Background. Olfactory identification (OI) ability implicates the integrity of the orbitofrontal cortex (OFC). Clinical populations in which neurodevelopmental compromise of the OFC has been implicated have consistently been linked to behavioral deficits in OI. Neuroimaging studies suggest that disturbances of the prefronto-striato-thalamic circuits including the OFC may be responsible for the mediation of Obsessive Compulsive Disorder (OCD) symptoms and associated cognitive impairments. An aberrant maturation of the aforementioned brain circuits has been suggested in paediatric OCD. However, until today, a few studies have assessed the olfactory function in patients with OCD. Besides, no study has been conducted in children with OCD. Objective. To explore the associations between olfactory processing and cognitive functioning in two different samples of OCD patients, children and adults, in comparison to age-, gender-, and IQ-matched normal controls. To identify potential areas of overlap and difference between childhood- and adults-onset OCD. Methods. 120 subjects (40 adults with OCD, 20 children with OCD, and 60 matched normal controls) will undergo the following tests: a 40-items University of Pennsylvania Smell Identification Test (UPSIT) and Cambridge Neuropsychological Automated Battery (CANTAB) tests of visual memory (Paired Associates Learning and Delayed Matching to Sample), executive functions (Spatial Span; Spatial Working Memory; Stocking of Cambridge; and Intra/Extradimensional set shift), attention (Rapid Visual Information Processing), decision making (Information Sampling Task) and response inhibition (Stop Signal Task).
The same assessment will be performed in a parallel sample of patients with Bipolar Disorder, as well as in a matched healthy control group. Memory function will be investigated by the Wechsler Memory Scale. All the subjects will be also assessed by the NES for Neurological Soft Signs, as an index of neurodevelopmental impairment
The project aims at integrating clinical and experimental evidence, not conclusive at the present state of research, into a more advanced knowledge model. The innovative objective of the study is represented by the possibility of evaluating the joint effects of early neurodevelopmental alterations and the use of substances of abuse in youth, in particular cannabis, on the dysfunctional characteristics underlying various mental disorders. The attention will be focused specifically on the relationship between alterations of the olfactory function, both in terms of olfactory threshold and olfactory discrimination, and neurocognitive profile. The objective is to expand the specific knowledge on the basic neuropsychological anomalies of mental disorders , in particular of the Obsessive-Compulsive Disorder and in Bipolar Disorder, and on the basic alterations of the olfactory function. Both of these anomalies can be interpreted as results of early alterations of the cerebral organization, also in relation to the evolutionary problems of the neurogenesis processes and of the organization of the interneuronal connectivity. In particular, the olfactory bulbs seem to represent a center of primary importance in the integration between sensory reception capacity from the environment and regulation of emotions and mood. The widespread use of cannabis at a young age makes crucial the knowledge of the effects of this substance on the maturation processes of the brain and on the integrative sensory and emotional functions. An integrated and dynamic evaluation of the relationship between the different functions investigated, in close relationship with the study of the clinical characteristics of the subjects studied, may produce a real advancement of knowledge in a field of scientific investigation still far from being conclusive and applicable in a clinically useful way to prevention and treatment of mental disorders.
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