Overactive performance monitoring in obsessive–compulsive disorder is independent of symptom expression
Abstract
Overactive performance monitoring has been consistently reported in obsessive-compulsive disorder (OCD). OCD is a clinically heterogeneous disorder and is characterized by several symptom dimensions that may have partially distinct neural correlates. We examined whether performance-monitoring alterations are related to symptom severity and symptom dimensions. Electrocortical correlates of performance monitoring were assessed in 72 OCD patients and 72 matched healthy comparison participants during a flanker task. Amplitudes of the error- and correct-related negativity as well as delta and theta power were used to quantify performance-monitoring activity, and a composite measure was derived using factor analysis. Symptom dimension scores were obtained from the Yale-Brown Obsessive Compulsive Scale symptom checklist. OCD patients showed increased electrocortical responses associated with correct and erroneous responses compared to healthy comparison participants. In patients, no correlations were obtained between performance monitoring and global symptom severity as well as lifetime symptom dimension scores. Only a statistical trend was found that higher symmetry/hoarding scores were associated with reduced performance-monitoring activity. For present symptom dimensions scores, an association with rituals/superstitious symptoms was obtained such that higher scores were associated with greater performance-monitoring activity. However, for both dimensions, subjects with low scores or high scores on each dimension were characterized by overactive performance monitoring compared to healthy controls. Overactive brain processes during performance monitoring are a neural correlate of OCD that is independent of global symptom severity and can be observed for all symptom dimensions. This supports the notion of overactive performance monitoring being a candidate endophenotype for OCD.
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Several studies support Endrass and Ullsperger's assertion that Pe/Pc is not altered in OCD.
“Still, several studies support Endrass and Ullsperger’s assertion [8, 9, 28–30].”
From Error-Related Brain Potentials as Biomarkers of Pathology Severity and Treatment Resistance in Patients With Obsessive-Compulsive Disorder (2026) · cites this paper as [28]
Patients included in previous studies that showed a significant increase in ERN/CRN amplitude of OCD patients compared with controls had significantly less severe forms of the disorder, with mean Y-BOCS scores ranging from 17 to 22.5.
“In comparison, patients included in previous studies that showed a significant increase in the ERN/CRN amplitude of OCD patients compared with controls [8, 9, 26, 28–30, 32] had significantly less severe forms of the disorder, with mean Y‐BOCS scores ranging from 17 to 22.5.”
From Error-Related Brain Potentials as Biomarkers of Pathology Severity and Treatment Resistance in Patients With Obsessive-Compulsive Disorder (2026) · cites this paper as [28]
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Self-citation
- Authors
- Riesel, A., Kathmann, N., & Endrass, T.
- Affiliations
- Humboldt-Universität zu Berlin (DE)
- Corresponding author
- Endrass, Tanja
- Venue
- European Archives of Psychiatry and Clinical Neuroscience
- Published
- 2014-03-28
- Volume
- 264
- Issue
- 8
- Pages
- 707-717
- ISSN
- 0003-9373 (ISSN-L)
- 0940-1334
- 1433-8491
- OpenAlex
- W2070530401
- Cited by
- 83
- References
- 64
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 7 · 2021: 12 · 2020: 9 · 2019: 7 · 2018: 5 · 2017: 7 · 2016: 8 · 2015: 9 · 2014: 5
- FWCI
- 11.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Archives of Psychiatry and Clinical Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Yale University
- Humboldt-Universität zu Berlin
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, performance monitoring, error-related negativity, flanker task, symptom dimensions, endophenotypes, delta and theta power
- MeSH terms
- Adult, Delta Rhythm, Evoked Potentials, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Severity of Illness Index, Theta Rhythm, Executive Function, Endophenotypes
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