Article

Amygdala activation in response to facial expressions in pediatric obsessive-compulsive disorder. [Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't]

Department of Psychology, Yale University, New Haven, Connecticut
Depression and Anxiety (Impact Factor: 4.41). 07/2010; 27(7):643 - 651. DOI: 10.1002/da.20718
Source: PubMed

ABSTRACT

Background: Exaggerated amygdala activation to threatening faces has been detected in adults and children with anxiety disorders, compared to healthy comparison (HC) subjects. However, the profile of amygdala activation in response to facial expressions in obsessive–compulsive disorder (OCD) may be a distinguishing feature; a prior study found that compared with healthy adults, adults with OCD exhibited less amygdala activation to emotional and neutral faces, relative to fixation [Cannistraro et al. (2004). Biological Psychiatry 56:916–920]. Methods: In the current event-related functional magnetic resonance imaging (fMRI) study, a pediatric OCD sample (N=12) and a HC sample (N=17) performed a gender discrimination task while viewing emotional faces (happy, fearful, disgusted) and neutral faces. Results: Compared to the HC group, the OCD group showed less amygdala/hippocampus activation in all emotion and neutral conditions relative to fixation. Conclusions: Like previous reports in adult OCD, pediatric OCD may have a distinct neural profile from other anxiety disorders, with respect to amygdala activation in response to emotional stimuli that are not disorder specific. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc.

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    • "Yet other studies have investigated whether the amygdala is also more responsive to more general emotional stimuli, not directly related to OCD symptoms, which is often the case in other anxiety disorders (Etkin and Wager, 2007). Initial studies suggested that amygdala reactivity to emotional faces was actually reduced (Britton et al., 2010; Cannistraro et al., 2004), which suggested that OCD may be different from other anxiety disorders by lacking generalized amygdala hypervigilance. However, more recent studies do suggest increased amygdala reactivity to emotional face stimuli as well (Cardoner et al., 2011; Via et al., 2014). "
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    ABSTRACT: Compulsivity is associated with alterations in the structure and the function of parallel and interacting brain circuits involved in emotional processing (involving both the reward and the fear circuits), cognitive control, and motor functioning. These brain circuits develop during the pre-natal period and early childhood under strong genetic and environmental influences. In this review we bring together literature on cognitive, emotional, and behavioral processes in compulsivity, based mainly on studies in patients with obsessive-compulsive disorder and addiction. Disease symptoms normally change over time. Goal-directed behaviors, in response to reward or anxiety, often become more habitual over time. During the course of compulsive disorders the mental processes and repetitive behaviors themselves contribute to the neuroplastic changes in the involved circuits, mainly in case of chronicity. On the other hand, successful treatment is able to normalize altered circuit functioning or to induce compensatory mechanisms. We conclude that insight in the neurobiological characteristics of the individual symptom profile and disease course, including the potential targets for neuroplasticity is an unmet need to advance the field.
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    • "However, amygdala over-responsiveness was not always observed in Anxiety Disorders (Marsh et al., 2008, Whalen et al., 2008) and per se may not be the most appropriate endpoint for pharmacologic studies. For example, a lower or equal, and not higher, amygdala response to negative emotional stimuli was observed in subjects with Anxiety Disorders (Phan et al., 2006; Marsh et al., 2008); and a higher, and not lower, activation to emotionally neutral stimuli were reported (Britton et al., 2010; Cooney et al., 2006), while no effects of amygdala response was found using agomelatine , a novel effective anxiolytic/antidepressant treatment (Lees et al., 2010). These observations suggested the engagement of regulatory processes generated in other components of the fear, stress and anxiety circuit, e.g., the prefrontal cortex (PFC) and anterior cingulate cortex (ACC), areas associated with cognitive appraisal and top– down emotion regulation (Etkin et al., 2006; Goldin et al., 2009; Blair et al., 2011). "
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    • "An abnormal amygdala response to emotional stimuli was reported in OCD patients, albeit with inconsistent results, showing both hyper-(Cardoner et al., 2011) and hypo-responsiveness (Britton et al., 2010). Consistent with a previous study showing less amygdala activation in OCD patients in response to multiple emotional stimuli (Britton et al., 2010), subjects in the present study exhibited decreased FC in the AMY to both incentive cues. OCD patients also showed increased FC between the NA and posterior insula during gain anticipation, but the FC between these regions was decreased during resting-state. "
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