A virtual reality game for patients with Obsessive-Compulsive Disorder : Neuro-imaging

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder characterized by obsessions and repetitive compulsions. To date, a diagnosis of OCD is based on retrospective and subjective measures. There is a need for standardized and objective tools to improve diagnostics.
Interestingly, virtual reality (VR) can be used to actively provoke and assess OCD specific symptoms in a controlled and standardized environment. In a former study, we showed the VR-game is capable of inducing OCD symptoms of self-reported anxiety and compulsive behaviour in OCD patients. We will now investigate whether the VR-game is able to activate the pathophysiological substrates of OCD. This will support the objectivity and specificity of the use of the VR-game as a tool to provoke and assess OCD symptoms.

The primary objective of this study is to investigate if the VR-game is able to activate the pathophysiological substrate associated with OCD in OCD patients, as opposed to healthy controls The secondary objective is to investigate the correlation between the activity of the substrate and the severity of OCD.

We will perform a cross-sectional study including 27 OCD patients and 27 healthy controls. The participants will play the VR-game while time alterations in blood flow are visualized with fMRI. A comparison between OCD-patients and healthy controls will be made.

The primary objective of this study is to investigate if a specifically designed VR-game is able to activate the pathophysiological substrate associated with OCD in OCD patients, as opposed to healthy controls. This will be investigated by visualizing brain activity using fMRI while participants play the game. We hypothesize increased VR-game output scores and increased brain activity within the orbitofrontal cortex, anterior cingulate cortex and the amygdala in OCD patients and relative to healthy controls.

The secondary objective is to investigate the correlation between the degree of activation of the pathophysiological substrate and the severity of OCD in OCD patients.

Subjects will participate only once, participation will take 3 hours.

In this research project we will investigate a virtual reality game (VR-game) for OCD. This VR-game is interactive and designed to provoke and assess OCD symptoms in a controlled and standardized way. In the VR-game OCD patients encounter 15 OCD-specific items like running gas, an open window and a dirty toilet. They are asked to rate their emotional responses, subdivided in anxiety, tension, uncertainty and urge to control on a 0-10 visual analogue scale. Subsequently they are expected to intervene in the OCD-specific item and rate their emotional responses again afterwards. Thereafter, OCD patients have the option to perform compulsive behavior (e.g. checking or repeating the intervention) followed by another rating of their emotional responses (for an overview, see figure 1).