OBJECTIVE: Obsessive-compulsive disorder (OCD) is associated with altered brain function related to processing of

negative emotions. To investigate neural correlates of negative valence in OCD, we pooled functional magnetic

resonance imaging data of 633 individuals with OCD and 453 healthy control participants from 16 studies using

different negatively valenced tasks across the ENIGMA (Enhancing Neuro Imaging Genetics through Meta-Analysis)

Consortium’s OCD Working Group.

METHODS: Participant data were processed uniformly using HALFpipe, to extract voxelwise participant-level

statistical images of one common first-level contrast: negative versus neutral stimuli. In preregistered analyses,

parameter estimates were entered into Bayesian multilevel models to examine whole-brain and regional effects of

OCD and its clinically relevant features—symptom severity, age of onset, and medication status.

RESULTS: We provided a proof of concept that participant-level data can be combined across several task

paradigms and observed one common task activation pattern across individuals with OCD and control

participants that encompasses frontolimbic and visual areas implicated in negative valence. Compared with

control participants, individuals with OCD showed very strong evidence of weaker activation of the bilateral

occipital cortex (P1 , 0.001) and adjacent visual processing regions during negative valence processing that was

related to greater OCD severity, late onset of the disorder, and an unmedicated status. Individuals with OCD also

showed stronger activation in the orbitofrontal, subgenual anterior cingulate, and ventromedial prefrontal cortex (all

P1 , 0.1) that was related to greater OCD severity and late onset.

CONCLUSIONS: In the first mega-analysis of this kind, we replicated previous findings of stronger ventral prefrontal

activation in OCD during negative valence processing and highlight the lateral occipital cortex as an important region

implicated in altered negative valence processing.