Background
Washing symptoms in Obsessive-Compulsive Disorder (OCD) are associated with increased
trait sensitivity to disgust. This study explored neural systems underlying sensitivity
to symptom-unrelated disgust and fear in OCD using functional neuroimaging.
Methods
Seventeen OCD subjects and 19 controls viewed facial expressions of disgust and fear
(versus neutral) presented just above the level of conscious awareness in a backward
masking paradigm.
Results
The OCD group showed greater activation than controls in the left ventrolateral prefrontal
cortex, but reduced activation in the thalamus, to facial expressions of disgust.
There were no between-group differences in response to fear. Further analysis using
a median-split to divide OCD subjects into high and low washers suggested that the
enhanced ventrolateral prefrontal cortex response was being driven by predominantly
female OCD subjects with high washing symptoms. These subjects also reported higher
levels of trait sensitivity to disgust.
Conclusions
These findings are consistent with previous reports of increased response to symptom-relevant
and generally disgusting stimuli in neural regions associated with disgust and autonomic
response processing in OCD patients with prominent washing symptoms. Together, these
findings point to increased sensitivity to disgust stimuli as a component of the pathophysiology
of the washing/contamination symptom dimension of OCD.
Key Words
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Article info
Publication history
Published online: November 13, 2006
Accepted:
June 8,
2006
Received in revised form:
April 28,
2006
Received:
December 21,
2005
Identification
Copyright
© 2007 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
