Altered neural circuit for working memory before and after symptom provocation in patients with obsessive-compulsive disorder

Objective: The authors compared the neural circuits recruited for working memory (WM) in obsessive-compulsive disorder (OCD) patients both at a neutral state and at a symptom provoked state. Method: Twelve OCD patients, and 12 age-, and sex-matched healthy subjects underwent [O-15]H2O positron emission tomography (PET) scanning, while performing WM task. In the patients, the tasks were performed both in the neutral and in the symptom provoked states. Results: In the OCD patients, the right caudate and the right superior parietal cortex (rSPC) displayed activations for WM at the neutral state, while the right cingulate cortex and rSPC displayed activations for WM at the symptom provoked state. Path analysis revealed that the activity of the caudate and orbitofrontal cortex was altered according to the interaction between WM and symptom provocation. Conclusion: The interaction between symptom provocation and WM occurring in the fronto-striatal system may hold the key to the neurobiology of OCD.