Withdrawn/Depressed Behaviors and Error-Related Brain Activity in Youth With Obsessive-Compulsive Disorder

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 55; no. 10; pp. 906 - 913.e2
• Main Authors: Hanna, Gregory L., MD, Liu, Yanni, PhD, Isaacs, Yona E., BS, Ayoub, Angela M., MSW, Torres, Jose J., MS, O’Hara, Nolan B., MS, Gehring, William J., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2016; Elsevier BV
• Subjects: Accuracy; Adolescent; Anxiety Disorders; Behavior; Behavior Rating Scales; biomarker; Brain; Brain - physiopathology; Brain activity; Check Lists; Checklists; Child; Child Behavior; Child Behavior Checklist; Child Behaviour Checklist; Childhood; Children; Circuits; Comorbidity; Cortex; Cortex (cingulate); Depression - physiopathology; Depression - psychology; Electroencephalography - methods; error-related negativity; Errors; Evoked Potentials - physiology; Female; Humans; Internalization; Male; Medical diagnosis; Mental depression; Mismatch negativity; Multiple Regression Analysis; Obsessive compulsive disorder; Obsessive-Compulsive Disorder - diagnosis; Obsessive-Compulsive Disorder - physiopathology; Obsessive-Compulsive Disorder - psychology; Pathophysiology; Patients; Pediatrics; Psychiatry; Psychomotor Performance - physiology; Reaction Time - physiology; Regression analysis; Severity; symptom dimensions; Youth; error-related negativity; Child Behavior Checklist; symptom dimensions; biomarker; obsessive-compulsive disorder
• ISSN: 0890-8567; 1527-5418
• DOI: 10.1016/j.jaac.2016.06.012

Abstract Objective The pathophysiology of obsessive-compulsive disorder (OCD) involves increased activity in cortico-striatal circuits connecting the anterior cingulate cortex (ACC) with other brain regions. The error-related negativity (ERN) is a negative deflection in the event-related potential following an incorrect response that is thought to reflect ACC activity. This study examined the relationship of the ERN to OCD symptom dimensions and other childhood symptom dimensions. Method The ERN, correct response negativity, and accuracy were measured during a flanker task to assess performance monitoring in 80 youth with a lifetime diagnosis of OCD and 80 matched healthy comparison participants ranging in age from 8 to 18 years. The relationship of the ERN to OCD symptom dimension scores and Child Behavior Checklist (CBCL) Syndrome Scale scores was examined in multiple linear regression analyses. Results Accuracy was significantly decreased and ERN amplitude significantly increased in patients compared with controls. ERN amplitude in patients was significantly correlated with accuracy, but not with OCD symptom dimensions, severity, comorbidity, or treatment. In a multiple linear regression analysis using age, accuracy, OCD, and CBCL Syndrome Scale scores as predictors of ERN amplitude, the ERN had significant associations only with Withdrawn/Depressed Scale scores and accuracy. Conclusion An enlarged ERN is a neural correlate of pediatric OCD that is independent of OCD symptom expression and severity. The finding of lower accuracy in pediatric cases requires replication. The relationship between an enhanced ERN and withdrawn/depressed behaviors warrants further research in youth with OCD and other internalizing disorders.