Magazine article Clinical Psychiatry News

Brain Abnormalities Appear Heritable in OCD

Magazine article Clinical Psychiatry News

Brain Abnormalities Appear Heritable in OCD

Article excerpt

BARCELONA -- Patients with obsessive-compulsive disorder and their unaffected first-degree relatives share a lack of cognitive flexibility and impairments in the ability to inhibit their motor response to cognitive stimuli--changes that appear linked to extensive functional and structural abnormalities in the brain.

These findings support the theory that there may be an identifiable neurocognitive endophenotype for the disorder, Dr. Naomi A. Fincberg said at the annual congress of the European College of Neuropsychopharmacology.

Dr. Fineberg of the Queen Elizabeth Hospital, Birmingham, England, discussed the research conducted with colleagues at the University of Cambridge (England). For 2 years, the team has been investigating brain and cognitive characteristics in patients with obsessive-compulsive disorder (OCD), their unaffected first-degree relatives, and healthy volunteers.

Their experiments have painted a picture of a unique set of brain abnormalities that appear to be highly heritable in affected families, whether or not members exhibit symptoms.

"We first started on this trail by looking at cognitive flexibility in these groups," Dr. Fineberg said.

The initial study included 20 patients with OCD, most of whom had symptoms of excessive washing and checking; 20 of their unaffected first-degree relatives; and 20 healthy controls. A stop-signal reaction test examined their ability to delay their response to a motor stimulus; a reversal-learning test measured cognitive flexibility.

"On the stop-signal test, not only were OCD patients impaired relative to controls, but so were their relatives. On the cognitive flexibility test, we saw the same pattern of impairment," she said.

These deficits existed in the absence of symptoms and of medication confounders in people who were at risk of OCD because of family history. (Am. J. Psychiatry 2007;164:335-8).

Dr. Fineberg and her associates then searched for a physiologic underpinning of these cognitive impairments. "We know that brain structure is highly heritable, and the question was, could we link this cognitive endophenotype to any specific structural abnormalities? …

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