How Decision-Making Mechanisms Go Awry in Teen OCD Brains

The following is excerpted from an online article posted by MedicalXpress.

A new study from UNSW Sydney shows that teenagers with OCD experience deficits in decision making and behavioral control. This is linked to abnormal activity in an area of the brain called the orbitofrontal cortex (OFC). The research was published in Biological Psychiatry Global Open Science.

"OCD is highly prevalent, affecting more than 750,000 Australians. People with OCD get stuck in loops of unwanted thoughts and behaviors," says first author Dr. Iain Perkes, Senior Lecturer at UNSW Medicine & Health and child and adolescent psychiatrist in Sydney Children's Hospitals Network.

The study involved 21 healthy adolescents and 20 adolescents with OCD. Participants were completed decision-making tasks to gain small food rewards. They did these tasks inside a magnetic resonance imaging (MRI) scanner, which showed blood flow in their brains associated with brain activity.

Participants were tested in terms of their ability to make decisions based on environmental cues, in exchange for food rewards.

Compared to the control group, adolescents with OCD struggled to make choices and control their behavior to gain food rewards. In addition, when the value of the food rewards was reduced, this had little influence on their behavior during the tasks.

"People with OCD experience difficulties using reward signals to guide their choices in an adaptive way. Those behavioral difficulties are associated with changes in the brain," Dr. Perkes says.

The MRI scans showed different patterns of activity in the brain for adolescents with OCD, compared to healthy adolescents. The differences were particularly strong in the OFC, a region of the brain responsible for decision-making, behavioral control and other cognitive functions.

In participants with OCD, specific areas of the OFC were hyperactive and others were hypoactive during the two decision-making tasks. These findings are consistent with previous research in rats, providing evidence of the specific OFC areas responsible for these psychological functions.

"As we understand the biological reality and underpinnings of mental health conditions like OCD, it helps to reduce stigma," Dr. Perkes says.

"It shifts the dialogue from 'Just pull your socks up, work harder' to 'There are changes in the brain, that's a real health condition.'"

"There is a real need to continue discovering new and better treatment paradigms."

Source: MedicalXpress
https://medicalxpress.com/news/2023-10-decision-making-mechanisms-awry-ocd-brains.html