Arbitration Between Habitual and Goal-directed Behavior in Obsessive-compulsive Disorder: Circuit Dynamics and Effects of Noninvasive Neurostimulation

Not Applicable

Completed

• Conditions: Decision-Making; OCD; tDCS; fMRI
• Interventions: Device: transcranial Direct Current Stimulation (tDCS)

• Registration Number: NCT04075890
• Lead Sponsor: University of California, Los Angeles

Brief Summary

People utilize two behavioral strategies, goal-directed and habitual, when engaging in value-based decision-making that involves rewarding or punishing outcomes. Accumulating evidence suggests an imbalance between habitual and goal-directed behavior in favor of habitual control in parallel with exaggerated tendency toward compulsive/harm avoidance behavior in OCD. In healthy subjects, an arbitration mechanism has been proposed recently that controls the balance between those two strategies of action selection. Arbitration regions regulate the goal-directed/habitual decision-making balance by selectively downregulating the activity of the habitual regions. This project aims to explore the neurobehavioral characteristics of arbitration mechanism and its relationship with behaviors and clinical phenotypes in OCD by applying computational cognitive neuroscience, clinical task-based functional magnetic resonance imaging (fMRI) and transcranial direct current stimulation (tDCS) method.

Detailed Description

Investigators will recruit 30 male and female adults (age 18-65) with OCD and 30 age-, sex-, and education-matched healthy (medically, neurologically and psychiatrically) controls for this project. Each participant will come for three sessions. There will be 3-4 days interval between sessions:

Session 1 that includes initial clinical assessment and obtaining T1 structural image (needed for neuronavigation analysis and electric field modeling).

Session 2 and 3 that include performing two separate decision-making and symptom provocation-avoidance tasks by participants with OCD and healthy controls under two conditions: while scanned inside the MRI scanner (no tDCS) or while receiving neuronavigated tDCS neurostimulation outside the scanner (no fMRI imaging). As participates will perform each task twice, there might be an order effect on task performance. For minimizing the impact of such a potential order effect on imaging and tDCS results, participants will be randomly assigned to undergo scanning in the session 2 and then receive tDCS in the session 3 or in the opposite order (tDCS in session 2 and then imaging in session 3) but in each session only one of imaging or tDCS experiments (for both tasks) will be conducted for each participant. OCD-relevant and aversive picture rating (explained below) will be done always in the session 3 as the last experiment.

Study Timeline

• Study Start: 2019-07-15
• Study First Submitted: 2019-08-29
• Study First Submitted QC: 2019-08-29
• Study First Posted: 2019-09-03
• Primary Completion: 2024-01-31
• Study Completion: 2024-01-31
• Status Verified: 2024-08
• Last Update Submitted: 2024-08-13
• Last Update Posted: 2024-08-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 40

Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
OCD subjects	transcranial Direct Current Stimulation (tDCS)	-
Healthy subjects	transcranial Direct Current Stimulation (tDCS)	-

Primary Outcome Measures

Name	Time	Method
Change in Action Selection Ratio	At baseline AND twice in two separate sessions with 3-4 days interval.	Participants perform a decision-making task in which goal-directed and habitual strategies of decision-making compete to govern the manner of action selection. Action Selection Ratio is the ratio of goal-directed/habitual action selection strategies during the task. Change in Action Selection Ratio will be measured across 3 sessions (baseline, during fMRI and finally tDCS sessions).
Arbitration-Habitual Connectivity	baseline	The fMRI based functional connectivity between the arbitration regions(the right and left inferior lateral prefrontal cortex and right frontopolar cortex) and habitual regions (putamen, supplementary motor area) measured by psychophysiological interactions method during decision-making and symptom provocationavoidance tasks.
Activity Level of Arbitration Regions	baseline	Activity level of arbitration regions including the right and left inferior lateral prefrontal cortex and right frontopolar cortex in terms of regional BOLD signals during decision-making and symptom provocation-avoidance tasks.
Change in Timing of Avoidance Behavior	At baseline but twice in two separate sessions with 3-4 days interval.	During symptom provocation-avoidance task, OCD-relevant photos will be shown to participants and they will be instructed to push a button to stop the picture presentation when they feel distressed such that they desire to stop viewing the photo. Timing of Avoidance Behavior is the interval between starting time of photo presentation until pushing the stop button. Change in Timing of Avoidance Behavior will be measured across 3 sessions (baseline, during fMRI and finally tDCS sessions).

Trial Locations

Locations (1)

UCLA; 🇺🇸 Los Angeles, California, United States