Neurobiology and Psychophysiology of Impaired Fear Learning and Extinction Processes in Obsessive-Compulsive Disorder

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Fear and anxiety are core characteristics of obsessive-compulsive disorder (OCD) which typically precede and accompany both obsessions as well as compulsions and thus constitute the driving force behind OCD symptomatology. There is increasing evidence for altered activity in core regions of the fear circuitry in OCD, and fear learning as well as fear extinction can be assumed to constitute central mechanisms of the disorder. These mechanisms should be investigated in order to increase our understanding of the processes involved in the development and/or maintenance of OCD psychopathology. Moreover, studying fear learning and extinction in OCD may help to enhance therapeutic efficacy considering that cognitive behavioral therapies used to treat obsessions and compulsions in OCD are typically extinction-based. However, little is known about the mechanisms subserving fear conditioning, extinction and extinction retention in OCD. First evidence suggests that extinction recall might be disrupted in OCD. Against this background, the planned project aims at investigating the neural and psychophysiological correlates of fear conditioning, extinction, and extinction retention in OCD using refined psychophysiological readouts (including startle electromyography and pupillometry), an fMRI fear reversal task and an anxiety provocation task to elucidate which mechanisms may be altered in association with these processes in patients with OCD. Moreover, using the method of actigraphy sleep and circadian rhythms will be explored as sleep is known to be related to emotional memory consolidation and may therefore help to disentangle the potential alterations in extinction recall in patients with OCD.