Neural Mechanisms of CBT Response in Hoarding Disorder

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

128 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-07-31

Study Completion Date

2019-06-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this research is to measure changes in brain activity with functional magnetic resonance imaging (fMRI) before and after cognitive-behavioral therapy for compulsive hoarding. Cognitive-behavioral therapy aims to help people change the thoughts and behaviors that maintain symptoms of hoarding. The investigators intend to enroll approximately 80 people with hoarding disorder and 40 people with no psychiatric disorder, between the ages of 20 and 60, for this study. The investigators believe that after treatment there will be changes in the brain activity of individuals with compulsive hoarding.

Related Clinical Trials

Explore similar clinical trials based on study characteristics and research focus.

Neural Mechanisms of Decision Making in Hoarding Disorder

NCT03487224

Hoarding Disorder

ACTIVE_NOT_RECRUITING

Improving Obsessive-compulsive Disorder Treatments: from Lesions to Neuromodulation Targets

NCT06490965

Obsessive-Compulsive Disorder

RECRUITING NA

Inhibitory Control of the Mind : Neural Bases and Impact for Obsessive-compulsive Disorders

NCT02850393

Obsessive Compulsive Disorder Healthy

UNKNOWN NA

Neurocircuit Mechanisms of OCD Across the Lifespan

NCT02437773

Obsessive-Compulsive Disorder

COMPLETED NA

Using Online Delivered Therapy and Brain Imaging to Better Understand OCD

NCT04630197

Obsessive-Compulsive Disorder

COMPLETED NA

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The long-term goal of the proposed research is to improve clinical outcomes for Hoarding Disorder (HD), a common and potentially debilitating condition that poses a severe public health burden. The PI has developed and tested a cognitive-behavioral therapy (CBT) that appears moderately effective, although there is clear room for improvement. In the present study, the investigators propose to merge this line of research with the PI's recent NIH-supported neuroimaging research that points to specific functional abnormalities in regions of interest (ROIs) related to cognitive and affective decisionmaking processes. Patients with HD n = 80) will be randomized to CBT or wait list (WL). At pre-treatment, mid-treatment, and post-treatment, patients will undergo functional magnetic resonance imaging (fMRI) during an acquiring and discarding decision-making task that has been used successfully in the investigators' previous work. In addition, patients will complete a number of laboratory tasks designed to assess decision-making capacity and impairment. A group of healthy control (HC) participants (n = 40) will also complete these measures as a normative control group. The primary aim of the proposed study is to determine the extent to which the observed patterns of neural activity in HD change following CBT. Under this aim, the investigators predict that HD patients (vs.HCs) will show greater hemodynamic activity in ROIs associated with cognitive and affective aspects of decision-making. The investigators further predict that HD patients receiving CBT (vs. WL) will show decreased activity in those ROIs, and will no longer differ from HCs following CBT. A secondary aim of the proposed study is to determine the relationship between change in activity in brain regions of interest and hoarding-related symptoms and impairments. The investigators expect, that hemodynamic activity in the target ROIs will correlate with symptoms of HD and with performance on decision-making tasks; and that change in brain activity will correspond to both symptom and mechanism changes over the course of treatment. Finally, an exploratory aim is to explore, using both data-driven and model-constrained approaches, patterns of pre-treatment neural activity that predict response to CBT. The investigators predict that among treated HD patients, pre-treatment activity in the target ROIs will correlate significantly with HD symptom change from pre- to posttreatment. Results of the proposed study are expected to elucidate the neural mechanisms of successful response to CBT treatment for hoarding patients, and to set the stage for further treatment development and possible improvements in outcome for this disorder.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Obsessive Compulsive Disorder

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Immediate Treatment

Cognitive-behavioral therapy

Group Type EXPERIMENTAL

Cognitive Behavioral Therapy

Intervention Type BEHAVIORAL

Group cognitive-behavioral therapy for hoarding disorder, 16 weeks

Delayed Treatment

This group will receive the cognitive-behavioral therapy after a 16 week delay

Group Type NO_INTERVENTION

No interventions assigned to this group

Healthy Control

This group is matched to the immediate treatment group on age and gender. They do not receive an active treatment and will be used a a healthy comparator group.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Cognitive Behavioral Therapy

Group cognitive-behavioral therapy for hoarding disorder, 16 weeks

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Aged 20-65
* Hoarding Disorder primary condition
* Score at least 4 on the CGI
* Free from all psychotropic medications for at least 4 weeks(5 weeks for fluoxetine)
* Participant is fluent in English
* Control over current living environment (i.e. not living in a nursing home or with relatives)
* Physically able to complete therapy assignments (i.e able to discard etc)
* Able to complete study measures
* If female: Using an approved method of contraception

Exclusion Criteria

* More than 10 sessions of CBT for HD
* Actively suicidality, previous suicide attempt, current use of self harming behaviors or is at risk for harming others
* Current or past diagnosis of serious psychological disorder (psychotic disorder, bipolar disorder, substance use disorder or uncontrolled anorexia)
* Psychiatric hospitalization within the past 12 months
* History of anoxic or traumatic brain injury
* Evidence of cognitive dysfunction that would interfere in the ability to provide informed consent or engage in CBT
* Claustrophobia
* Pacemaker, aneurysm clip, or other metal in the body that would pose a risk during fMRI?
* If female: Pregnant or lactating

Minimum Eligible Age

20 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes