# Central and Peripheral Nervous System Correlates of Difficulty Discarding in Hoarding Disorder

> **NIH NIH R21** · HARTFORD HOSPITAL · 2020 · $159,745

## Abstract

There is a critical gap in our understanding of the underlying neurobiological mechanisms of difficulty
discarding, the core behavioral feature of hoarding disorder (HD). This gap represents an important problem
because, until it is filled, the field will not be able to precisely identify mechanistic targets for new treatment
development in HD. The long-term goal of the proposed research is to identify biomarkers of difficulty
discarding in HD and to develop treatments that engage those biomarkers. This is important because current
treatments for HD are only modestly effective, with only a 35% response rate across studies. The short-term
goal here is to determine the peripheral (PNS) and central nervous system (CNS) correlates of difficulty
discarding behavior in HD and to distinguish these correlates from related psychopathology. The rationale for
this goal is that by assessing PNS and CNS responses and the degree to which they are unique to HD and
specifically to difficulty discarding, we will identify meaningful biomarker-based intervention targets. We will
recruit 40 patients with primary HD, 40 clinical controls with anxiety disorders but not HD, and 40 healthy
controls without psychiatric disorders. We will assess electrodermal, cardiac, and neural (EEG) activity during
a series of discarding-relevant and emotionally neutral (discarding-irrelevant) tasks. Our central hypothesis is
that patients with HD will demonstrate greater psychophysiological arousal and error related negativity during
the discarding-relevant task than will anxious and healthy control participants. The proposed study will pursue
the following specific aims: 1) determine the PNS and CNS correlates of difficulty discarding by comparing
PNS and CNS activity during the discarding and neutral tasks; 2) determine the causal relationship between
PNS and CNS activity and discarding behavior; and 3) determine whether PNS and CNS correlates of difficulty
discarding are present to a greater degree in HD relative to other psychopathology. Our approach is innovative
because it uses multilevel analysis and will examine, for the first time, the immediate CNS effects of discarding
decisions in clinical HD participants. Our focus on the neurobiological mechanisms of HD is significant, as HD
is a common and poorly treated condition and the proposed study will have direct implications for biomarker-
informed novel treatment development.

## Key facts

- **NIH application ID:** 10024084
- **Project number:** 5R21MH122182-02
- **Recipient organization:** HARTFORD HOSPITAL
- **Principal Investigator:** James Charles McPartland
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $159,745
- **Award type:** 5
- **Project period:** 2019-09-25 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10024084

## Citation

> US National Institutes of Health, RePORTER application 10024084, Central and Peripheral Nervous System Correlates of Difficulty Discarding in Hoarding Disorder (5R21MH122182-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10024084. Licensed CC0.

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