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

恐惧和焦虑是强迫症（OCD）的核心特征，通常在强迫和强迫之前和伴随出现，因此构成了强迫症症状背后的驱动力。越来越多的证据表明，强迫症患者恐惧回路核心区域的活动发生了改变，恐惧学习和恐惧消退可以被认为是强迫症的核心机制。这些机制应该进行调查，以增加我们对强迫症精神病理发展和/或维持过程的理解。此外，考虑到用于治疗强迫症的强迫和强迫的认知行为疗法通常是基于消退的，研究强迫症的恐惧学习和消退可能有助于提高治疗效果。然而，人们对强迫症中恐惧条件反射、消退和消退保留的机制知之甚少。第一个证据表明，灭绝记忆可能在强迫症中被打乱。在此背景下，计划中的项目旨在研究强迫症中恐惧条件反射、消退和消退保留的神经和心理生理学相关性，使用精确的心理生理学读数（包括惊吓肌电图和瞳孔测量）、fMRI恐惧逆转任务和焦虑激发任务，以阐明强迫症患者中与这些过程相关的机制可能发生改变。此外，使用活动描记睡眠和昼夜节律的方法将被探索，因为已知睡眠与情绪记忆巩固有关，因此可能有助于解开强迫症患者灭绝回忆的潜在改变。

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.