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Brain Advance Access originally published online on December 7, 2007
Brain 2008 131(1):155-164; doi:10.1093/brain/awm277
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© The Author (2007). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Neural correlates of cognitive inflexibility during task-switching in obsessive-compulsive disorder

Bon-Mi Gu1, Ji-Young Park2, Do-Hyung Kang3, Seung Jae Lee3, So Young Yoo3, Hang Joon Jo4, Chi-Hoon Choi5, Jong-Min Lee4 and Jun Soo Kwon1,2,3,6

1Interdisciplinary Program in Brain Science, 2Interdisciplinary Program in Cognitive Science, 3Department of Psychiatry, Seoul National University College of Medicine, 4Department of Biomedical Engineering, Hanyang University, 5Department of Radiology, National Medical Center and 6BK 21 Human Life Science, Seoul National University College of Medicine

Correspondence to: Jun Soo Kwon, Department of Psychiatry, Seoul National University College of Medicine, 28 Yeongon-dong, Chongno-gu, Seoul 110-744, Korea E-mail: kwonjs{at}plaza.snu.ac.kr

A deficit in cognitive flexibility is acknowledged as a cognitive trait for obsessive-compulsive disorder (OCD). However, no investigations to date have used a cognitive activation paradigm to specify the neural correlates of this deficit in OCD. The objective of this study was to clarify how abnormal brain activities relate to cognitive inflexibility in OCD, using a task-switching paradigm. A task-switching paradigm which has two kinds of task-set was applied to 21 patients with OCD and 21 healthy subjects of matching age, IQ and sex, during an event-related functional magnetic resonance imaging experiment. Compared with the healthy subjects, patients with OCD exhibited a significantly higher error rate in task-switch trials (P < 0.05). Healthy controls showed significant activation in various areas, including dorsal frontal-striatal regions, during task-switching, whereas patients with OCD showed no activation in these areas. Significant differences were also observed in the dorsal frontal-striatal regions and ventromedial prefrontal and right orbitofrontal cortexes between patients with OCD and healthy controls. Correlation analysis indicated that the activations of orbitofrontal cortex were related with the performance in both groups and also with the activation of anterior cingulate cortex in the OCD group. These findings replicate previous studies of cognitive inflexibility in OCD and provide neural correlates related to a task-switching deficit in OCD. The results suggest that impaired task-switching ability in OCD patients might be associated with an imbalance in brain activation between dorsal and ventral frontal-striatal circuits.

Key Words: cognitive flexibility; OCD; task-switching; frontal-striatal circuit; orbitofrontal cortex

Abbreviations: OCD, obsessive-compulsive disorder; OFC, orbitofrontal cortex; ACC, anterior cingulate cortex; PFC, prefrontal cortex; fMRI, functional magnetic resonance imaging; BDI, Beck depression inventory; BAI, Beck anxiety inventory

Received June 16, 2007. Revised October 11, 2007. Accepted October 22, 2007.


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