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NCT07480408

Neural Mechanisms of the Sensorymotor Circuit in Sensory Phenomena in OCD

Sponsor: Shanghai Mental Health Center

View on ClinicalTrials.gov

Summary

The goal of this clinical study is to investigate the neural mechanisms of abnormal sensory phenomena in patients with Obsessive-Compulsive Disorder and to evaluate whether modulation of the insula-supplementary motor area circuit can improve these symptoms. The study will include adult patients with OCD (with or without sensory phenomena) and healthy volunteers. The main questions it aims to answer are: * Do patients with OCD show abnormal activity in the insula-SMA circuit compared with healthy controls? * Is this abnormality associated with the presence and severity of abnormal sensory phenomena? * Can low-frequency rTMS targeting the Supplementary Motor Area improve sensory phenomena and obsessive-compulsive symptoms? Researchers will compare an on-line rTMS group (viewing body-focused videos during stimulation) with an off-line rTMS group (resting during stimulation) to evaluate whether task engagement enhances treatment effects. Participants will: * Complete clinical assessments and behavioral tasks. * Undergo EEG and fMRI assessments. * Receive low-frequency rTMS targeting the Supplementary Motor Area. * Repeat assessments after the intervention.

Official title: Neural Mechanisms of the Insula-Supplementary Motor Area Circuit in Sensory Phenomena in Obsessive-Compulsive Disorder

Key Details

Gender

All

Age Range

18 Years - 55 Years

Study Type

INTERVENTIONAL

Enrollment

120

Start Date

2026-05-01

Completion Date

2028-12-31

Last Updated

2026-03-20

Healthy Volunteers

Yes

Conditions

Obsessive - Compulsive Disorder

Interventions

DEVICE

repetitive transcranial magnetic stimulation (rTMS)

Repetitive transcranial magnetic stimulation (rTMS) will be delivered at 1 Hz with a total of 1,200 pulses per session, administered five times per day for six consecutive days. Target localization will be based on each participant's T1-weighted structural MRI, using a neuronavigation system to establish an individualized head model and identify the Supplementary Motor Area. The stimulation intensity will be set at 110% of the individual resting motor threshold (RMT).

Inclusion Criteria: OCD with abnormal sensory phenomena 1. Meet the diagnostic criteria for Obsessive-Compulsive Disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 2. Aged 18-55 years. 3. Score ≥16 on the Yale-Brown Obsessive Compulsive Scale, indicating moderate to severe symptoms. 4. Score \>6 on the Sensory Phenomena Scale (SPS), indicating moderate to severe sensory phenomena. 5. Right-handed. 6. Either medication-free or on stable medication for at least 8 weeks. OCD without abnormal sensory phenomena 1. Meet the diagnostic criteria for Obsessive-Compulsive Disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 2. Aged 18-55 years. 3. Score ≥16 on the Yale-Brown Obsessive Compulsive Scale. 4. Score ≤6 on the Sensory Phenomena Scale (SPS). 5. Right-handed. 6. Either medication-free or on stable medication for at least 8 weeks. Exclusion criteria 1. Meeting diagnostic criteria in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition for psychiatric disorders other than OCD or obsessive-compulsive personality disorder. 2. OCD symptoms so severe that required assessments cannot be completed. 3. Presence of severe suicidal ideation or high suicide risk. 4. Pregnant women or women planning pregnancy in the near future. 5. History of epilepsy or any medical condition that may induce seizures or intracranial hypertension. 6. Contraindications to MRI, such as metallic implants. 7. Clinically significant medical illnesses or abnormal laboratory findings. 8. Inability to complete study procedures due to severe symptoms, low cognitive functioning, or poor cooperation. Healthy Controls Inclusion criteria 1. No current or past psychiatric disorders meeting diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 2. Aged 18-55 years. 3. Right-handed. Exclusion criteria 1\. Pregnant women or women planning pregnancy in the near future. 2. History of epilepsy or any medical condition that may induce seizures or intracranial hypertension. 3\. Presence of severe suicidal ideation or high suicide risk. 4. Contraindications to MRI, such as metallic implants. 5. Clinically significant medical illnesses or abnormal laboratory findings. 6. Inability to complete study procedures due to severe symptoms, low cognitive functioning, or poor cooperation.

Locations (1)

Shanghai Mental Health Center

Shanghai, China