Odile van den Heuvel

Non-invasive brain stimulation in OCD: from disease model to personalized targeting.

Guest speaker:

Odile van den Heuvel
Psychiatrist and professor, Neuropsychiatry, Amsterdam UMC.

Abstract:

In my talk I will illustrate how I used my initial structural and functional MRI studies in patients with obsessive-compulsive disorder (OCD) (and their unaffected relatives) to adapt existing disease models on altered cortico-striatal-thalamo-cortical circuit function towards a lifespan approach in OCD and how this adapted ‘OCD model’ led to the proof-of-concept rTMS-fMRI study on emotion regulation and to the first randomized controlled trial comparing different rTMS targets as adjuvant treatment to intensive behavioral therapy (TMS-Induced Plasticity Improving Cognitive Control in OCD – TIPICCO trial). Using pre-post treatment fMRI studies, we were able to show rTMS target specific effects on the neural circuits. We also studied the neural correlates at baseline associated with good clinical response. I will present the ongoing multi-center RCT TETRO (TMS in Exposure Therapy Resistant OCD) and explain how we will use the biomarkers on neuroplasticity to understand mechanisms of effect and variation in treatment response. Finally, I will discuss the planned n-of-1 studies as part of the recently started VICI project, in which every individual patient will be treated with his/her personalized rTMS target.