Modulation of the OCD neural network by conventional treatment

项目总结/摘要 姆克林医院项目4 拟议项目的主要目标，题为“调制的强迫症神经网络的常规 治疗，”是研究如何对严重强迫症的常规干预-密集的暴露和反应， 预防（ERP）治疗和护理药物管理标准-影响假定的OCDnet进一步 我们了解了强迫症的有效治疗是如何影响神经回路的， 回避和厌恶的不确定性。为了实现这一目标，P4将识别vlPFC，rACC， 追踪PAAT和临床症状报告中的表现的纹状体、dACC、OFC和吻侧纹状体 在强迫症患者中，他们接受强化治疗，并随着时间的推移经历疾病负担的变化。 该项目将跟踪95名强迫症患者，使用密集的大脑和行为纵向评估 在典型的~ 8周治疗过程中。P4将利用我们小组的运营经验， 强迫症的MRI（功能和结构）和详细的系列临床评估，以及我们的工具包， 纵向评估，目前部署在其他NIMH资助的数据收集工作，并与 核心C的成员，以确定OCDnet的变化，持续回避（根据PAAT和 探索性的基于设备的措施），和强迫症的临床变化。三组综合考察访问 （治疗前、治疗期间和治疗后）进行MRI和临床评估，将提供疾病轨迹信息 用于在粗略的时间尺度上探测变化的构造之间的关系，辅之以低负担， 数字表型分析，以捕捉中间和更精细的时间尺度上的变化。阐述了如何 与临床和治疗参数变化相关的假定OCDnet变化将为以下方面提供目标： 强迫症的新干预措施，并帮助了解如何以及在哪些个人目前可用的治疗 达到最佳的治疗效果。

PROJECT SUMMARY/ABSTRACT McLean Hospital Project 4 The main goal of the proposed project, entitled “Modulation of the OCD neural network by conventional treatment,” is to study how conventional interventions for severe OCD – intensive exposure and response prevention (ERP) therapy and standard of care medication management – affect the putative OCDnet to further our understanding of how commonly available, efficacious treatments for OCD impact neural circuits involved in avoidance and aversive uncertainty. To achieve this goal, P4 will identify abnormalities in the vlPFC, rACC, insula, dACC, OFC and rostral striatum that track with performance on the PAAT and clinical symptom reports in individuals with OCD as they receive intensive treatment and undergo changes in illness burden over time. The project will follow 95 individuals with OCD using intensive longitudinal assessment of brain and behavior over the typical ~8wk treatment course. P4 will build on our group’s operational experience performing serial MRI (functional and structural) and detailed serial clinical assessments in OCD, and our toolkit for intensive longitudinal assessment, currently deployed in other NIMH-funded data collection efforts and developed with members of Core C, to identify changes in the OCDnet, persistent avoidance (as measured on PAAT and with exploratory device-based measures), and clinical changes in OCD. Three sets of comprehensive study visits (before, during, and after treatment) with MRI and clinical assessments will provide illness trajectory information for probing relationships between changing constructs at a coarse timescale, complemented by low-burden, digital phenotyping to capture variation at intermediate and finer time scales. Elucidating the ways in which the putative OCDnet changes in relation to changes in clinical and therapeutic parameters will provide targets for new interventions for OCD and help understand how and in which individuals currently available treatments achieve their optimal therapeutic benefit.