Abnormal Brain Activity Seen in Hoarding Disorder

Decision-making brain activity in the anterior cingulate cortex and insula distinct from OCD

WEDNESDAY, Aug. 8 (HealthDay News) -- Patients with hoarding disorder (HD) display stimulus-dependent abnormal neural activity in the anterior cingulate cortex and insula that is not present in patients with obsessive-compulsive disorder (OCD) or in healthy control individuals, according to research published in the August issue of the Archives of General Psychiatry.

David F. Tolin, Ph.D., of the Institute of Living in Hartford, Conn., and colleagues using functional magnetic resonance imaging (fMRI) to assess the neural mechanisms of impaired decision making in HD in a cohort of 43 adults with HD, 31 with OCD, and 33 healthy control subjects.

The researchers found that stimulus-dependent abnormal activity in the anterior cingulate cortex and insula was observed in patients with HD that was not seen in those with OCD or in healthy controls. For patients with HD, compared to the other groups, fMRI showed excessive signals in these regions of the brain when they were trying to decide what to do with items that belonged to them that were not present when considering objects that did not belong to them. Not only did these changes in neural function correlate with a patient's rating of their indecisiveness and the severity of their hoarding, but these were not attributable to depression or OCD symptoms.

"Findings suggest a biphasic abnormality in anterior cingulate cortex and insula function in patients with HD related to problems in identifying the emotional significance of a stimulus, generating appropriate emotional response, or regulating affective state during decision making," the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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