Mindfulness-Based Cognitive Therapy: Efficacy and fMRI-based Response Predictors in a Group of OCD Patients
Status:
Unknown status
Trial end date:
2018-12-01
Target enrollment:
Participant gender:
Summary
Obsessive-Compulsive Disorder (OCD) patients have a response rate of 50-60% to exposure and
response prevention (ERP) therapy and SSRI antidepressants. Mindfulness-Based Cognitive
Therapy (MBCT) consists of training the participant to non-react to negative thoughts and
emotions. Applying MBCT to OCD patients may help them behave with equanimity in response to
their obsessions, and therefore acknowledge them with the same attention and intention as
they admit any other disturbing thought without reacting to it. MBCT has demonstrated
effectiveness in major depression, but much less attention has been given to MBCT in OCD. ERP
and MBCT, although sharing aspects like exposure, are based on different theoretic and
therapeutic factors. EPR is based on a direct anxiety habituation process whereas MBCT trains
a holistic manner of becoming familiarized with distressful thoughts and emotions while
learning to develop a new relationship to them. Thus, MBCT may decrease anxiety indirectly
through a major attention awareness and non-reactivity to thoughts and emotions.
OCD is characterized by altered cortical-striatal-thalamic-cortical (CSTC) circuit and
default mode network (DMN) connectivity when performing different tasks and during the
resting state. It has been establish that the ventral CSTC circuit is mostly associated with
emotional processing, while the dorsolateral aspect of the CSTC circuit is preferentially
involved in cognitive processing. In this regard, we hypothesized that clinical amelioration
will be accompanied by a re-establishment of functional connectivity within dorsolateral and
DMN circuits, which will in turn be associated with improvement of certain neuropsychological
processes. CSTC and DMN circuits have also shown to be sensitive to prolonged stress
situations. Specifically, childhood trauma has been related to larger brain volumes and it
has been associated with different OCD clinical subtypes.
Aims: 1. To assess MBCT effectiveness in treatment non-naive OCD patients. 2. To study
cognitive and neuropsychological characteristics that mediate or moderate MBCT response. 3.
To examine the changes in cognitive, neuropsychological and neuroimaging patterns associated
with an MBCT intervention. 4. To identify a brain biomarker for positive response to MBCT in
non-naïve OCD patients. 5. To study cognitive, neuropsychological and early stress expousure
mediators or moderators of functional changes in CSTC and DMN patterns in response to MBCT.
Phase:
N/A
Details
Lead Sponsor:
Corporacion Parc Tauli
Collaborators:
Children's Hospital Medical Center, Cincinnati Hospital Universitari de Bellvitge University of Arizona