Altered function and connectivity of the medial frontal cortex in pediatric obsessive-compulsive disorder

Kate Dimond Fitzgerald, Emily R. Stern, Mike Angstadt, Karen C. Nicholson-Muth, McKenzie R. Maynor, Robert C. Welsh, Gregory L. Hanna, Stephan F. Taylor

Research output: Contribution to journalArticlepeer-review

126 Scopus citations


Background Exaggerated concern for correct performance has been linked to hyperactivity of the medial frontal cortex (MFC) in adult obsessive-compulsive disorder (OCD), but the role of the MFC during the early course of illness remains poorly understood. We tested whether hyperactive MFC-based performance monitoring function relates to altered MFC connectivity within task control and default mode networks in pediatric patients. Methods Eighteen pairs of OCD and matched healthy youth underwent functional magnetic resonance imaging during performance monitoring and at rest. Task-related hyperactivations in the posterior and ventral MFC were used as seeds for connectivity analyses during task and resting state. Results In posterior MFC, patients showed greater activation of dorsal anterior cingulate cortex (dACC) than control subjects, with greater activation predicting worse performance. In ventral MFC, control subjects exhibited deactivation, whereas patients activated this region. Compared with control subjects, patients showed increased dACC-ventral MFC connectivity during task and decreased dACC-right anterior operculum and ventral MFC-posterior cingulate connectivity during rest. Conclusions Excessive activation and increased interactions of posterior and ventral MFC during performance monitoring may combine with reduced resting state connectivity of these regions within networks for task control and default mode to reflect early markers of OCD. Alteration of reciprocal interactions between these networks could potentiate the intrusion of ventral MFC-based affectively laden, self-referential thoughts, while disrupting posterior MFC-based performance-monitoring function in young patients.

Original languageEnglish
Pages (from-to)1039-1047
Number of pages9
JournalBiological Psychiatry
Issue number11
StatePublished - 1 Dec 2010
Externally publishedYes


  • Default mode network
  • Medial frontal cortex
  • Pediatric obsessive-compulsive disorder
  • Performance monitoring
  • Resting state connectivity
  • Task control network


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