Emotional processing and disgust sensitivity in OCD patients with and without contamination-type obsessive-compulsive symptoms – An fMRI study.

Abstract Objective Disgust is described as a relevant emotion in OCD, particularly in contamination-type OCD, and may be involved in emotional processing in this OCD-subtype. The present study aimed to investigate the neural correlates of distress processing in contamination-type compared to non-contamination-type OCD, and the relation to disgust sensitivity. Methods Forty-three OCD patients (n = 19 contamination-type OCD) were exposed to OCD-related, fear-related and neutral pictures. Subjective distress per stimulus was assessed by a visual analogue scale (VAS) and disgust sensitivity by the DS-R. BOLD brain activation was compared between stimuli that provoked high versus low distress at individual level. Results In contamination- and non-contamination-type OCD, the dorsomedial prefrontal cortex, operculum, visual association cortex and caudate nucleus were activated during high versus low distress. Only in contamination-type OCD, disgust sensitivity correlated positively with the VAS scores and was associated with neural activation in the dorsomedial and visual association cortex, but not with the operculum. Conclusions Brain activation during distress processing in OCD is similar across the OCD subtypes and related to effortful emotion regulation, processing of aversive internal states and attention. In contamination-type OCD, the distress response is related to disgust sensitivity, which correlates with brain regions associated with attention and emotion regulation.