- Case-control differences in task-related activation vary by age and task, with distinct adult versus child activation patterns during inhibition and error processing.
- Adults with OCD show increased somatomotor activation during inhibition and reduced fronto-striatal activation during errors; children show occipital and frontoparietal increases.
- Greater symptom severity associates with weaker inhibition-related activation in adults and stronger activation in children, implying state dependence and developmental specificity.
Biol Psychiatry. 2026 Oct 3:S0006-3223(26)01580-5. doi: 10.1016/j.biopsych.2026.09.021. Online ahead of print.
ABSTRACT
OBJECTIVE: Obsessive-compulsive disorder (OCD) is a chronic condition in which impaired inhibitory control and excessive error monitoring may contribute to maintenance of obsessions and compulsions. This mega-analysis investigates neural activation during response inhibition and error processing using adult (OCD=563; control=348) and child (OCD=83, control=114) data from the ENIGMA-OCD consortium and the ABCD study (probable OCD=343; control=361).
METHODS: Individual participant data was uniformly processed using HALFpipe to extract statistical maps for response inhibition and error processing contrasts. Bayesian multilevel models were used to assess regional and whole-brain effects of OCD, and to examine the association between the OCD clinical profile and task-related activation.
RESULTS: Across inhibitory control tasks, both OCD and control participants showed robust activation in regions implicated in response inhibition and error processing. During response inhibition, compared to controls, adults with OCD showed stronger somatomotor cortex activation, while children with OCD showed stronger occipital cortex activation. Children with probable OCD from the ABCD cohort showed weaker activity in the frontoparietal network in the anterior insula/frontal operculum region. During error processing, relative to controls, adults with OCD showed weaker activation in fronto-striatal regions, while children with OCD showed stronger activation in frontoparietal and attention networks. Greater OCD symptom severity was associated with weaker task-related activation in adults and stronger activation in children during response inhibition.
CONCLUSION: Case-control differences in brain activation during inhibitory control varied by age group and task contrast. Symptom severity emerged as the main clinical correlate of activation during inhibition, suggesting that inhibitory control deficits in OCD may be both state-dependent and developmentally specific.
PMID:42829058 | DOI:10.1016/j.biopsych.2026.09.021
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