Neurobehavioural stratification of the obsessive-compulsive trends and validation of a neurofeedback-based intervention

• Applicant: Dr. Pegah Sarkheil
• Subject Area: Clinical Psychiatry, Psychotherapy, Child and Adolescent Psychiatry ; Human Cognitive and Systems Neuroscience
• Term: since 2020
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 448334688

Obsessions and/or compulsion are the main presentation of obsessive-compulsive disorder (OCD), which is a prevalent and highly debilitating mental health condition. In addition, obsessive-compulsive (OC) symptoms are fundamental components of many other mental disorders like depression, substance use disorder as well as schizophrenia. It is increasingly recognized that the current psychiatric diagnostic categories do not align well with distinct neurobiological abnormalities. Transdiagnostic approaches that link the behavioral symptom dimensions to the neural processes facilitate the search for disease markers, which predict psychopathology and allow for precisely directed interventions. In particular, the search for OC pathologies in the large community-based data, which is not confined to the OCD diagnosis, is a highly relevant approach since 1) heterogeneous presentations of OC-related symptoms are common in various psychiatric disorders and 2) current treatment response of OC symptoms to the available pharmacological and psychotherapeutic treatments is slow and insufficient. In the proposed project, we aim at investigation of OC related pathologies at behavioral and neural levels in a multimodal fashion. The aim is detecting neurobehaviorally-derived, objectively measurable intermediate phenotypes, which correspond closer to the etiological disease mechanisms. Furthermore, we propose a neuromodulatory approach, using fMRI neurofeedback method to demonstrate the use of intermediate phenotypes in developing targeted intervention in treatment of OC symptoms. The first study leverages large-scale neuroimaging and behavioral data from IMAGEN (www.imagen-europe.com, n=2000) and emerging multivariate statistical methods to explore patterns of brain functional connectivity that link to OC psychopathology in subclinical conditions. In the second study, the effectiveness of fMRI neurofeedback in the clinically relevant neuro-behavioral patterns will be explored to showcase a translational approach from the experimental to the clinical settings. Neurofeedback will be applied to target functional connectivity patterns in the cortico-striatal circuitries, which are known to be relevant neural aberrations in the OC psychopathology. These steps promise progress towards alleviating the urgent need for effective treatment management of debilitating and prevalent OC symptoms in the future. We perform a series of investigations that with a multimodal, dimensional approach can account for stratification of the heterogeneous OC pathologies and has the potential of capturing the relevant intermediate phenotypes. Ultimately, we aim to investigate new clinical interpretations that are closer to the underlying pathologies and can directly been used in development of effective treatment paradigms.

• DFG Programme: Research Grants
• International Connection: Canada
• Cooperation Partner: Professor Dr. Danilo Bzdok