This project seeks to identify causal neural mechanisms underlying unwanted, repetitive behaviors (compulsions). Using non-invasive brain stimulation coupled with practice in a computer task, we will modulate activity in a target brain region and measure effects on compulsive behaviors and related measures. This work could ultimately lead to the ability to treat compulsions more effectively by targeting the regions of the brain that can help or hinder attempts to overcome compulsions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
TRIPLE
Enrollment
203
Computerized "brain training" to provide practice in overriding avoidance habits.
Non-invasive method for temporary, focal stimulation of brain areas. Delivered in a continuous Theta Burst Stimulation (TBS) pattern.
Computer-based task practice in a non-active/inert task.
Western Psychiatric Institute and Clinic
Pittsburgh, Pennsylvania, United States
Brain activation in target region
Mean Cerebral Blood Flow (CBF) in orbitofrontal cortex collected via functional Magnetic Resonance Imaging (fMRI)
Time frame: 10-60min post-intervention
Effort to resist compulsive behaviors in response to laboratory triggers
Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: self-reported effort needed to resist (0-100 scale)
Time frame: 60min post-intervention
Duration of compulsive behaviors in response to laboratory triggers
Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: duration of compulsive behavior performance (% of total time allotted)
Time frame: 60min post-intervention
Intensity of urges to perform compulsive behaviors in response to laboratory triggers
Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: self-reported urge intensity (0-100 scale)
Time frame: 60min post-intervention
Goal-directed cognition
Neuropsychological test of flexible goal-directed cognition (two-step task): switch score (higher score=better performance)
Time frame: 90min-1 week
Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
Clinician-administered measurement of obsessions and compulsions (range: 0-40; higher score=worse outcome)
Time frame: 1 week
WHO Disability Assessment Scale 2.0
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Sham stimulation of non-brain areas. Delivered in a continuous Theta Burst Stimulation (TBS) pattern.
Self-report measure of general functioning and disability (0-100; higher score=worse outcome)
Time frame: 1 week
Obsessive Compulsive Inventory-Revised (OCI-R)
Self-report measure of obsessions and compulsions (0-72; higher score=worse outcome)
Time frame: 1 week
Effort to resist compulsive behaviors in response to laboratory triggers
Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: self-reported effort needed to resist (0-100 scale)
Time frame: 1 week
Duration of compulsive behaviors in response to laboratory triggers
Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: duration of compulsive behavior performance (% of total time allotted)
Time frame: 1 week
Intensity of urges to perform compulsive behaviors in response to laboratory triggers
Custom-made laboratory assessment of ability to override compulsive behaviors in response to idiographic triggers: self-reported urge intensity (0-100 scale)
Time frame: 1 week
Brain activation in target region
Mean Cerebral Blood Flow (CBF) in orbitofrontal cortex collected via functional Magnetic Resonance Imaging (fMRI)
Time frame: 1 week