OCD & Related Disorders

The research of the Psychiatric NeuroCognition Lab (“PNCLab”) uses a multi-method approach to investigating the pathophysiology of psychiatric disorders, focusing on heterogeneity in obsessive-compulsive disorder (OCD) and transdiagnostic features shared with other disorders.

The lab’s work seeks to understand the fundamental problem of variability of treatment efficacy among patients with the same diagnosis by employing a program of research to:

1) identify behavioral and neural mechanisms underlying core processes contributing to within-disorder heterogeneity and
2) target those mechanisms using methods to manipulate neural circuit functioning in order to alter behavior and, ultimately, psychopathological symptoms.

The majority of the lab’s work has focused on identifying and targeting mechanisms underlying sensory processing abnormalities in OCD.

Clinically, sensory symptoms in OCD manifest as aversive sensations that drive compulsions instead of fear (collectively referred to as “sensory phenomena” and including sensory-based urges and “not-just-right” experiences).

Sensory phenomena are prevalent in over half of individuals with OCD, where they cause significant distress and functional impairment, yet are not well addressed by standard treatment approaches.

Research in the lab has found that sensory phenomena in OCD are associated with alterations of interoception (the detection and integration of sensations from within the body) and the hyper-functioning of neural circuits involving the insula, sensorimotor regions, and orbitofrontal cortex.

Current projects test the use of pharmacological (high-dose ondansetron) and neuromodulatory (TMS) manipulations to inhibit the functioning of the insula and sensorimotor cortical areas in order to decrease the severity of sensory phenomena.

Although the lab’s core research focus is on OCD, an overarching goal is to test whether these mechanisms are specific to OCD or exist across disorders.

Additional areas of research in the lab investigate interoception and sensory symptoms in major depression and autism spectrum disorder, as well as other transdiagnostic processes such as perseverative cognition.

The overall aim of this work is to use mechanistic findings to develop and refine treatments targeting individual behavioral and neural characteristics within the framework of a personalized medicine approach.

Active Studies

Recent Publications

  • Bragdon LB, Nota JA, Eng GK, Recchia N, Kravets P, Collins KA, Stern ER. Failures of Urge Suppression in Obsessive-Compulsive Disorder: Behavioral Modeling Using a Blink Suppression Task. J Obsessive Compuls Relat Disord. 2023 Jul;38:100824. doi: 10.1016/j.jocrd.2023.100824. Epub 2023 Jun 22. PMID: 37521712; PMCID: PMC10373599.
  • Bragdon LB, Eng GK, Recchia N, Collins KA, Stern ER. Cognitive Neuroscience of Obsessive-Compulsive Disorder. Psychiatr Clin North Am. 2023 Mar;46(1):53-67. doi: 10.1016/j.psc.2022.11.001. Epub 2022 Dec 27. PMID: 36740355.
  • Bragdon LB, Eng GK, Belanger A, Collins KA, Stern ER. Interoception and Obsessive-Compulsive Disorder: A Review of Current Evidence and Future Directions. Front Psychiatry. 2021 Aug 25;12:686482. doi: 10.3389/fpsyt.2021.686482. PMID: 34512412; PMCID: PMC8424053.
  • Collins KA, Eng GK, Tural Ü, Irvin MK, Iosifescu DV, Stern ER. Affective and somatic symptom clusters in depression and their relationship to treatment outcomes in the STAR*D sample. J Affect Disord. 2022 Mar 1;300:469-473. doi: 10.1016/j.jad.2021.12.046. Epub 2021 Dec 21. PMID: 34952119.
  • Eng GK, Collins KA, Brown C, Ludlow M, Tobe RH, Iosifescu DV, Stern ER. Relationships between interoceptive sensibility and resting-state functional connectivity of the insula in obsessive-compulsive disorder. Cereb Cortex. 2022 Nov 21;32(23):5285-5300. doi: 10.1093/cercor/bhac014. PMID: 35257146; PMCID: PMC9712718.
  • Eng GK, Collins KA, Brown C, Ludlow M, Tobe RH, Iosifescu DV, Stern ER. Dimensions of interoception in obsessive-compulsive disorder. J Obsessive Compuls Relat Disord. 2020 Oct;27:100584. doi: 10.1016/j.jocrd.2020.100584. Epub 2020 Sep 10. PMID: 33194538; PMCID: PMC7665060.
  • Stern ER, Eng GK, De Nadai AS, Iosifescu DV, Tobe RH, Collins KA. Imbalance between default mode and sensorimotor connectivity is associated with perseverative thinking in obsessive-compulsive disorder. Transl Psychiatry. 2022 Jan 12;12(1):19. doi: 10.1038/s41398-022-01780-w. PMID: 35022398; PMCID: PMC8755709.
  • Stern ER, Brown C, Ludlow M, Shahab R, Collins K, Lieval A, Tobe RH, Iosifescu DV, Burdick KE, Fleysher L. The buildup of an urge in obsessive-compulsive disorder: Behavioral and neuroimaging correlates. Hum Brain Mapp. 2020 Apr 15;41(6):1611-1625. doi: 10.1002/hbm.24898. Epub 2020 Jan 9. PMID: 31916668; PMCID: PMC7082184.