The Neural Correlates of Positive Versus Negative Thought-Action Fusion in Healthy Young Adults
Sang Won Lee 1, 2, Hyunsil Cha 3, Tae Yang Jang 2, 4, Eunji Kim 3, Huijin Song 5, Yongmin Chang 6, 7, Seung Jae Lee 2, 4*
1Department of psychiatry, Kyungpook National University Chilgok Hospital, Daegu, Korea, 2Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea, 3Department of Medical & Biological Engineering, School of Medicine, Kyungpook National University, Daegu, Korea, 4Department of Psychiatry, Kyungpook National University Hospital, Daegu, Korea, 5Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea, 6Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Korea, 7Department of Radiology, Kyungpook National University Hospital, Daegu, Korea
Received: July 31, 2020; Revised: December 11, 2020; Accepted: December 11, 2020; Published online: December 11, 2020.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: Thought-action fusion (TAF), one of the most-studied dysfunctional beliefs in obsessive-compulsive disorder, represents an individual’s belief that his/her thoughts directly influence events. TAF belief types are divided into personal thoughts relating to positive (positive TAF) and negative outcomes (negative TAF). However, the neural mechanisms underlying both aspects of the TAF response remain elusive.
Methods: This functional magnetic resonance imaging study aimed to investigate the neural circuits related to positive and negative TAF and their relationships with psychological measures. Thirty-one healthy male volunteers participated in a modified TAF task wherein they were asked to read the name of a close person embedded in positive statements (PS) or negative statements (NS).
Results: Conjunction analysis revealed activation of the fusiform and lingual gyri, midcingulate and superior medial frontal gyri, inferior orbitofrontal gyrus, and temporoparietal junction. The NS > PS comparison showed additional activation in the precuneus and medial prefrontal cortex, superior frontal gyrus, insula, globus pallidus, thalamus, and midbrain. Precuneus activity was associated with the TAF score among these areas. Moreover, activity in the inferior orbitofrontal gyrus, insula, superior, middle and medial frontal gyri, globus pallidus, inferior parietal lobule, and precuneus was associated with dimensional obsessive–compulsive scores. In contrast, the PS > NS comparison revealed no significant activation.
Conclusion: These results suggest that negative TAF, relative to positive TAF, recruits additional regions for self-referential processing, salience, and habitual responding, which may contribute to the activation of the belief that a negative thought increases the probability of that negative outcome.
Keywords: Thought-action fusion, Cognitive theory, Obsessive-compulsive disorder, Cortico-striato-thalamo-cortical circuit, Affective network, Salience network

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