To explore the neural basis of cognitive inflexibility, a significant feature of OCD, across various cognitive tasks and to assess the shared and distinct neural mechanisms involved.
Approach:
Cognitive Tasks: The review examines eight tasks that challenge cognitive flexibility: set-shifting (Wisconsin Card Sorting Task, Intra/Extra-Dimensional Set Shift), feedback adaptation (Reversal Learning), interference control (Stroop Color and Word Test), response inhibition (Go/No-Go Task and Stop Signal Task), working memory updating (n-back Task), and value-based flexibility (Delay Discounting Task).
Neural Mechanisms: It details the involvement of core structures (anterior cingulate cortex, caudate nucleus, orbital frontal cortex, prefrontal cortex) and peripheral structures (putamen, thalamus, parietal cortex) in cognitive inflexibility, highlighting the complexity of interactions among these networks.
Key Findings:
Cognitive inflexibility in OCD is linked to functional abnormalities in a largely shared set of core neural structures.
The cortico-striato-thalamo-cortical network is central to cognitive inflexibility in OCD, with contributions from the salience network and default mode network.
Cognitive inflexibility involves failures in interaction between multiple neural networks rather than dysfunction in a single system.
Interpretation:
Cognitive inflexibility in OCD represents a complex interplay of various neural processes rather than a singular dysfunction.
Limitations:
The precise neural mechanisms of persistent cognitive inflexibility remain unclear.
The review does not reach a consensus on the contribution of cognitive inflexibility versus other executive deficits.
Conclusion:
Cognitive inflexibility is a prominent neuropsychological feature of OCD.
