Control and Reward Circuits in Obsessive Compulsive Disorder

New York State Psychiatric Institute80 enrolled

Overview

The purpose of this study is to examine the brain functioning of OCD patients and healthy controls before and after treatment with Exposure and Response Prevention (EXRP) therapy.

The capacity to coordinate thoughts and actions to execute goal-directed behaviors (cognitive control) and the capacity to anticipate, respond to, and learn from reward (reward processing) are key processes for human behavior. Dysfunction in these processes has been hypothesized to contribute to repetitive thoughts and behaviors in many disorders, including obsessive-compulsive disorder (OCD), Tourette Syndrome (TS), and eating disorders. We will use multimodal imaging to investigate neural circuits that support cognitive control and reward processing, using OCD as a model system. The short-term goal is to clarify how circuit-based abnormalities contribute to repetitive thoughts/behaviors; these data will inform future transdiagnostic studies. The long-term goal is to identify control and reward circuit-abnormalities as targets for new transdiagnostic treatments.

Study Type

INTERVENTIONAL

Allocation

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Obsessive-Compulsive Disorder

Interventions

Exposure & Response Prevention (EX/RP)BEHAVIORAL

Exposure and Response Prevention (EX/RP) is a type of Cognitive Behavioral Treatment for treating OCD.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 55 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria for Patients: * Male and females with OCD aged 18-55 * Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Diagnosis of OCD * Not on psychotropic medication Exclusion Criteria for Patients: * Presence of metallic devices or dental braces in the body that are contraindicators for MR imaging * Comorbid psychiatric conditions that significantly elevate the risk of study participation (e.g. psychotic disorders, bipolar disorder, evidence of dementia or other cognitive disorder, suicidality) * Unstable medical conditions that need attention and would make participation in the study unsafe (e.g. very high blood pressure) * Use of psychotropic medication * Females who are pregnant or post-menopausal Inclusion Criteria for Healthy Volunteers \- Male and females aged 18-55 Exclusion Criteria for Healthy Volunteers * Presence of metallic devices or dental braces in the body that are contraindicators for MR imaging * Any psychiatric diagnosis * Use of psychotropic medication * Diagnosis of OCD in a first degree relative * Females who are pregnant or post-menopausal * Unstable medical conditions that need attention and would make participation in the study unsafe (e.g. very high blood pressure)

Locations (1)

NY State Psychiatric Institute

New York, New York, United States

Outcomes

Primary Outcomes

Change from baseline in brain activation (fMRI) and fractional anisotropy (Diffusion tensor imaging) after therapy

Time frame: Baseline & approximately 10 weeks later

Secondary Outcomes

Change in reaction times and correct responses on Stop signal reaction time task

Time frame: Baseline and approximately 10 weeks later, at second scan

Data from ClinicalTrials.gov

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