Reduced prefrontal activation in pediatric patients with obsessive-compulsive disorder during verbal episodic memory encoding

Marcelo Camargo Batistuzzo, Joana Bisol Balardin, Maria Da Graça Morais Martin, Marcelo Queiroz Hoexter, Elisa Teixeira Bernardes, Sonia Borcato, Marina De Marco E. Souza, Cicero Nardini Querido, Rosa Magaly Morais, Pedro Gomes De Alvarenga, Antonio Carlos Lopes, Roseli Gedanke Shavitt, Cary R. Savage, Edson Amaro, Euripedes C. Miguel, Guilherme V. Polanczyk, Eliane C. Miotto

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Objective Patients with obsessive-compulsive disorder (OCD) often present with deficits in episodic memory, and there is evidence that these difficulties may be secondary to executive dysfunction, that is, impaired selection and/or application of memory-encoding strategies (mediation hypothesis). Semantic clustering is an effective strategy to enhance encoding of verbal episodic memory (VEM) when word lists are semantically related. Self-initiated mobilization of this strategy has been associated with increased activity in the prefrontal cortex, particularly the orbitofrontal cortex, a key region in the pathophysiology of OCD. We therefore studied children and adolescents with OCD during uncued semantic clustering strategy application in a VEM functional magnetic resonance imaging (fMRI)-encoding paradigm. Method A total of 25 pediatric patients with OCD (aged 8.1-17.5 years) and 25 healthy controls (HC, aged 8.1-16.9) matched for age, gender, handedness, and IQ were evaluated using a block design VEM paradigm that manipulated semantically related and unrelated words. Results The semantic clustering strategy score (SCS) predicted VEM performance in HC (p <.001, R2 = 0.635), but not in patients (p =.099). Children with OCD also presented hypoactivation in the dorsomedial prefrontal cortex (cluster-corrected p <.001). Within-group analysis revealed a negative correlation between Yale-Brown Obsessive Compulsive Scale scores and activation of orbitofrontal cortex in the group with OCD. Finally, a positive correlation between age and SCS was found in HC (p =.001, r = 0.635), but not in patients with OCD (p =.936, r = 0.017). Conclusion Children with OCD presented altered brain activation during the VEM paradigm and absence of expected correlation between SCS and age, and between SCS and total words recalled. These results suggest that different neural mechanisms underlie self-initiated semantic clustering in OCD.

Original languageEnglish (US)
Pages (from-to)849-858
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number10
StatePublished - Oct 1 2015
Externally publishedYes


  • functional magnetic resonance imaging
  • obsessive-compulsive disorder
  • semantic clustering
  • verbal episodic memory

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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