Selected Colloquium
Session Room 217
Session Room 217
Tuesday, June 17, 10:50 AM – 11:50 AM
Selected Colloquium 9: Recent Advances in Obsessive Compulsive Disorder (OCD)
Abstract
Obsessive Compulsive Disorder (OCD) characterized by a vicious cycle of intrusive, unwanted, irresistible thoughts, images, ideas, and urges often leading to compulsions, is a disabling psychiatric condition.
The underlying mechanism encompassing cognitive, affective and behavioural/motoric domains is not clearly understood. However, the direct corticostriatopallidothalamo cortical (CSPTC) circuit overdrive is a postulated circuitry framework. Multiple networks including salience network,(SN)( the detection of salient stimuli and regulating the switching between default-mode and executive networks),default mode network(DMN)( self-referential processes and episodic memory retrieval),and central executive network.( planning, set-shifting, cognitive flexibility and inhibition, decision-making), sensorimotor network (hypo-connectivity), , fronto-parietal network(subserving attentional shifting and cognitive control ,frontostriatal /frontolimbic network (reward, learning and adaptive selection of behaviour) and altered connectivity between DMN and SN to the visual network are involved in explaining the complex”thougt-Affect-Action” conundrum seen in OCD.1-3
Cognitive Behavioral Therapy (CBT) with exposure and response prevention (E/RP) is one of the first-line evidence-based treatments for OCD, however the availability, access and compliance of cognitive behavioral treatments limit their use. Pharmacotherapy with serotonin reuptake inhibitors give more than 50% improvement. Multiple metaanalyses indicate efficacy for nonpharmacologic and pharmacologic intervention. The effectiveness of exposure and response prevention combined with pharmacotherapy has proven more effective. Many patients will be treatment resistant where additional treatment approaches have to be followed. Pharmacological outlook using NbN nomenclature will be useful.4-5
Discussion focuses on investigative potential and clinical utility of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in OCD where a CSTC circuitry-based knowledge is used in the application and research 6
Obsessive Compulsive Disorder (OCD) characterized by a vicious cycle of intrusive, unwanted, irresistible thoughts, images, ideas, and urges often leading to compulsions, is a disabling psychiatric condition.
The underlying mechanism encompassing cognitive, affective and behavioural/motoric domains is not clearly understood. However, the direct corticostriatopallidothalamo cortical (CSPTC) circuit overdrive is a postulated circuitry framework. Multiple networks including salience network,(SN)( the detection of salient stimuli and regulating the switching between default-mode and executive networks),default mode network(DMN)( self-referential processes and episodic memory retrieval),and central executive network.( planning, set-shifting, cognitive flexibility and inhibition, decision-making), sensorimotor network (hypo-connectivity), , fronto-parietal network(subserving attentional shifting and cognitive control ,frontostriatal /frontolimbic network (reward, learning and adaptive selection of behaviour) and altered connectivity between DMN and SN to the visual network are involved in explaining the complex”thougt-Affect-Action” conundrum seen in OCD.1-3
Cognitive Behavioral Therapy (CBT) with exposure and response prevention (E/RP) is one of the first-line evidence-based treatments for OCD, however the availability, access and compliance of cognitive behavioral treatments limit their use. Pharmacotherapy with serotonin reuptake inhibitors give more than 50% improvement. Multiple metaanalyses indicate efficacy for nonpharmacologic and pharmacologic intervention. The effectiveness of exposure and response prevention combined with pharmacotherapy has proven more effective. Many patients will be treatment resistant where additional treatment approaches have to be followed. Pharmacological outlook using NbN nomenclature will be useful.4-5
Discussion focuses on investigative potential and clinical utility of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in OCD where a CSTC circuitry-based knowledge is used in the application and research 6