Brain activation in OCD: A novel functional magnetic resonance imaging (fMRI) study
People with OCD respond to many things differently than people without the disorder. For example, people with OCD may be more anxious overall or may respond more to particular stimuli (such as dirt or unevenness). We are investigating the brain mechanisms underlying some of these effects using a novel functional magnetic resonance imaging (fMRI) scan sequence never before utilized in OCD. This fMRI investigation is being done in collaboration with Alan Anticevic, PhD.
Neurofeedback using functional near-infrared spectroscopy
This study will use near-infrared spectroscopy (NIRS) to measure brain activity during neurofeedback. The purpose of neurofeedback is to teach people to improve self-regulation by learning to regulate brain activity. A NIRS cap designed to detect activity in specific brain regions is placed on the head. Information on this brain activity is then “fed back” to the person in the form of waves displayed on a computer screen. A person will try to regulate their brain activity by using different cognitive strategies to move the waves up and down. Although this is not a treatment study, it may lead to improvement in controlling brain activity.
In this study, we are investigating how people with OCD think and solve problems. Participants complete tasks on a computer and/or tablet which involve basic decision-making. In these tasks, they are presented with a series of visual stimuli, and asked to respond to these stimuli with a button-press. Participants may also be asked to complete other questionnaires. This testing may last up to two hours, with breaks provided as needed.
Transcranial direct current stimulation
This study is exploring ways in which non-invasive brain stimulation can be integrated with principles of cognitive-behavioral therapy for OCD and related-disorders. More specifically, we are combining a single session of transcranial direct current stimulation (tDCS) with two sessions of a lab challenge designed to help understand exposure and response prevention (ERP). This experiment requires two appointments, scheduled 24-48 hours apart, and will take 3-4 hours to complete.
tDCS is a safe and minimally invasive form of brain stimulation that involves passing a mild electrical current (less than that of a 9 volt battery) between electrodes placed on the scalp. Some of this electrical current enters the brain and can change brain activity. ERP is gold-standard behavioral treatment for OCD that involves approaching anxiety provoking situations of a moderate level while resisting typical compulsive behaviors. This can lead to gradual reductions in anxiety and other negative emotions. While this study itself is an experiment and does not involve dedicated treatment of OCD, it may help us identify ways to improve the effect of treatment.
During the first session, participants will: complete a series of questionnaires, learn about ERP, identify moderately challenging exposures with a psychologist or psychiatrist, receive active or sham (placebo) tDCS, then complete 60 minutes of an ERP experimental challenge. Participants will then return 24-48 hours later to complete 60 additional minutes of ERP challenge. Basic physiological measures such as electroencephalography (EEG) skin conductance will be collected during most experimental procedures.
Exploring the genetics of OCD
It is clear that the risk for developing OCD depends in part on our genes; but the specific genes that contribute to OCD, and how they do so, are not well understood. Patients who we see in our clinic have the opportunity to give blood for genetic analysis. By comparing the specific genes of patients with OCD with other patients or with individuals with no psychiatric diagnosis, we hope to better understand the various complicated factors that contribute to the genetics of the illness.