Emotional Processing in Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis of 25 Functional Neuroimaging Studies

摘要: Abstract Background Patients with obsessive-compulsive disorder (OCD) experience aversive emotions in response to obsessions, motivating avoidance and compulsive behaviors. However, there is considerable ambiguity regarding the brain circuitry involved emotional processing OCD, especially whether activation altered amygdala. Methods We conducted a systematic literature review performed meta-analysis—seed-based d mapping—of 25 whole-brain neuroimaging studies (including 571 patients 564 healthy control subjects) using functional magnetic resonance imaging or positron emission tomography, comparing of OCD subjects during presentation emotionally valenced versus neutral stimuli. Meta-regressions were employed investigate possible moderators. Results compared subjects, showed increased bilateral amygdala, right putamen, orbitofrontal cortex extending into anterior cingulate ventromedial prefrontal cortex, middle temporal left inferior occipital cortices processing. Right amygdala hyperactivation was most pronounced unmedicated patients. Symptom severity related precuneus. Greater comorbidity mood anxiety disorders associated higher insula as well lower cortex. Conclusions show processing-related limbic, frontal, regions. Previous mixed evidence role has likely been influenced by patient characteristics (such medication status) low statistical power.