We are excited to announce the 2022 IOCDF Research Grant awardees! This year, we awarded $1.6 million in funding to researchers pursuing exciting and impactful projects on a range of topics in OCD and related disorders including PANDAS/PANS. To read more about the 2022 IOCDF Research Grant Award Winners and their projects, continue reading below!
These nine winning grants were selected through a rigorous and highly competitive peer-review process, where a panel of 74 top researchers was asked to review grants in their areas of expertise. Two grants totaling $100,000 for PANDAS/PANS research were funded by a partnership with PANDAS Network. The most highly rated projects in the first round were then subjected to a second round of scrutiny from the full committee. The final nine projects represent the strongest and most promising science from an excellent pool of applications.
IOCDF Breakthrough Award Recipients
Neural Mechanisms of Active Avoidance in Obsessive Compulsive Disorder
Principal Investigators: Emily Stern, PhD & Mohammed R. Milad, PhD
Nathan Kline Institute for Psychiatric Research/Research Foundation for Mental Hygiene (Orangeburg, NY)
Award Amount: $500,000
According to behavioral models of OCD, compulsions are avoidance behaviors that alleviate distress from obsessions in the short term. Over time, this reinforces beliefs that obsessions are intolerable and that these compulsions must be performed to bring relief. One of the core aspects and main benefits of ERP is eliminating these avoidance behaviors – yet we still do not understand exactly how the brains of people with OCD work as these behaviors unfold. This study will use neuroimaging techniques and an avoidance learning task to learn what happens in the brain during avoidance behaviors in 60 people with OCD and 60 people in a control group. As people with OCD have a wide range of symptoms, it will also look at how brain function during avoidance is associated with this variability of symptoms. By looking at the neural correlates of avoidance behaviors in OCD, this study aims to provide new directions for existing treatments and potentially lead to new interventions.
CBT Augmentation to Promote Medication Discontinuation in Pediatric OCD
Principal Investigator: Eric Storch, PhD
Baylor College of Medicine (Houston, TX)
Award Amount: $499,891
Several treatments have shown efficacy for treating pediatric OCD: cognitive behavioral therapy (CBT), medication with a serotonin reuptake inhibitor (SRI), and their combination (SRI+CBT). Although best practice suggests using CBT to treat children with mild-to-moderate OCD, SRIs are still typically prescribed first regardless of severity – even though they have modest therapeutic effects, a range of serious side effects, and potentially damaging outcomes. An adult trial demonstrated that gradual SRI discontinuation resulted in noninferior outcomes relative to SRI continuation across 24 months of follow-up after SRI+CBT, suggesting that SRI treatment can be safely discontinued with the help of CBT. This study will examine SRI tapering for 141 children with at least moderate OCD receiving CBT across 24 weeks of follow-up, to assess whether this will reduce OCD symptoms and ultimately lead to successful SRI discontinuation. These results will be used to inform policy and practice regarding maximizing outcomes among children, lessening exposure to unnecessary treatments, and returning youth to everyday living. Beyond pediatric OCD, this project hopes to serve as a possible model for other conditions, such as anxiety disorders.
IOCDF Innovator Award Recipient
The IOCDF Innovator Award was funded by the Walder Family Charitable Fund.
Dissecting the Temporal and Causal Relationships between OCD and Bipolar Disorder
Principal Investigator: Dorothy Grice, MD
Icahn School of Medicine at Mount Sinai (New York, NY)
Award Amount: $300,000
Compared to the general population, people with OCD are 10 times more likely to have a bipolar disorder (BPD) diagnosis. Research has shown that BPD comorbidity is associated with more severe OCD, and worse health and quality of life outcomes. Treatment for people with both conditions also differs from standard OCD treatments to account for BPD symptoms. As a first diagnosis of OCD is associated with a higher risk of a later diagnosis of BPD, understanding the causes behind co-occurring OCD and BPD is necessary. These causes may be shared genetic and/or environmental risk factors that increase the chance of both conditions occurring, and/or causal relationships where one disorder increases the likelihood of the other. Using a large national demographic and clinical dataset and large-scale genetic studies, this study aims to explore shared genetic and environmental risk between OCD and BPD, and assess whether OCD increases the likelihood of BPD. With these findings, the study will develop models to predict a future BPD diagnosis in people with OCD.
Michael A. Jenike Young Investigator Award Recipients
Expanding the Genetic Landscape of Pediatric OCD
Principal Investigator: Emily Olfson, MD, PhD
Yale School of Medicine (New Haven, CT)
Award Amount: $49,993
While the role of genetic factors in the development of OCD has been emphasized through research, more attention is needed to identify specific risk factors and underlying biological pathways. Past OCD genomic studies focused on single categories of genetic variation, but data suggests that a combination of genetic changes may impact an individual’s likelihood of developing OCD. Past genomic studies in OCD have a vast variety of factors, yet these all require different analysis techniques. This study will examine rare, common, sequence, and structural genetic variations simultaneously within the same individuals with OCD using a sample of 200 family trios. With the help of a whole-exome DNA sequencing study of families where the child has a primary OCD diagnosis that demonstrated the role of rare sequence variation, this study will add genome-wide array data to examine the role of rare and common variants. Additionally, the data from these 200 families will be combined with a separate cohort of 200 families with body-focused repetitive behavior diagnoses to examine genetic factors that are shared and distinct across the OCD spectrum. By integrating different categories of genetic variation, this study aims to advance our understanding of the genomic landscape of pediatric OCD and related conditions, provide insight into how variants impact risk of developing OCD, and inform future interventions.
Improving Access to Evidence-based Interventions for Adolescents with Body Dysmorphic Disorder
Principal Investigator: Daniel Rautio, Msc, PhD Candidate
Karolinska Institutet (Solna, Sweden)
Award Amount: $49,750
Body dysmorphic disorder (BDD) is a common and impairing disorder that typically onsets before the age of 18. Although cognitive behavioral therapy (CBT) can effectively prevent severe long-term consequences of BDD if applied at an early age, it is scarcely available. To address this gap, Internet-delivered CBT (ICBT) was developed as a form of guided self-help, and was shown to be an effective treatment for adults with BDD. A pilot study by the authors of this project that assesses ICBT for adolescents with BDD is also showing promising treatment effects. This study will expand the pilot into a randomized controlled trial to test ICBT’s efficacy on 136 adolescents with BDD over the course of 14 weeks, compared to an Internet-based supportive therapy control. It will assess ICBT’s effects on BDD symptom severity, how well participants respond to treatment, and cost-effectiveness of the application. By examining these factors, this study hopes to show that evidence-based treatment for young people with BDD is effective – and available.
Perinatal Obsessive Compulsive Disorder: A Person-centered, Dynamic Systems Approach
Principal Investigator: Samantha Hellberg, MA
University of North Carolina at Chapel Hill (Chapel Hill, NC)
Award Amount: $49,566
1 in 5 parents experience perinatal distress (PND), significant mental health challenges that impact their – and their children’s and families’ – lives and wellbeing. While perinatal mood and anxiety disorders (PMADs) have received increasing attention, more research on perinatal OCD (pOCD) is needed. Although symptoms vary from person to person, individuals with pOCD often have highly distressing thoughts surrounding the safety and wellness of their children, and engage in compulsive behaviors to try to reduce the resulting distress. Individual differences in how PND is experienced pose a major obstacle to understanding, preventing, and treating pOCD effectively. Ambulatory assessment (AA) may offer novel opportunities to examine individual pOCD experiences in real-world settings, but no studies have used AA to examine pPOCD. This study aims to address this research gap by using smartphone-based longitudinal AA to assess 66 pregnant individuals at high risk for PND during late pregnancy and the first postpartum months. By looking at associations among symptoms and relevant events and feelings in real time, this study will probe into the individual differences, onset, and progression of pOCD presentations. Through the context-aware, time-sensitive, and person-specific inferences about pOCD, this research into AA can inform future personalized interventions for parents at a critical stage.
Examining Circadian and Non-circadian Phenotypes in Obsessive Compulsive Disorder with Delayed Bedtimes
Principal Investigator: Rebecca Cox, PhD
University of Colorado, Boulder (Boulder, CO)
Award Amount: $49,933
Relapse rates following OCD treatment are 50%, suggesting the existence of unidentified and untreated mechanisms in OCD. One of these mechanisms relates to circadian rhythm – the body’s biological clock. One indicator of circadian rhythms is sleep timing, and previous research has found that people with OCD tend to have later sleep timing (going to bed and waking up later), which is associated with worse OCD symptoms. However, it is still unclear whether later sleep timing in OCD is due to a delayed circadian rhythm or non-circadian factors such as staying up later engaging in compulsions. This study will clarify the role of circadian rhythms in later sleep timing in OCD by measuring the associations between the timing of melatonin, desired bedtime in adults with OCD, and later sleep timing. The findings will provide important insight into whether circadian rhythms could be a new target for OCD treatment.
IOCDF and PANDAS Network Young Investigator Award Recipients
A Modifiable Transcriptomic Signature of Immune Dysfunction in Pediatric Obsessive Compulsive Disorder (OCD)
Primary Investigator: Shrujna Patel, PhD
Sydney Children’s Hospital Network (Sydney, Australia)
Award Amount: $50,000
Research shows that many children with PANS have dysfunctional immune systems. When conventional psychiatric medications fail, treatments such as intravenous immunoglobulin (IVIG) have shown some success; however, IVIG is short-term, costly, and invasive. Further research into such treatments is impeded by lack of knowledge about PANS biomarkers. Using RNA sequencing of whole blood, this team identified a transcriptomic signature of immune dysfunction in children with PANS, whose features are modifiable with IVIG and associated with clinical improvements. This study aims to validate this signature in a larger cohort of children with PANS, examine it at a cellular level, and explore how IVIG modifies this signature at a cellular level. The results from this study will provide the first evidence for a signature of immune dysfunction in children with PANS, increasing our potential at finding effective treatments.
Elucidating the Role of RXRA Factor in Myeloid Cells for Immune-mediated Mechanisms of OCD
Primary Investigator: Uğur Akcan, PhD
Columbia University (New York, NY)
Award Amount: $50,000
PANDAS may be associated with a form of basal ganglia encephalitis (BGE) caused by repetitive Group A Streptococcus (GAS) infections. Findings show that the immune response targeting repetitive GAS infections can lead to inflammation of the brain and nervous system. As not every child develops BGE, there may be a genetic component related to the development of PANDAS. This team has identified approximately 20 genes associated with BGE, one of which is Retinoid X Receptor Alpha (RXRɑ) – responsible for regulating innate and adaptive immune responses. Using imaging techniques on mice and humans, this study aims to assess the importance of RXRɑ for regulating the immune response of myeloid cells that can affect the nervous system following repetitive GAS infections. Additionally, it proposes to test the effects of RXRɑ loss in mouse myeloid cells to understand effects on the nervous system after these infections. These explorations may aid in developing potential biomarkers and therapeutics to assist in diagnostic and treatment strategies for PANDAS.