Anterior limb of internal capsule stimulation in obsessive-compulsive disorder : how it affects decision-making under risk and ambiguity

• Autor(a) principal: Monteiro, Maria Silva Graça
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.14/37816
• topic: Obsessive-compulsive disorder; Deep brain stimulation; Decision-making towards ambiguity; Decision making towards risk; Perturbação obsessivo-compulsiva; Estimulação cerebral profunda; Tomada de decisão perante a ambiguidade; Tomada de decisão perante o risco; Domínio/Área Científica::Ciências Sociais::Psicologia

Purpose: Decision-making processes are a basis of human condition, every day we are confronted with situations where we have to make a decision, and sometimes, the outcomes of these situations are unpredictable and involve some risk. Unbalances in the decision-making process may lead to psychiatric disorders. It is known that a main symptom of obsessive-compulsive disorder (OCD) is the presence of doubt, and therefore, an aversion to risky behaviors and situations; some authors even consider OCD as a disorder of decision-making. This study aims to understand the impact the chronic stimulation of the anterior limb of the internal capsule (ALIC) on the decision-making profile towards ambiguity and risk of OCD patients. Participants and method: Three OCD patients with DBS were matched with OCD only patients and healthy controls. Two behavioral tasks, the Risky Choice or Sure Amount of Money and the Iowa Gambling Task were performed in the ON and OFF condition by the DBS patients. The patients performed the Raven’s Progressive Matrices and answered to the Everyday Risk Inventory on the washout period. Before the first and second time that the DBS subjects performed the behavioral tasks, the Subjective Units of Disturbance Scale was applied. OCD and healthy controls also repeated the behavioral task. All subjects also completed the Yale-Brown Obsessive-Compulsive Scale. Results: DBS subjects showed a lesser risk averse profile towards ambiguity when the DBS was ON (IGTON < IGTOFF). Also, patients with DBS had a lesser risk averse profile towards risk, than their matched OCD controls (RCSAMDBS > RCSAMOCD). Lastly, DBS treated patients show the same decision-making profile towards risky than their matched healthy controls (RCSAMDBS = RCSAMDBS). Conclusion: The stimulation of the ALIC, in OCD patients, makes them less averse towards ambiguity. Also, the stimulation of this target makes patients less averse to risk, when compared with obsessive-compulsive patients. Finally, DBS patients seem to able to take the same risk than their matched healthy controls.