Increased Error-Related Brain Activity in Youth with Obsessive-Compulsive Disorder and Other Anxiety Disorders.

Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI, USA. Electronic address: .
Neuroscience Letters (Impact Factor: 2.03). 05/2013; 541. DOI: 10.1016/j.neulet.2013.02.017


The error-related negativity (ERN) is a negative deflection in the event-related potential after an
incorrect response that is thought to reflect activity in the anterior cingulate cortex (ACC) and is
often increased in patients with anxiety disorders. This study measured the ERN and correct
response negativity (CRN) during an Eriksen flanker task to assess performance monitoring in
26 youth with obsessive-compulsive disorder (OCD), 13 youth with a non-OCD anxiety disorder
consisting of either generalized anxiety disorder or separation anxiety disorder, and 27 agematched
healthy controls ranging in age from 8 to 16 years. Compared to healthy controls, ERN
amplitude was significantly increased in patients with either OCD or a non-OCD anxiety
disorder. There were no significant group differences in CRN amplitude. Treatment with a
serotonergic antidepressant or cognitive-behavior therapy had no effect on the ERN in patients.
Scores from the Child Behavior Checklist DSM-oriented anxiety problems scale had a
significant correlation with ERN amplitude in all subjects. The results provide further evidence
that the pathophysiology of OCD and some non-OCD anxiety disorders involves increased ACC
activity and that the ERN may serve as a quantitative phenotype in genetic and longitudinal
studies of these complex traits.

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    ABSTRACT: Obsessive-compulsive disorder (OCD) is characterized by overactivity in frontal and striatal brain regions, and event-related potential studies have shown increased brain activity during performance monitoring. The error-related negativity (ERN) is a component of the event-related potential that is observed following incorrect responses, and signals the need for behavioral adjustments. ERN enhancements have even been considered as a biomarker or endophenotype of OCD. However over the past years, enhanced ERN amplitudes, although less reliably, were also found in anxiety and affective disorders. These results question the specificity of ERN alterations to OCD. The present review summarizes current findings on performance monitoring and feedback processing in OCD and their relation to behavioral measures. Further, it discusses possible differential mechanisms contributing to amplitude variations in different clinical conditions.
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    ABSTRACT: Overactive performance monitoring, indexed by greater error-related brain activity, has been frequently observed in individuals with obsessive-compulsive disorder (OCD). Similar alterations have been found in individuals with major depressive and generalized anxiety disorders. The main objective was to extend these findings by investigating performance monitoring in individuals with social anxiety disorder (SAD) and to evaluate the specificity of performance-monitoring changes in OCD. Event-related potentials were used to examine error-related brain activity during a flanker task in 24 individuals with OCD, 24 individuals with SAD, and 24 healthy controls with no history of neurological or psychiatric disorders. Error-related negativity (ERN) and correct-related negativity served as electrophysiological indicators for performance monitoring. Enhanced ERN was expected for both clinical groups, but differential associations with clinical symptoms were explored. ERN amplitudes were larger in individuals with OCD and SAD than in healthy controls. Correlational analyses did not reveal significant associations between ERN and clinical symptomatology in OCD, but a significant correlation with depressive symptoms was found in the SAD group. These findings further strengthen the idea that overactive performance monitoring is independent of clinical symptoms in OCD. Furthermore, it may also represent a transdiagnostic vulnerability indicator, although the relationship with clinical symptoms observed in the SAD group needs additional evaluation. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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