# Modulating prefrontal circuits underlying behavioral flexibility   in OCD: a TMS study

> **NIH NIH P20** · BUTLER HOSPITAL (PROVIDENCE, RI) · 2021 · $326,616

## Abstract

PROJECT SUMMARY/ABSTRACT
The primary goal of this proposed COBRE Center for Neuromodulation Project is to elucidate neural circuits
underlying impairments in behavioral flexibility in OCD, using transcranial magnetic stimulation as a probe of
the system and fMRI to measure functional changes within neural circuitry implicated in behavioral (in)flexibility
in obsessive-compulsive disorder (OCD). OCD is a chronic and impairing neuropsychiatric disorders
associated with impairments in behavioral flexibility – most notably, the compulsions which are a hallmark of
the disorder. Patients with OCD also show impaired behavioral flexibility on a range of experimental tasks
(e.g., set-shifting, task-switching, reversal learning). Moreover, neuroimaging findings in OCD routinely show
abnormal patterns of activation during tasks probing behavioral flexibility. The proposed research project will
use slow frequency (1-Hz) rTMS to probe dysfunctional circuitry, targeting frontal pole, an area involved in
higher level cognitive control processes which likely plays a key role in coordination between multiple neural
circuits involved in behavioral flexibility and which shares structural and functional connections to circuitry
implicated in behavioral inflexibility in OCD. We aim to test whether (1) slow frequency (1-Hz) rTMS to frontal
pole can affect functional changes within circuits showing abnormal functioning during behavioral flexibility in
OCD, (2) whether rTMS targeting this circuitry can affect behavioral changes in a population with deficits in
behavioral flexibility, and (3) whether circuit functioning relates to behavioral performance following rTMS.
While a number of studies have shown abnormal neural circuit functioning during behavioral flexibility tasks in
OCD, to our knowledge, this will be the first to move beyond correlational findings to directly examine changes
to circuit functioning following a probe of the system using TMS. The long-term goal of this work is to inform
target identification for development of neurocircuit-based interventions which may improve treatment
outcomes for those with OCD.

## Key facts

- **NIH application ID:** 10106655
- **Project number:** 5P20GM130452-03
- **Recipient organization:** BUTLER HOSPITAL (PROVIDENCE, RI)
- **Principal Investigator:** Sarah Lynn Garnaat
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $326,616
- **Award type:** 5
- **Project period:** 2019-03-01 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10106655

## Citation

> US National Institutes of Health, RePORTER application 10106655, Modulating prefrontal circuits underlying behavioral flexibility   in OCD: a TMS study (5P20GM130452-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10106655. Licensed CC0.

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