Academic journal article Indian Journal of Psychiatry

Neuropsychological Disposition and Its Impact on the Executive Functions and Cognitive Style in Patients with Obsessive-Compulsive Disorder

Academic journal article Indian Journal of Psychiatry

Neuropsychological Disposition and Its Impact on the Executive Functions and Cognitive Style in Patients with Obsessive-Compulsive Disorder

Article excerpt

Byline: Sreemoyee. Tarafder, Pallabi. Bhattacharya, Debika. Paul, Gautam. Bandyopadhyay, Pritha. Mukhopadhyay

Background: Recent brain imaging and electrophysiological studies have consistently shown dysfunction of the fronto-striatal thalamic pathways in patients with obsessive-compulsive disorder (OCD). Aim To study the relationship of neuropsychological disposition with the executive functions and cognitive style in patients with OCD. Methods: Twenty OCD patients (14 males, 6 females) and 20 normal control subjects, matched for all relevant variables including age, sex and education, were studied. Neuropsychological disposition was assessed on the Adult Neuropsychological Questionnaire (ANQ), the executive functions were assessed through Wisconsin Card Sorting Test (WCST), and the cognitive style was assessed by employing the Embedded Figure Test (EFT). Results: Subcortical-cerebellar-spinal domain of ANQ was found to be associated with cognitive style and executive functions. Conclusion: The impairment of executive functions and poor activation of specific neurological circuitry in OCD patients affirms the neurobiological basis of the disorder.

Introduction

The impairment of executive functions[1] and of some specific cognitive functions such as visuo-spatial,[2] spatial working memory, spatial recognition, motor initiation and execution[3] along with poor memory functions and organizational capacity,[4] in patients with the obsessive-compulsive disorder (OCD), despite their average intelligence,[4],[5] indicates poor activation of specific neurological circuit responsible for these specific cognitive functions, which implies a neurobiological basis of the disorder. Recent brain imaging and electro-physiological works have consistently shown dysfunction of the fronto-striatal thalamic pathways in OCD subjects.[6] Moreover, functional MRI studies provide ample evidence of abnormal hyperactivity in orbito-frontal subcortical circuits responsible for the pathogenesis of OCD.[7] On the other hand, recent studies have revealed the role of the same fronto-striatal circuit in the executive functioning.[3],[8] In our previous work as well the executive function has been observed to be impaired in the OCD group.[9]

The close interlinking of similar type of brain substrates and neural circuits in both executive dysfunction as well as in the OCD suggests a possible role of neuropsychological deficit condition in the pathogenesis of OCD. As the executive function is the basic mechanism to regulate the cognitive functions, an executive dysfunction is expected to interfere with the overall information processing system. It is surmised, therefore, that the cognitive style, which determines a mode of processing and organizing cognitive information by disembedding the figure from the ground, may, also be a function of one's neuro-psychological disposition. Since figure-ground visual perception depends on top-down processing of visual stimuli as well,[10] patients with OCD may well be assumed to encounter difficulty in cognitive differentiation. Although there have been a few attempts to understand the impairment in executive functions related to the OCD group,[9],[11] there still exists a paucity of information in literature concerning the effect of neuropsychological disposition on cognitive style and executive functions.

With the objective to better understand the (i) status of executive function and cognitive style in patients with OCD as compared to normal controls, (ii) the neuropsychological disposition and its relationship with executive function and cognitive style in patients with OCD, and, (iii) the relationship of executive functions and cognitive style, a thorough neuropsychological investigation was carried out by employ-ing the Adult Neuropsychological Questionnaire (ANQ), the Wisconsin Card Sorting Test (WCST) and the Embedded Figure Test (EFT).

Methods

Sample

Twenty patients (14 males, 6 females) with OCD diagnosed using the DSM-IV criteria by psychiatrists of the Department of Psychiatry, R. …

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