Developmental Aspects of Error and High-Conflict-Related Brain Activity in Pediatric Obsessive-Compulsive Disorder: A FMRI Study with a Flanker Task before and after CBT

Autor/inn/en	Huyser, Chaim; Veltman, Dick J.; Wolters, Lidewij H.; de Haan, Else; Boer, Frits
Titel	Developmental Aspects of Error and High-Conflict-Related Brain Activity in Pediatric Obsessive-Compulsive Disorder: A FMRI Study with a Flanker Task before and after CBT
Quelle	In: Journal of Child Psychology and Psychiatry, 52 (2011) 12, S.1251-1260 (10 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0021-9630
DOI	10.1111/j.1469-7610.2011.02439.x
Schlagwörter	Anxiety Disorders; Conflict; Psychopathology; Patients; Attention Deficit Disorders; Brain Hemisphere Functions; Correlation; Children; Adolescents; Diagnostic Tests; Task Analysis; Cognitive Restructuring; Behavior Modification; Control Groups; Age Differences; Error Patterns; Therapy + Suchen Sie Ihr Suchwort? Konflikt; Psychopathologie; Patient; Attention deficit hyperactivity disorder; ADHS; Aufmerksamkeits-Defizit-Hyperaktivitäts-Störung; Aufmerksamkeitsstörung; Korrelation; Child; Kind; Kinder; Adolescent; Adolescence; Adoleszenz; Jugend; Jugendalter; Jugendlicher; Diagnostic test; Diagnostischer Test; Aufgabenanalyse; Behaviour modification; Verhaltensänderung; Age; Difference; Age difference; Altersunterschied; Fehlertyp; Therapie
Abstract	Background: Heightened error and conflict monitoring are considered central mechanisms in obsessive-compulsive disorder (OCD) and are associated with anterior cingulate cortex (ACC) function. Pediatric obsessive-compulsive patients provide an opportunity to investigate the development of this area and its associations with psychopathology. Methods: Repeated measures were carried out using functional magnetic resonance imaging (fMRI) during the performance of an interference task, the arrow version of the Flanker paradigm, before and after cognitive-behavioral treatment of 25 medication-free pediatric obsessive-compulsive patients compared with age- and gender-matched healthy controls. Results: During error trials compared to correct trials, pediatric OCD patients and controls showed an interaction effect of Group x Time x Age in the ACC and insula. This effect was mainly driven by an increased activation in older OCD subjects, which was also present after treatment. During high-conflict trials compared with low-conflict trials, a Group x Time x Age interaction effect was found in bilateral insula. This effect was driven by an increase of BOLD (blood oxygen level dependent) signal in older OCD patients before but not after treatment. In addition, a Group x Time interaction effect in dorsomedial prefrontal cortex, premotor region and ACC was found. This effect was driven by an increase of BOLD signal in OCD subjects relative to controls over time. Conclusions: Compared to healthy controls, children and adolescents with OCD show increased activation of the ACC during error responses and in bilateral insular cortex during high-conflict tasks, which is age dependent and which is only partially affected by cognitive-behavioral therapy (CBT). Therefore, we suggest that ACC functioning is a vulnerability marker in pediatric OCD, whereas insular dysfunction may be state dependent. (As Provided).
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Update	2017/4/10