Do Individuals With Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder Share Similar Neural Mechanisms of Decision-Making Under Ambiguous Circumstances?

Yudan Luo; Lu Chen; Hongchen Li; Yi Dong; Xiaoqin Zhou; Linlin Qiu; Lei Zhang; Yaxiang Gao; Chunyan Zhu; Fengqiong Yu; Kai Wang

doi:10.3389/fnhum.2020.585086

Do Individuals With Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder Share Similar Neural Mechanisms of Decision-Making Under Ambiguous Circumstances?

Front Hum Neurosci. 2020 Oct 22:14:585086. doi: 10.3389/fnhum.2020.585086. eCollection 2020.

Authors

Yudan Luo^{1

2

3}, Lu Chen^{1

2

3}, Hongchen Li⁴, Yi Dong⁵, Xiaoqin Zhou⁶, Linlin Qiu¹, Lei Zhang^{1

2

3}, Yaxiang Gao¹, Chunyan Zhu^{1

2

3}, Fengqiong Yu^{1

2

3}, Kai Wang^{1

2

3

7}

Affiliations

¹ Department of Medical Psychology, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.
² School of Mental Health and Psychological Sciences, Collaborative Innovation Centre of Neuropsychiatric Disorder and Mental Health, Hefei, China.
³ School of Mental Health and Psychological Sciences, Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
⁴ School of Civil Engineering, Wangjiang University of Technology, Ma'anshan, China.
⁵ School of Mental Health and Psychological Sciences, Anhui Mental Health Center, Hefei, China.
⁶ The Chaohu Affiliated Hospital of Anhui Medical University, Hefei, China.
⁷ Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

Abstract

Impaired decision-making is well documented in obsessive-compulsive disorder (OCD) and a range of electrophysiological and functional neuroimaging measures have begun to reveal the pathological mechanisms that underlie the decision-making process. Obsessive-compulsive personality disorder (OCPD) has core symptoms that often overlap with OCD, but similarities between these disorders at the behavioral and neurological levels are often unclear, including whether OCPD exhibits similar decision-making deficits and shared neurological dysfunction. To address these issues, we examined 24 cases of OCD, 19 cases of OCPD, and 26 matched normal control (NC) subjects during the revised Iowa Gambling Task (IGT) using event-related potentials (ERPs). The net IGT scores were lower for OCD subjects than for OCPD or NC subjects, thus indicating that OCD subjects chose more disadvantageous options and were "short-sighted" with regards to information. The feedback-related negativity (FRN) waveform (lose-win) was larger in both OCD and OCPD subjects, which suggested that obstacles exist in the feedback process. Consequently, these subjects might share similar neural mechanisms under ambiguous decision-making circumstances. Furthermore, IGT net scores were significantly and negatively correlated with Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scales. This implies that more severe obsessive-compulsive symptoms inspired more negative emotions that led to worse decision-making ability. Therefore, although similar neural mechanisms might exist, this led to different behaviors in which OCPD is associated with better behavioral performance compared to OCD patients.

Keywords: Iowa Gambling Task (IGT); decision-making; event-related potentials; obsessive-compulsive disorder (OCD); obsessive-compulsive personality disorder (OCPD).