Overlapping Neural Circuits Implicated in Pediatric OCD
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Obsessive Compulsive Disorder
- Sponsor
- New York State Psychiatric Institute
- Enrollment
- 55
- Locations
- 1
- Primary Endpoint
- Brain Activation Associated With the Resolution of Cognitive Conflict
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The purpose of this study is to examine the brain functioning of children and adolescent with OCD before and after treatment with Exposure and Response Prevention (EXRP) therapy.
Detailed Description
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. The investigators will use multimodal imaging to investigate neural circuits that support cognitive control and reward processing, using pediatric 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 trans-diagnostic studies. The long-term goal is to identify control and reward circuit-abnormalities as targets for new trans-diagnostic treatments.
Investigators
Rachel Marsh
Irving Philips Professor of Medical Psychology (in Child Psychology)
New York State Psychiatric Institute
Eligibility Criteria
Inclusion Criteria
- •Participants must be 5-17 at the time of consent
- •Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Diagnosis of OCD as the principal problem
- •Not on psychotropic medication and not receiving current psychotherapy for OCD
- •Written informed assent by the participants (8 and older) and consent by the parent
- •Participants and a parent/guardian must be able to read and understand English
Exclusion Criteria
- •DSM-IV current diagnosis of major depressive disorder, attention-deficit hyperactivity disorder, Tourette's/Tic Disorder, or substance/alcohol abuse
- •DSM-IV lifetime diagnosis of psychotic disorder, bipolar disorder, eating disorder, pervasive developmental disorder, or substance/alcohol abuse
- •Active suicidal ideation
- •Females who are pregnant or nursing
- •Major medical or neurological problems
- •Presence of metallic device or dental braces
- •A current or past diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS)
- •Individuals who are currently receiving CBT, other forms of psychotherapy, or psychotropic medications
- •Individuals who have received a full course of CBT in the past
- •A positive pregnancy test
Outcomes
Primary Outcomes
Brain Activation Associated With the Resolution of Cognitive Conflict
Time Frame: single time point: baseline
Task-based functional magnetic resonance imaging (fMRI) will be acquired from children and adolescents diagnosed with OCD and healthy comparison subjects (HCs) during their performance of a Simon Spatial Compatibility Task. In each trial, participants are presented with a leftward or rightward pointing arrow that is either congruent or incongruent with their position (left or right) on the screen. Participants are instructed to respond as quickly and accurately as possible to the direction in which the arrow was pointing by pressing a button on a response box using the index finger for left and the middle finger for right. Brain activation during the resolution of cognitive conflict is computed by contrasting blood-oxygen-level-dependent (BOLD) signal during Incongruent versus Congruent trials. BOLD signal is expressed in arbitrary units (A.U.s).
Secondary Outcomes
- Structural Connectivity (Streamline Counts)(Single time point (baseline))
- Functional Connectivity(single time point: Baseline)
- Brain Gray Matter Thickness(Single time point: Baseline)