BACKGROUND Obsessive-compulsive disorder (OCD) has complex genetic underpinnings, particularly in its early-onset form, which places siblings at a 10-fold increased risk of developing the disorder. Examination for neurocognitive markers preceding pediatric OCD onset has not been conducted, although markers have been identified in adult OCD. This study compared neurocognition across groups of OCD-affected youth (n = 87), unaffected siblings of those with early-onset OCD (n = 67), and healthy controls (HC; n = 79). METHODS A total of 233 participants aged 6-18 years old completed standardized neurocognitive tests of cognitive flexibility, decision making, planning, response inhibition, spatial working memory, attention, recognition nonverbal memory, and intelligence. They were administered the Anxiety Disorders Interview Schedule-Parent version (ADIS-P) and completed self-report anxiety and OCD questionnaires. Linear mixed-effects models tested for differences between groups, adjusting for age, gender, IQ, state anxiety, and ethnicity, and accounting for random effects of family membership. RESULTS OCD-affected youth and unaffected siblings performed significantly worse on planning in comparison to HCs (Cohen's d = 0.74; 95% CI = [0.11, 1.36]; Cohen's d = 0.75; 95% CI = [0.12, 1.38], respectively; omnibus group effect p = .007). No other significant between-group differences were identified. CONCLUSIONS Neurocognitive performance differences between groups identified planning as a preexisting trait marker of pediatric OCD, while no other domain presented as a marker of pediatric OCD. This differs from adult OCD, which is associated with broader cognitive impairments. Investigating longitudinal trajectories and predictive significance of neurocognition in those affected by, and at risk for, early-onset OCD is warranted. Ideally, this will enhance individualized risk stratification and inform future prevention and early intervention strategies.

中文翻译：

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儿童强迫症的神经认知风险标志物。

背景强迫症 (OCD) 具有复杂的遗传基础，特别是其早发形式，这使兄弟姐妹患该疾病的风险增加了 10 倍。尚未对儿童强迫症发作前的神经认知标志物进行检查，尽管已在成人强迫症中发现了标志物。本研究比较了受强迫症影响的青年（n = 87）、早发性强迫症患者的未受影响兄弟姐妹（n = 67）和健康对照（HC；n = 79）的神经认知。方法 共有 233 名 6-18 岁的参与者完成了认知灵活性、决策、计划、反应抑制、空间工作记忆、注意力、识别非语言记忆和智力的标准化神经认知测试。他们接受了焦虑症访谈时间表 - 家长版本 (ADIS-P) 并完成了自我报告的焦虑和强迫症问卷。线性混合效应模型测试了组间差异，调整了年龄、性别、智商、状态焦虑和种族，并考虑了家庭成员的随机效应。结果 与 HC 相比，受 OCD 影响的青年和未受影响的兄弟姐妹在计划方面的表现明显较差（Cohen's d = 0.74；95% CI = [0.11, 1.36]；Cohen's d = 0.75；95% CI = [0.12, 1.38]；综合组效应 p = .007）。没有发现其他显着的组间差异。结论 组间的神经认知表现差异将计划确定为儿科强迫症的一个预先存在的特征标志物，而没有其他领域作为儿科强迫症的标志物出现。这与成人强迫症不同，后者与更广泛的认知障碍有关。有必要研究受早发性强迫症影响和风险的人的神经认知的纵向轨迹和预测意义。理想情况下，这将加强个体化风险分层，并为未来的预防和早期干预策略提供信息。