Control and Reward Circuits in Obsessive Compulsive Disorder

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Control & Reward Circuits as Targets for Repetitive Thoughts and Behaviors

Conditions
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Obsessive-Compulsive Disorder

Intervention / Treatment
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* Behavioral: Exposure & Response Prevention (EX/RP)


Participation Criteria
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Eligibility Criteria
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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)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients with OCD<br>Behavioral: Exposure & Response Prevention (EX/RP) | Behavioral: Exposure & Response Prevention (EX/RP)<br>* Exposure and Response Prevention (EX/RP) is a type of Cognitive Behavioral Treatment for treating OCD.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in brain activation (fMRI) and fractional anisotropy (Diffusion tensor imaging) after therapy |  | Baseline & approximately 10 weeks later | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in reaction times and correct responses on Stop signal reaction time task |  | Baseline and approximately 10 weeks later, at second scan | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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OCD, Functional Magnetic Resonance Imaging (fMRI)