Obsessive-Compulsive Disorder
Conditions
Brief summary
This study investigates whether slow-frequency repetitive transcranial magnetic stimulation targeting frontal pole can acutely modulate brain circuits which show abnormal functioning during behavioral flexibility in obsessive-compulsive disorder, as well as performance on a behavioral task.
Interventions
DEVICErTMS
1-Hz rTMS targeting frontal pole
DEVICEsham rTMS
sham rTMS targeting frontal pole
Sponsors
Butler Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Subject)
Masking description
Arms denoted as open-label do not include masking
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
OCD group * current primary diagnosis of obsessive-compulsive disorder and Yale-Brown Obsessive Compulsive Scale total score ≥ 16; * 18-55 years of age; * ability to speak, read, write, and understand English sufficiently well to complete study procedures and provide informed consent; * either no use of psychiatric medication or stable psychiatric medication use for 6 weeks prior to study entry, limited to use of serotonin reuptake inhibitors and PRN use of benzodiazepines (other psychiatric medication use excluded), and * right-handed. Inclusion Criteria: Healthy Control group * 18-55 years of age; * ability to speak, read, write, and understand English sufficiently well to complete study procedures and provide informed consent; * right-handed.
Exclusion criteria
OCD group * active problematic substance use; * lifetime psychosis or bipolar mood disorder or OCD beliefs of delusional nature; * clinically significant hoarding symptoms; * active suicidal or homicidal ideation; * significant neurological disease or intracranial pathology; * use of medications which increase risk for seizures during TMS; * significant or unstable medical disorders or contraindication to TMS or MRI scan.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Resting-state functional connectivity with ventral striatum | Before rTMS and approximately 1 day following open-label rTMS | Resting-state functional connectivity with ventral striatum (assessed via fMRI) |
| Resting-state functional connectivity with dorsal striatum | Before rTMS and approximately 1 day following open-label rTMS | Resting-state functional connectivity with dorsal striatum (assessed via fMRI) |
| Cognitive flexibility task performance | Before rTMS and approximately 1 day following open-label rTMS | Behavioral performance on a cognitive flexibility task (% trials correct) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Resting-state functional connectivity with ventral striatum | Before rTMS and within 30 minutes immediately following rTMS | Resting-state functional connectivity with ventral striatum (assessed via fMRI) |
| Change in regional activation in orbitofrontal cortex | Before rTMS and within 30 minutes immediately following rTMS | Change in task-based regional activation (assessed via functional magnetic resonance imaging; fMRI) in orbitofrontal cortex |
| Cognitive flexibility task performance | Before rTMS and within 30 minutes immediately following rTMS | Behavioral performance on a cognitive flexibility task (% trials correct) |
| Resting-state functional connectivity with dorsal striatum | Before rTMS and within 30 minutes immediately following rTMS | Resting-state functional connectivity with dorsal striatum (assessed via fMRI) |
| Change in regional activation in dorsolateral prefrontal cortex | Before rTMS and within 30 minutes immediately following rTMS | Change in task-based regional activation (assessed via fMRI) in dorsolateral prefrontal cortex |
| Change in regional activation in anterior cingulate cortex | Before rTMS and within 30 minutes immediately following rTMS | Change in task-based regional activation (assessed via fMRI) in anterior cingulate cortex |
Countries
United States
Outcome results
None listed