Functional and structural neural indices of risk aversion in obsessive-compulsive disorder (OCD)

Roee Admon, Maya Bleich-Cohen, Ronit Weizmant, Michael Poyurovsky, Sarit Faragian, Talma Hendler

Research output: Contribution to journalArticlepeer-review


Obsessive-compulsive disorder (OCD) patients suffer from risk aversion, which may be mediated by their exaggerated response to threat and diminished response to reward. In this study, 13 OCD patients and 13 healthy matched controls underwent functional magnetic resonance imaging (fMRI) while playing an interactive risky choice game encompassing distinct intervals of threat and reward; as well as anatomical diffusion tensor imaging (DTI). Compared to healthy controls OCD patients were reluctant to make risky choices during the game. Furthermore, they displayed higher amygdala activation to threat; lower nucleus accumbens (Nacc) activation to reward and reduced functional connectivity of the amygdala and Nacc to two frontal regions, the orbito-frontal cortex (OFC) and the dorsal anterior cingulate cortex (dACC), respectively. OCD patients also displayed reduced structural integrity in clusters within the uncinate and cingulum fiber tracts. Finally, these deficits in limbic-frontal connectivity pathways, both at the functional and structural level, were associated with severity of OCD symptoms, as well as with each other. Our results thus suggest that risk aversion in OCD is mediated by abnormal limbic responses to threatening and rewarding stimuli, as well as by deficient functional and structural limbic-frontal connectivity. Such deficiency characterization may aid in identifying neural predictors for treatment response and localizing individual targets for direct neural intervention treatments.

Original languageEnglish
Pages (from-to)207-213
Number of pages7
JournalPsychiatry Research - Neuroimaging
Issue number2-3
StatePublished - Aug 2012
Externally publishedYes

Bibliographical note

Funding Information:
This research was supported by the Levy Edersheim Gitter Institute for Neuroimaging and the Adams Super Center for Brain Studies, Tel Aviv University (R.A. and T.H.). Many thanks to Mrs. Vicki Myers and Dr. Itamar Kahn for their support at various stages of the project.


  • Amygdala
  • Connectivity
  • Diffusion tensor imaging (DTI)
  • Functional magnetic resonance imaging (fMRI)
  • Nucleus accumbens
  • Reward
  • Threat

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Radiology Nuclear Medicine and imaging
  • Neuroscience (miscellaneous)


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