Working memory dysfunction in obsessive-compulsive disorder: A neuropsychological and functional MRI study

Tomohiro Nakao, Akiko Nakagawa, Eriko Nakatani, Maiko Nabeyama, Hirokuni Sanematsu, Takashi Yoshiura, Osamu Togao, Mayumi Tomita, Yusuke Masuda, Kazuko Yoshioka, Toshihide Kuroki, Shigenobu Kanba

Research output: Contribution to journalArticlepeer-review

111 Citations (Scopus)


Previous neuropsychological studies indicate that OCD subtypes such as checking rituals might be associated with a working memory deficit. On the other hand, functional neuroimaging studies found functional abnormalities of the frontal cortex and subcortical structures in OCD. Combined with functional imaging method, we applied neuropsychological batteries to demonstrate a working memory deficit in OCD by comparison with normal controls. In addition, working memory and brain activation were further examined with symptom-based analysis. Forty patients with OCD and 25 normal controls were examined using neuropsychological tests including the WAIS-R, WCST, WMS-R, and R-OCFT and functional MRI (fMRI) during the N-back task including 0- and 2-back task. On fMRI, the brain regions activated during the performance and the differences in the activation between patients and controls were identified. Additional analyses of severity and subtypes were conducted by using Y-BOCS severity score, symptom-checklist and Leckman's four-factor model, respectively. On the neuropsychological tests, the OCD patients had significantly lower scores on the delayed recall section of the WMS-R and the immediate recall section of the R-OCFT compared to the controls. On fMRI, the patients showed greater activation in the right dorsolateral prefrontal cortex (DLPFC), left superior temporal gyrus (STG), left insula, and cuneus during two-back task compared to the controls. Right orbitofrontal cortex activity showed a significant positive correlation with Y-BOCS scores in OCD. Furthermore, patients with obsessions/checking rituals (n = 10) showed severer memory deficits and decreased activity in the postcentral gyrus than patients with cleanliness/washing rituals (n = 14). In conclusion, we found neuropsychological dysfunction and brain abnormalities in OCD. Furthermore, our results suggested that symptom severity and symptom subtype such as obsessions/checking might affect neuropsychological dysfunction and related brain activities.

Original languageEnglish
Pages (from-to)784-791
Number of pages8
JournalJournal of Psychiatric Research
Issue number8
Publication statusPublished - May 2009

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Biological Psychiatry


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