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Biol Psychiatry Cogn Neurosci Neuroimaging. 2018 Mar 24. pii: S2451-9022(18)30070-3. doi: 10.1016/j.bpsc.2018.03.007. [Epub ahead of print]

Emotion Regulation in Obsessive-Compulsive Disorder, Unaffected Siblings, and Unrelated Healthy Control Participants.

Author information

1
OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway; Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands. Electronic address: anders.lillevik.thorsen@helse-bergen.no.
2
Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands; GGZ inGeest, Amsterdam, the Netherlands.
3
Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
4
Department of Psychiatry, University of Groningen and University Medical Center, Groningen, the Netherlands; Department of Specialized Trainings, Drenthe Mental Health Institution, Assen, the Netherlands; Altrecht Academic Anxiety Center, Utrecht, the Netherlands.
5
Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands.
6
Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands.
7
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
8
OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway.
9
OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands.

Abstract

BACKGROUND:

Functional neuroimaging endophenotypes of obsessive-compulsive disorder (OCD) have been suggested during executive tasks. The purpose of this study was to investigate whether behavioral and neural responses during emotion processing and regulation also represent an endophenotype of OCD.

METHODS:

Forty-three unmedicated adult OCD patients, 19 of their unaffected siblings, and 38 healthy control participants underwent 3T functional magnetic resonance imaging during an emotion regulation task including neutral, fear-inducing, and OCD-related visual stimuli. Stimuli were processed during natural appraisal and during cognitive reappraisal, and distress ratings were collected after each picture. We performed between-group comparisons on task behavior and brain activation in regions of interest during emotion provocation and regulation.

RESULTS:

Siblings reported similar distress as healthy control participants during provocation, and significantly less than patients. There was no significant three-group difference in activation during fear provocation or regulation. Three-group comparisons showed that patients had higher amygdala and dorsomedial prefrontal cortex activation during OCD-related emotion provocation and regulation, respectively, while siblings were intermediate between patients and control participants but not significantly different from either. Siblings showed higher left temporo-occipital activation (compared with both healthy control participants and patients) and higher frontolimbic connectivity (compared with patients) during OCD-related regulation.

CONCLUSIONS:

Unaffected siblings do not show the same distress and amygdala activation during emotional provocation as OCD patients. Siblings show distinct activation in a temporo-occipital region, possibly related to compensatory cognitive control. This suggests that emotion regulation is not a strong endophenotype for OCD. When replicated, this contributes to our understanding of familial risk and resilience for OCD.

KEYWORDS:

Emotion regulation; Emotional provocation; Endophenotype; Familial risk; Obsessive-compulsive disorder; fMRI

PMID:
29753591
DOI:
10.1016/j.bpsc.2018.03.007

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