背景:强迫症(OCD)的特征是持续性,不想要的想法和重复的行动。这种重复的想法和/或行为可以通过减少焦虑或避免潜在的威胁或伤害来加强。因此可以奖励个人。奖励系统可能参与OCD的症状学研究得到了研究的支持,这些研究表明奖励相关区域的奖励处理发生了变化,例如腹侧纹状体(VS)和眶额皮质(OFC),患有强迫症的成年人。然而,尚不清楚这是否也适用于患有强迫症的青少年.
方法:使用功能磁共振成像,举行了两次会议,重点是金钱奖励(1)或损失(2)的预期和接收,每个都与口头(控制)条件形成对比。在每个会话中,将患有强迫症的青少年(n1=31/n2=26)与典型发展中(TD)对照(n1=33/n2=31)进行比较,都是10-19岁,在适应性货币激励延迟任务的预期和反馈阶段。
结果:数据显示VS过度激活,但不是OFC,与TD组相比,当预期强迫症的金钱回报和损失时。
结论:这些发现表明,强迫症中异常的神经奖励和损失处理与获得或维持奖励的更大动机有关,但与实际接收无关。更大程度的奖励“想要”可能会导致患有强迫症的青少年越来越频繁地重复某些行为,然后成为习惯(即,强迫症症状)。
BACKGROUND: Obsessive-compulsive disorder (OCD) is characterized by persistent, unwanted thoughts and repetitive actions. Such repetitive thoughts and/or behaviors may be reinforced either by reducing anxiety or by avoiding a potential threat or harm, and thus may be rewarding to the individual. The possible involvement of the reward system in the symptomatology of OCD is supported by studies showing altered reward processing in reward-related regions, such as the ventral striatum (VS) and the orbitofrontal cortex (OFC), in adults with OCD. However, it is not clear whether this also applies to adolescents with OCD.
METHODS: Using functional magnetic resonance imaging, two sessions were conducted focusing on the anticipation and receipt of monetary reward (1) or loss (2), each contrasted to a verbal (control) condition. In each session, adolescents with OCD (n1=31/n2=26) were compared with typically developing (TD) controls (n1=33/ n2=31), all aged 10-19 years, during the anticipation and feedback phase of an adapted Monetary Incentive Delay task.
RESULTS: Data revealed a hyperactivation of the VS, but not the OFC, when anticipating both monetary reward and loss in the OCD compared to the TD group.
CONCLUSIONS: These findings suggest that aberrant neural reward and loss processing in OCD is associated with greater motivation to gain or maintain a reward but not with the actual receipt. The greater degree of reward \'wanting\' may contribute to adolescents with OCD repeating certain actions more and more frequently, which then become habits (i.e., OCD symptomatology).