Brain activation by disgust-inducing pictures in obsessive-compulsive disorder
Introduction
The emotion of disgust may have an important role in the psychobiology of obsessive-compulsive disorder (OCD) (for a review, see Stein et al 2001). Recent studies have identified several regions of the brain that are involved in the facial recognition of “disgust” (e.g., the insula and putamen) Sprengelmeyer et al 1997, Sprengelmeyer et al 1998. Sprengelmeyer et al (1997) have noted that OCD patients have deficits when asked to identify facial representations of disgust, in comparison with other anxiety disorders. Furthermore, Phillips et al (2000) have shown that OCD individuals respond to “disgusting” stimuli differently from healthy volunteers—with functional magnetic resonance imaging (fMRI) activity in the insula. In this study, we used disgust-inducing pictures from the International Affective Picture System (IAPS)1Center for the Study of Emotion and Attention 2001, Lang et al 2001 to evaluate insula activation in OCD subjects compared with healthy volunteers. Activation patterns to disgust-inducing stimuli were compared, with activations prompted both by neutral pictures and by other arousing pictures (i.e., scenes of physical threat). As whole-brain data were collected, differences in all functionally active areas were similarly tested.
Section snippets
Subjects
Eight right-handed OCD subjects (five female/three male, age range 24–55, mean 41.8 years) with obsessions and compulsions predominantly focused on contamination (mean Yale-Brown Obsessive-Compulsive Scale [Y-BOCS] score of 25.13 ± 5.69) and eight right-handed healthy volunteers, gender- and age-matched (five female/three male, age range 34–44, mean 38 years), from a pool of 12 volunteers, participated. All participants signed written, informed consent as approved by the Health Science Center
Psychological and behavioral measures
On Haidt’s 32-item Disgust Scale (Haidt et al 1994), OCD subjects showed higher mean values than the healthy volunteers (73.5 ± 19.2 vs. 59.4 ± 13.6), with a near significant Mann–Whitney U test: [Z(7)= −1.84, p = .065]. The correlation between the level of disgust measured by the Haidt disgust scale and the level of OCD subject’s impairment measured by the Y-BOCS was positive (R = .55), but not significant for this small population.
Activation in healthy volunteers
Different patterns of brain activation were found during
Discussion
In this preliminary work, we aimed to identify the neural substrates recruited in the brains of individuals with OCD (concerned with cleaning and germs) and a matched group of healthy volunteers, when presented with pictures that are considered disgusting or that depict physical threat. The brain activation found for disgust included, most notably, the insula, part of the gustatory cortex that processes unpleasant tastes and smells, and a region reported to mediate the disgust response by
Acknowledgements
This work was supported by a National Alliance for Research on Schizophrenia and Depression Young Investigator Award to YL and by grants from the National Institute of Mental Health: MH37757, MH43975, and P50-MH523384.
The authors thank Dean Sabatinelli, Jin Tong Mao, Jeffrey Fitzsimmons, and Lewis Baxter for their technical assistance during the conception and design of this project.
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