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Reversal Learning as a Neuropsychological Indicator for the Neuropathology of Obsessive Compulsive Disorder? A Behavioral Study

Received August 21, 2006; revised March 19, 2007; accepted April 2, 2007. Dr. Valerius is affiliated with the Department of Psychosomatic Medicine and Psychotherapy at the Central Institute of Mental Health in Mannheim, Germany; Drs. Lumpp, Kuelz, Freyer, and Voderholzer are affiliated with the Department of Psychiatry at the University of Freiburg, Germany. Address correspondence to Gabriele Valerius, Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, J5, D-68159 Mannheim, Germany.

A dysfunction of the fronto-striatal loop has been associated with obsessive-compulsive disorder (OCD). Functional imaging studies suggest that reversal learning is affected by deficits in fronto-striatal brain areas and thus should be impaired in patients with OCD. The authors compared patients with OCD and healthy comparison subjects on a reversal learning task. Correlation analyses and group comparisons showing prolonged reaction times of different response parameters are associated with increasing severity of compulsions. The reversal learning task has been shown to be associated with ventral fronto-striatal brain activation by functional magnetic resonance imaging (fMRI) in healthy comparison subjects. The purpose of this article is to suggest that the reversal learning task can be used as a neuropsychiatric measurement of the ventral fronto-striatal dysfunction in OCD.

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