field, and a focus of research in the WSU Department of Psychiatry and Behavioral Neurosciences.

David Rosenberg, MDDavid Rosenberg, MDWayne State UniversityThe reported work is part of a large multi-center project funded by the National Institutes of Mental Health. The project is coordinated by Wayne State University, and in addition to Drs. Rosenberg and Diwadkar, involves Gregory Hanna, M.D. (University of Michigan), and Paul Arnold, M.D., Ph.D. (University of Toronto). “This is the second successful collaborative R01 led by WSU, and includes new and highly innovative directions in fMRI research made possible by our superlative in-house expertise here,” Dr. Rosenberg said.

The paper complements WSU’s OCD research most recently featured in a May 2014 episode of ABC News’ ongoing series on the disorder featured on “20/20.” “The new results in the paper makes their focus on our work here even more compelling,” Dr. Rosenberg added.

The investigative team will soon combine complex imaging techniques with genetic mapping to identify complex neurobiological mechanisms that contribute to OCD and obsessive-compulsive behaviors. The doctors said the NIMH is focused on identifying biological mechanisms underlying neuropsychiatric disease. “We are fully seized of this initiative and our collective efforts are aligned in that direction.”

The work was supported by the National Institute of Mental Health (MH059299), the Children’s Hospital of Michigan Foundation, the Prechter World Bipolar Foundation, the Lycaki-Young Fund from the State of Michigan, the Miriam Hamburger Endowed Chair of Child Psychiatry, the Paul and Anita Strauss Endowment, the Donald and Mary Kosch Foundation, The Mark M. Cohen Neuroscience Research Fund, Detroit Wayne County Health Authority and Gateway Community Health.