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Cited by 6Obsessive-Compulsive Spectrum DisordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychoanalysis and Psychopathology Research

Identifying subgroups of urge suppression in Obsessive-Compulsive Disorder using machine learning

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Eng, Goi Khia, De Nadai, Alessandro S., Collins, Katherine A., Recchia, Nicolette, Tobe, Russell H., Bragdon, Laura B., Stern, Emily R.·2024·Journal of Psychiatric Research
DOI 10.1016/j.jpsychires.2024.06.052PMC PMC11409861
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Abstract

Obsessive-compulsive disorder (OCD) is phenomenologically heterogeneous. While predominant models suggest fear and harm prevention drive compulsions, many patients also experience uncomfortable sensory-based urges ("sensory phenomena") that may be associated with heightened interoceptive sensitivity. Using an urge-to-blink eyeblink suppression paradigm to model sensory-based urges, we previously found that OCD patients as a group had more eyeblink suppression failures and greater activation of sensorimotor-interoceptive regions than controls. However, conventional approaches assuming OCD homogeneity may obscure important within-group variability, impeding precision treatment development. This study investigated the heterogeneity of urge suppression failure in OCD and examined relationships with clinical characteristics and neural activation. Eighty-two patients with OCD and 38 controls underwent an fMRI task presenting 60-s blocks of eyeblink suppression alternating with free-blinking blocks. Latent profile analysis identified OCD subgroups based on number of erroneous blinks during suppression. Subgroups were compared on behavior, clinical characteristics, and brain activation during task. Three patient subgroups were identified. Despite similar overall OCD severity, the subgroup with the most erroneous eyeblinks had the highest sensory phenomena severity, interoceptive sensitivity, and subjective urge intensity. Compared to other subgroups, this subgroup exhibited more neural activity in somatosensory and interoceptive regions during the early phase (first 30 s) of blink suppression and reduced activity in the middle frontal gyrus during the late phase (second 30 s) as the suppression period elapsed. Heterogeneity of urge suppression in OCD was associated with clinical characteristics and brain function. Our results reveal potential treatment targets that could inform personalized medicine.

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Authors
Eng, G. K., De Nadai, A. S., Collins, K. A., Recchia, N., Tobe, R. H., Bragdon, L. B., & Stern, E. R.
Affiliations
Nathan Kline Institute for Psychiatric Research (US)
Corresponding author
Eng, Goi Khia
ORCID
Venue
Journal of Psychiatric Research
Publisher
Elsevier BV
Published
2024-09
Volume
177
Pages
129-139
ISSN
0022-3956 (ISSN-L)
DOI
10.1016/j.jpsychires.2024.06.052
PMC
PMC11409861
OpenAlex
W4400147047
Cited by
6
References
82
Citations by year
2026: 4 · 2025: 2
FWCI
3.01
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Psychiatric Research (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
Funders
  • National Institutes of Health
  • NIMH (R21/R33MH107589, R01MH111794)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
obsessive-compulsive disorder, interoceptive sensitivity, sensory phenomena, phenotypic heterogeneity, latent profile analysis, somatosensory cortex, middle frontal gyrus, personalized medicine, treatment goals
MeSH terms
Machine Learning, Adult, Blinking, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Obsessive-Compulsive Disorder, Young Adult, Interoception

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