Neurofeedback for obsessive compulsive disorder: A randomized, double-blind trial.

We aim to develop fMRI neurofeedback as a treatment for obsessive compulsive disorder (OCD). In prior work, we found that providing neurofeedback of activity in the anterior prefrontal cortex (aPFC) improved control over contamination anxiety in a subclinical population. Here, we present the results of a randomized, double-blind clinical trial (NCT02206945) testing this intervention in patients with OCD. We recruited patients with primary symptoms in the fear-of-harm/checking or contamination/washing domains. During neurofeedback, they viewed symptom provocative images and attempted to up- and down-regulate the aPFC during different blocks of time. The active group received two sessions of neurofeedback and the control group received yoked sham feedback. The primary outcome measure was the Yale-Brown Obsessive-Compulsive Symptom scale. The secondary outcome was control over aPFC. Thirty-six participants completed feedback training (18 active, 18 control). The active group had a slightly but significantly greater reduction of obsessive-compulsive symptoms after neurofeedback compared to the control group (p<.05) but no significant differences in control over the aPFC. These data demonstrate that neurofeedback targeting the aPFC can reduce symptoms in OCD. Future investigations should seek to optimize the training protocol to yield larger effects and to clarify the mechanism of action.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest Dr. Michelle Hampson is the editor of fMRI Neurofeedback, Academic Press and Dr. Chris Pittenger is the editor of Obsessive-Compulsive Disorder: Phenomenology, Pathophysiology, and Treatment, Oxford University Press, 2017. Dr. Brian Zaboski and Dr. Chris Pittenger consult for and receive research support from Biohaven Pharmaceuticals and Ceruvia Lifesciences. Dr. Chris Pittenger consults for and receives research support from Transcend Therapeutics and Freedom Biosciences, consults for UCB Biopharma, Nobilis Therapeutics, and F-Prime Capital Partners, and holds equity in Alco Therapeutics. Dr. Mariela Rance, Dr. Zhiying Zhao, Stephen A. Kichuk, Emma Romaker, William N. Koller, Christopher Walsh, Cheyenne Harris-Starling, Suzanne Wasylink, Dr. Thomas Adams Jr., and Dr. Patricia Gruner report no financial interests or potential conflicts of interest.