Brain Activation in Child and Adolescent OCD and Symptom Provocation

Jaspers-Feyer, Lin, Chan, Ellwyn, Lim, Best, et al. (2019) Investigated obsessive compulsive disorder (OCD) in children and adolescents between the ages of 9 and 18 years with fMRI during symptom provacation across the dimensions Contamination, Bad Thoughts, and Just Right symptoms.

The study also did include pictures of fear and neutral pictures for comparison. The authors wanted to investigate the neural correlates underlying symptom provocation in children and adolescents with OCD versus healthy control subjects. 

The symptom provocation task consisted of picture triads. These were 24 pictures of the five above mentioned conditions. Behavioral responses were assessed as how bothersome the picture was to the participant. The Just Right dimension, consisting of pictures associated with symmetry, ordering, and counting showed a differece among the group with OCD and healthy control subjects considering how bothersome they were, With OCD subjects scoring higher. The Contamination dimension did not differ between the two groups. Compared to healthy control subjects, the pictures of Bad Thoughts did also not differentiate them concerning bothersomness.

The fMRI results revealed that collapsing the dimensions of symptoms showed increased activation of the left temporal gyrus.

It is suggested that the involvement of the temporal poles are involved in pediatric symptom provocation (Jaspers-Feyer et al., 2019).