Increased Error-Related Brain Activity in Pediatric Obsessive-Compulsive Disorder Before and After Treatment

• Published in: The American journal of psychiatry 2008-01, Vol.165 (1), p.116-123
• Main Authors: Hajcak, Greg, Franklin, Martin E., Foa, Edna B., Simons, Robert F.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Biological and medical sciences; Brain; Brain - physiopathology; Children & youth; Cognition & reasoning; Cognitive Therapy - methods; Diagnostic and Statistical Manual of Mental Disorders; Electroencephalography - statistics & numerical data; Evoked Potentials - physiology; Female; Gyrus Cinguli - physiopathology; Humans; Image Processing, Computer-Assisted; Male; Medical imaging; Medical sciences; Monitoring systems; Motor Skills - physiology; Neurology; Neuroses; Obsessive compulsive disorder; Obsessive-Compulsive Disorder - diagnosis; Obsessive-Compulsive Disorder - physiopathology; Obsessive-Compulsive Disorder - therapy; Obsessive-compulsive disorders; Patients; Psychiatric Status Rating Scales - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychomotor Performance - physiology; Psychopathology. Psychiatry; Reaction Time - physiology; Severity of Illness Index; Studies; Task Performance and Analysis; Treatment Outcome; Visual Perception - physiology
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/appi.ajp.2007.07010143

Objective: The error-related negativity is a negative deflection in the event-related potential maximal approximately 50 msec after the commission of errors. The error-related negativity is generated in the anterior cingulate cortex, and both anterior cingulate cortex hyperactivity and increased error-related brain activity have been reported in adults with obsessive-compulsive disorder (OCD). However, no study to date, to the authors' knowledge, has examined error-related brain activity in pediatric patients with OCD, and no study has examined error-related brain activity in OCD both before and after treatment. Method: The error-related negativity was measured in 18 treatment-seeking pediatric patients with OCD and 18 age-matched comparison subjects. Of these patients, 10 returned for a second testing session after cognitive behavior therapy; 13 comparison children participated a second time after a comparable interval. Results: In the pretreatment group, the error-related negativity was reliably larger in pediatric patients with OCD in relation to comparison subjects. This difference was also evident after treatment. There was no relationship between error-related negativity and symptom severity or changes in symptom severity. Conclusions: Consistent with studies in adult patients, increased error-related brain activity is evident in pediatric patients with OCD. Furthermore, increased error-related brain activity does not appear to change as a function of symptom reduction after therapy. These results suggest that an increased error-related negativity may be a trait-like marker for psychopathology and might be a useful endophenotype.