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

> **NIH NIH P20** · BUTLER HOSPITAL (PROVIDENCE, RI) · 2022 · $276,025

## 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:** 10338144
- **Project number:** 5P20GM130452-04
- **Recipient organization:** BUTLER HOSPITAL (PROVIDENCE, RI)
- **Principal Investigator:** Sarah Lynn Garnaat
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $276,025
- **Award type:** 5
- **Project period:** 2019-03-01 → 2022-12-09

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10338144

## Citation

> US National Institutes of Health, RePORTER application 10338144, Modulating prefrontal circuits underlying behavioral flexibility in OCD: a TMS study (5P20GM130452-04). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10338144. Licensed CC0.

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