Name: Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging (Video) | JoVE Journal
Uploaded: 2025-03-14T13:00:00.000+00:00
Duration: 9 min 14 s
Description: Explore neural correlates of cognitive reappraisal in obsessive-compulsive disorder using task-based fMRI. This protocol compares OCD patients and healthy controls to identify brain networks involved in emotion regulation.

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5 minutes

This work has been funded by Portuguese National funds through the Foundation for Science and Technology (FCT) - project UIDB/50026/2020 (DOI 10.54499/UIDB/50026/2020), UIDP/50026/2020 (DOI 10.54499/UIDP/50026/2020), and LA/P/0050/2020 (DOI 10.54499/LA/P/0050/2020), and by the project NORTE-01-0145-FEDER-000039, supported by Norte Portugal Regional Operational Programme (NORTE 2020) under the PORTUGAL 2020 Partnership Agreement through the European Regional Development Fund (ERDF). MPP was supported by a grant RYC2021-031228-I funded by MCIN/AEI/10.13039/501100011033 and by the &#34;European Union NextGenerationEU/PRTR&#34;.

In the past 3 years, PM has received grants, CME-related honoraria, or consulting fees from Angelini, AstraZeneca, Bial Foundation, Biogen, DGS-Portugal, FCT, FLAD, Janssen-Cilag, Gulbenkian Foundation, Lundbeck, Springer Healthcare, Tecnimede, and 2CA-Braga.

This protocol allows researchers to explore the neural correlates of emotion regulation in patients with OCD in comparison to controls, using an fMRI cognitive reappraisal task. This design shows potential for enhancing our understanding of the brain's mechanisms for regulating emotions through deliberate strategies and can be used in patients with OCD as well as other psychiatric populations. Moreover, we carefully designed the protocol using the latest neuroimaging gold standards (a multiband sequence, fMRIPrep preprocessing, and an appropriate multiple comparison correction method, for example). Particular care was taken to ensure that both participant groups were matched on sociodemographic variables and that participants with data of poor quality were excluded from the analysis.
Despite all these precautions, we had negative findings (i.e., no between-group differences) in some of the analyses. At the behavioral level, the group effect was non-significant in the analysis of in-scanner ratings using a 2 x 3 repeated-measures ANOVA for the full sample. This finding aligns with previous meta-analyses and systematic reviews in psychiatric populations23,44, suggesting potential influences from social desirability effects, intra-scanner behavioral assessments, or impaired self-awareness of emotional experience. However, significant group differences emerged in the Success variable, indicating that individuals with OCD exhibited worse emotion regulation. Thus, despite an overall similarity in the pattern of ratings across conditions for both groups, alterations are still observable when concentrating on the Maintain and Regulate conditions only. 
Moreover, when repeating this analysis for the different emotion regulation subgroups, the Reinterpretation subgroup was the only one showing the same pattern of findings as for the full sample, while the Distancing and the Both strategies subgroups did not show successful emotion regulation based on the in-scanner ratings, nor statistically significant differences between groups for the success variable. This points towards a beneficial impact of using reinterpretation strategies during this task both for ensuring successful emotion regulation in general, and for detecting significant differences between control and patient groups. In any case, the general findings suggest limited evidence for cognitive reappraisal deficits in OCD patients, which may be more pronounced when confronting symptom-specific stimuli (such as images with specific symptom content45), contrasting with relatively preserved reappraisal abilities when exposed to stimuli of general negative content.
The modest difference in the success in regulating emotions did not correspond to significant differences in brain activation when analyzing the full sample. Nevertheless, when specifically focusing in the Reinterpretation subgroup, patients with OCD showed decreased activation in the precuneus when experiencing emotions in comparison to controls. The precuneus, as part of the default mode network (DMN), is a region critically involved in self-referential processing46, and this could reflect a better ability of the controls who use reinterpretation strategies to adapt to the task demands, properly engaging in emotional processing during the Maintain condition (while OCD patients fail to do so). Regarding PPI analysis, it revealed connectivity differences for the full sample between regions of the left frontoparietal network, particularly between the left angular gyrus and the left vlPFC-regions critical for selective attention, cognitive control, and working memory47,48. While the absence of task-related fMRI activation differences for the full sample alongside significant connectivity alterations in the frontoparietal network might initially appear contradictory, we argue that this underscores the relevance of employing different neuroimaging analyses. Such approaches yield distinct insights, suggesting that certain neuroimaging modalities and analytical methods might be required to detect specific alterations. Moreover, further differences were found by the emotion regulation subgroup analyses, identifying additional disruptions in connectivity linked to the amygdala and medial PFC seeds, with controls demonstrating stronger connectivity in key regulatory networks, particularly when engaging in the Reinterpretation strategy.
Taken together, these findings suggest that emotion regulation deficits in OCD are not global but are context- and strategy-dependent. While some neural networks supporting emotion regulation remain functional, others exhibit distinct alterations, particularly in response to specific strategies. These results highlight the importance of considering individual differences in emotion regulation strategies and the neural mechanisms underlying these processes when evaluating OCD. Future studies should explore the impact of symptom-specific stimuli and examine potential therapeutic interventions targeting these disrupted networks.
A further consideration pertains to the task's design limitations, as it inherently poses a challenge to assess participants' engagement and performance in experiencing and regulating emotion. To attempt to mitigate this limitation, we conducted a postMRI interview asking participants which emotion regulation strategies they used during the task and excluded those participants who did not adequately perform the task. In this line, future studies using similar designs could enhance robustness by incorporating objective psychophysiological measures like heart-rate variability, which could offer more reliable assessments of emotion regulation performance. Moreover, we attempted to disentangle the differential behavioral and neural effects of using reinterpretation or distancing strategies (or both), but future studies better powered for these analyses will shed light on the robustness and replicability of our preliminary findings.

Functional magnetic resonance imaging (fMRI) is a powerful tool for understanding psychiatric disorders because it allows researchers to observe brain function with relatively high spatial resolution, offering insights into the neural mechanisms underlying these conditions1. By detecting changes in blood flow, fMRI can pinpoint regions of the brain that are more active during specific tasks or in response to particular stimuli, highlighting abnormalities in brain function associated with disorders like depression, anxiety, schizophrenia, and bipolar disorder. Furthermore, fMRI can reveal functional connectivity patterns, showing how different parts of the brain communicate with each other, which is crucial for understanding the complex networks disrupted in psychiatric disorders2. This non-invasive technique not only helps in identifying the neural correlates of psychiatric symptoms but also aids in exploring the psychological processes that could be underlying both symptom profiles and the effectiveness of treatments3.
Emotion regulation is one such process, which involves initiating new emotional responses or altering ongoing ones through various regulatory processes. There are several types of emotion regulation strategies, including attentional deployment (distraction), cognitive reappraisal (reinterpreting the meaning and personal connection to a stimulus), and suppression of emotional experience or expression4,5. Regarding reappraisal, previous fMRI studies have found that it is related to activation in the dorsal anterior cingulate cortex (ACC), dorsomedial and lateral frontal cortices, as well as temporal and parietal regions6,7. These frontal and cingulate brain regions are part of the frontoparietal cognitive control network, which plays a role in effortful regulation. In the context of reappraisal, this network helps cognitively reframe the negatively affective meaning of a stimulus into more neutral terms8. This network, in turn, controls bottom-up ventral and limbic regions such as the amygdala, involved in automatically evaluating emotional stimuli9. Previous studies using dynamic causal modeling analysis have examined the relationship between these dorsal and ventral regions during emotion regulation tasks using fMRI. They found that while the inferior frontal gyrus (IFG) is closely connected with the dorsolateral prefrontal cortex (PFC), the ventromedial PFC represents the main pathway through which prefrontal regions directly influence the amygdala10,11.
Obsessive-compulsive disorder (OCD) is a psychiatric disorder that affects 1-3% of the population, characterized by distressing and recurring thoughts, urges, or images (obsessions), followed by repetitive mental or physical behaviors (compulsions)12. When exposed to disorder-relevant stimuli, patients with OCD experience negative emotions such as fear, anxiety, disgust, or guilt13,14, along with increased activity in ventral frontal and limbic brain regions like the orbitofrontal cortex (OFC), the rostral ACC, and the amygdala15. Moreover, previous studies have shown that patients with OCD have difficulties regarding emotion regulation, particularly when employing cognitive reappraisal strategies16. Thus, it is hypothesized that the augmented emotional reactivity found in OCD is linked to these emotion regulation impairments17,18,19. Indeed, cognitive-behavior therapy (a first-line treatment for OCD20) includes training patients in emotion regulation strategies to help them cognitively reappraise negative, symptom-triggering situations as non-threatening.
Neurobiologically, the dysfunctional interplay between ventral and dorsal networks is thought to be associated with altered emotional processing and regulation in various psychiatric disorders21,22,23. In OCD, both functional and structural neuroimaging studies have revealed impairments in brain areas linked to these networks24,25,26, with some functional deficits normalizing after symptom improvement27,28. This evidence supports the idea that the emotion regulation difficulties found in OCD could be related to impaired control functioning of dorsal brain regions and/or hyperactivation in the ventral system. Thus, restoring the balance between these networks through cognitive reappraisal training may potentially improve patients&#39; symptoms29. Despite this evidence, there is a scarcity of previous literature exploring, through the use of fMRI, the neural correlates of cognitive emotion regulation in OCD. Thus, the definition of a standardized protocol that could be used by all research teams interested in this topic would allow the advancement of knowledge in this research area in a consistent and robust way.

<table><tbody><tr><td>AFNI</td><td>National Institute of Mental Health</td><td>RRID:SCR_005927</td><td>https://afni.nimh.nih.gov/</td></tr><tr><td>Diagnostic and Statistical Manual of Mental Disorders</td><td>American Psychiatric Association</td><td>5th edition</td><td></td></tr><tr><td>fMRIPrep</td><td>NiPreps Community</td><td>RRID:SCR_016216</td><td>Based on Nipype (RRID:SCR_002502). Pipeline details: https://fmriprep.org/en/stable/workflows.html</td></tr><tr><td>FSL</td><td>FMRIB Software Library, Analysis Group, FMRIB, Oxford</td><td></td><td></td></tr><tr><td>JASP&amp;nbsp;</td><td>JASP Team, University of Amsterdam, the Netherlands</td><td></td><td></td></tr><tr><td>Magnetic resonance imaging (MRI) scanner</td><td>Siemens</td><td>Verio 3T</td><td></td></tr><tr><td>MRI-compatible response pad</td><td>Lumina&amp;ndash;Cedrus Corporation</td><td></td><td></td></tr><tr><td>PsychoPy3</td><td>University of Nottingham</td><td></td><td></td></tr><tr><td>SPM12</td><td>Wellcome Trust Center for Neuroimaging</td><td></td><td>https://www.fil.ion.ucl. ac.uk/spm/</td></tr></tbody></table>

exploring the neural correlates of cognitive reappraisal in obsessive-compulsive disorder using task-based functional magnetic resonance imaging

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging

Patients with obsessive-compulsive disorder (OCD) show heightened brain activity in limbic and orbitofrontal regions when confronted with negative emotions, which could be associated with impairments in emotion regulation skills. The ability to regulate emotions is a necessary coping mechanism when facing emotionally distressing situations, and deliberate emotion regulation strategies such as cognitive reappraisal have been extensively studied in the general population. Despite this, little is known about potential deliberate emotion regulation deficits in OCD patients and the associated neural correlates. Here, we describe a protocol to investigate the neural correlates of deliberate emotion regulation (cognitive reappraisal) using functional magnetic resonance imaging (fMRI) in OCD patients in comparison to a matched control sample. This protocol follows current gold standards for neuroimaging studies and includes both task activation and connectivity analysis (as well as behavioral data) to allow a more complete investigation. Therefore, we expect it will contribute to expanding the knowledge of the neural correlates of emotion (dys)regulation in OCD, and it could also be applied to explore emotion regulation deficits in other psychiatric disorders.

Table 2 includes a summary of the clinical and sociodemographic information of the participants. The study included 67 adult individuals (34 OCD patients and 31 HC). However, six participants (four patients and two controls) were excluded due to MRI artifacts or suboptimal task performance (when interviewed at the end, two participants reported that no regulation strategies were applied and that they were not paying attention). The final sample consisted of 30 patients with OCD (17 females; mean age = 28.97, SD = 11.14 years) and 29 HC (15 females; mean age = 29.35, SD = 12.14 years). Both groups were matched with respect to age, years of education, sex/gender distribution, and the emotion regulation strategy used during the task. Table 2 also presents clinical information for the group of patients with OCD, including symptom severity, age of onset, and medication status.
Regarding the ratings during the task for the full sample, the Huynh-Feldt test was used as our 2 x 3 repeated-measures ANOVA violated the assumption of sphericity. The main effect of condition was statistically significant (F(1.783, 98.067) = 112.728, p &lt; .001), and post-hoc tests revealed that the Maintain condition significantly differed from the Observe condition (pointing towards successful negative emotion induction for both groups; t = −14.423, pholm &lt; .001), and that the Regulate condition differed from Maintain (indicating also successful emotion regulation for both groups; t = 3.597, pholm &lt; .001) (Figure 2). However, the main effect of group was not statistically significant (F(1, 55) = 0.155, p = .695), and there was also no significant interaction between groups and conditions (F (1.783, 98.067) = 1.877, p = .163). However, the Success variable significantly differed between groups (t(55) = 2.15, p = .036), with controls showing better regulation than patients with OCD.
When exploring this for the Distancing subgroup, the assumption of sphericity was also violated so the Huynh-Feldt test was used again as our 2 x 3 repeated-measures ANOVA. The main effect of condition was statistically significant (F(1.398, 27.961) = 35.704, p &lt; 0.001), and post-hoc tests revealed that the Maintain condition significantly differed from the Observe condition (indicating successful negative emotion induction; t = −7.666, pholm &lt; 0.001), but with the Regulate condition no longer significantly differing from Maintain (pointing towards a failure in successfully regulating emotions; t = 0.755, pholm &lt; 0.455) (Figure 2). The main effect of group was also not significant (F(1, 20) = 0.887, p = 0.358), and the same regarding the interaction between group and condition (F (1.398, 27.961) = 0.103, p = 0.832). Accordingly, the Success variable was also not significantly different between groups (t(20) = -0.132, p = 0.896).
Regarding the Reinterpretation subgroup, a 2 x 3 repeated-measures ANOVA without sphericity correction was performed, since the assumption of sphericity was not violated. The main effect of condition was also significant (F(1.8, 23.404) = 28.355, p &lt; 0.001), and post-hoc tests revealed that the Maintain condition significantly differed from the Observe condition (pointing towards successful negative emotion induction; t = −7.48, pholm &lt; 0.001), and that the Regulate condition differed from Maintain (indicating successful emotion regulation; t = 2.983, pholm &lt; 0.006) (Figure 2). However, the main effect of group was not statistically significant (F(1, 13) = 2.623, p = 0.129), and there was also no significant interaction between groups and conditions (F (1.8, 23.404) = 2.312, p = 0.126). However, the Success variable significantly differed between groups (t(13) = 2.664, p = 0.019), with controls showing better regulation than patients with OCD.
Finally, with regards to the Both strategies subgroup, a 2 x 3 repeated-measures ANOVA without sphericity correction was also performed, since the assumption of sphericity was not violated. The main effect of condition was statistically significant (F(1.592, 22.294) = 27.772, p &lt; 0.001), and post-hoc tests revealed that the Maintain condition significantly differed from the Observe condition (indicating successful negative emotion induction; t = −7.114, pholm &lt; 0.001), but with the Regulate condition no longer significantly differing from Maintain (pointing towards a failure in successfully regulating emotions; t = 1.634, pholm &lt; 0.114) (Figure 2). The main effect of group was not statistically significant (F(1, 14) = 0.245, p = 0.629), and there was also no significant interaction between groups and conditions (F (1.592, 22.294) = 0.143, p = 0.867). Similarly, the Success variable was not significantly different between groups (t(13) = 0.597, p = 0.56).
Overall, when considering the full sample, negative emotion induction was successful, and emotion regulation was effective in both groups, although controls seemed to show better emotion regulation than patients with OCD when considering the success variable. Regarding the specific emotion regulation strategy subgroups, negative emotion induction was successful for all of them, while emotion regulation appeared to fail for the Distancing and Both strategies subgroups, being successful only for the Reinterpretation subgroup. Moreover, only this subgroup showed significant group differences in the success variable, with controls presenting better emotion regulation in comparison to patients with OCD (in line with the full sample). This provides evidence toward the benefits of employing reinterpretation strategies in this task both for ensuring successful emotion regulation in general and for detecting significant differences between control and patient groups. These findings should be taken with caution though, given the decreased sample size of each subgroup and the associated loss of statistical power when performing the subgroup analyses.
Regarding the psychometric scales, there were no significant between-group differences on the ERQ, but patients with OCD scored significantly higher than HC in all OCI-R subscales, with the exception of OCI-R Hoarding (Table 2).
Finally, with regards to the fMRI task activation results, there were no significant between-group differences for the full sample at the whole-brain level for Maintain &gt; Observe or Regulate &gt; Maintain at the selected multiple comparison corrected threshold. However, when exploring the subgroups depending on the emotion regulation strategy used, significant between-group differences emerged for the Reinterpretation and Both strategies subgroups. Specifically, for the Reinterpretation subgroup, controls presented higher activation than patients with OCD in the precuneus for the Maintain &gt; Observe contrast. On the other hand, for the Both strategies subgroup, patients with OCD presented increased activation in the right posterior insula and the bilateral precentral gyri also for the Maintain &gt; Observe contrast (see Table 3 and Figure 3). There were no statistically significant findings for the Distancing subgroup or for the Regulate &gt; Maintain contrast.
Furthermore, regarding the PPI analysis, it revealed that for the full sample, the connectivity between the left angular gyrus seed and the left ventrolateral PFC (vlPFC) was significantly higher in controls compared to patients with OCD for the contrast Maintain &gt; Observe, while the opposite pattern was found for Regulate &gt; Maintain (increased connectivity in patients with OCD). When exploring the different strategy subgroups, an increased connectivity was found between the left amygdala seed and both the right inferior temporal gyrus (ITG) and the left middle occipital gyrus (MOG) for the Distancing subgroup and the Maintain &gt; Observe contrast. Moreover, the connectivity of this same seed with the right dorsolateral PFC (dlPFC), the right caudate tail and the left medial PFC was also increased in patients for the Both strategies subgroup and the Regulate &gt; Maintain contrast. Finally, for the Reinterpretation subgroup, the connectivity between the medial PFC seed and the right precentral gyrus was significantly higher in controls compared to patients with OCD for the contrast Regulate &gt; Maintain (Table 3 and Figure 4).
In summary, the whole-brain task activation analysis showed no significant between-group differences for the full sample, but subgroup analyses highlighted specific differences tied to the emotion regulation strategy employed. For example, the Reinterpretation strategy revealed decreased precuneus activation in OCD patients, while the Both strategies subgroup showed increased activation in regions such as the posterior insula and precentral gyri in OCD patients for the Maintain &gt; Observe contrast. These findings point to potential strategy-specific neural alterations in OCD, which interestingly are evident not when regulating emotions (Regulate &gt; Maintain contrast) but when experiencing them (Maintain &gt; Observe contrast). This points towards a general effect on emotional processing of having different approaches to emotion regulation. Functional connectivity analyses (PPI) offered further insights, revealing altered connectivity patterns in OCD patients. Notably, the left angular gyrus-vlPFC network showed reduced connectivity in OCD patients for the Maintain &gt; Observe contrast, while the Regulate &gt; Maintain contrast exhibited the opposite pattern. Subgroup analyses identified additional disruptions in connectivity linked to the amygdala and medial PFC seeds, with controls demonstrating stronger connectivity in key regulatory networks, particularly when engaging in the Reinterpretation strategy.
<img alt="Graph comparing HC and OCD groups' conditions; observe, maintain, and regulate with subgroup analysis." class="xfigimg" src="/files/ftp_upload/67217/67217fig02.jpg" data-altupdatedat="1788304762000" data-alt="Figure 2"> 
Figure 2: Behavioral results. Mean (95% Confidence Interval) in-scanner emotional ratings for each group and each condition (1 being 'neutral' and 5 being 'extremely negative'), for the full sample (top), as well as for the different subgroups depending on the emotion regulation strategy used (bottom). Abbreviations: HC = healthy control; OCD = obsessive-compulsive disorder. <a href="https://www.jove.com/files/ftp_upload/67217/67217fig02large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Brain imaging diagram; comparison of OCD vs. HC activation; interpretation strategies." class="xfigimg" src="/files/ftp_upload/67217/67217fig03.jpg" data-altupdatedat="1788304762000" data-alt="Figure 3"> 
Figure 3: fMRI task activation results. Between-group differences in whole-brain activation for the Reinterpretation and the Both strategies subgroups for the Maintain &gt; Observe contrast. Findings are significant at the whole-brain level p &lt; .05 FWE-cluster corrected <a href="https://www.jove.com/files/ftp_upload/67217/67217fig03large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
<img alt="Brain network activity analysis, MRI brain diagram, subgroup comparison; cognitive process mapping." class="xfigimg" src="/files/ftp_upload/67217/67217fig04.jpg" data-altupdatedat="1788304762000" data-alt="Figure 4"> 
Figure 4: fMRI task psychophysiological interaction results. Between-group differences in whole-brain connectivity for the full sample and the different strategy subgroups for the left angular gyrus (2), the left amygdala (3), and the medial PFC (5) seeds. Seeds are represented in red, while regions with differential connectivity are represented in yellow (OCD &gt; HC) or blue (HC &gt; OCD) for the Maintain &gt; Observe contrast, and in green (OCD &gt; HC) or purple (HC &gt; OCD) for the Regulate &gt; Maintain contrast. Findings are significant at the whole-brain level p &lt; .05 FWE-cluster corrected. See Table 3 for findings surviving an additional Bonferroni correction by the number of seeds explored. Abbreviations: HC = healthy control; OCD = obsessive-compulsive disorder. <a href="https://www.jove.com/files/ftp_upload/67217/67217fig04large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>
Table 2: Sociodemographic and clinical characteristics of the participants. Total N = 58 for the OCI-R subscales, N = 57 for the in-scanner emotional ratings, and N = 54 for the strategy used during the task. Abbreviations: AP = anti-psychotics; Dist = distancing; ERQ = Emotion Regulation Questionnaire; HC = healthy controls; OCD = obsessive-compulsive disorder; OCI-R = Obsessive-Compulsive Inventory-Revised; Reint = reinterpretation; SD = standard deviation; SSRI = selective serotonin reuptake inhibitors; Y-BOCS = Yale-Brown Obsessive-Compulsive Scale. <a href="https://www.jove.com/files/ftp_upload/67217/67217_Table2.xlsx" target="_blank">Please click here to download this Table.</a>
Table 3: fMRI task results. Between-group differences in task activation and psychophysiological interaction analysis for the full sample as well as for the different strategy subgroups. Findings are significant at the whole-brain level p &lt; .05 FWE-cluster corrected. *PPI findings that remain significant after an additional Bonferroni correction by the number of seeds explored (p &lt; .05 / 6 = p &lt; .0083). Abbreviations: dlPFC, dorsolateral prefrontal cortex; HC, healthy controls; ITG, inferior temporal gyrus; Ke, cluster extent in voxels; MNI, Montreal Neurological Institute; MOG, middle occipital gyrus; OCD, obsessive-compulsive disorder; PFC, prefrontal cortex; PPI, psychophysiological interaction analysis; vlPFC, ventrolateral prefrontal cortex. <a href="https://www.jove.com/files/ftp_upload/67217/67217_Table3.xlsx" target="_blank">Please click here to download this Table.</a>
Supplementary File 1: Sociodemographic questionnaire used (in Portuguese), accompanied by a translation to English. <a href="https://www.jove.com/files/ftp_upload/67217/Supp1_Sociodemographic.pdf" target="_blank">Please click here to download this File.</a>
Supplementary File 2: Clinical questionnaire used (in Portuguese), accompanied by a translation to English. <a href="https://www.jove.com/files/ftp_upload/67217/Supp2_Clinical.pdf" target="_blank">Please click here to download this File.</a>
Supplementary File 3: Portuguese version of the OCI-R used, accompanied by a translation to English. <a href="https://www.jove.com/files/ftp_upload/67217/Supp3_OCIR.pdf" target="_blank">Please click here to download this File.</a>
Supplementary File 4: Portuguese version of the ERQ used, accompanied by a translation to English. <a href="https://www.jove.com/files/ftp_upload/67217/Supp4_ERQ.pdf" target="_blank">Please click here to download this File.</a>
Supplementary File 5: Portuguese version of the Y-BOCS used, accompanied by a translation to English. <a href="https://www.jove.com/files/ftp_upload/67217/Supp5_YBOCS.pdf" target="_blank">Please click here to download this File.</a>
Supplementary File 6: Presentation used for explaining the cognitive reappraisal task and train participants on distancing and reinterpretation strategies before scanning, accompanied by a translation to English. <a href="https://www.jove.com/files/ftp_upload/67217/Supp6_ReappraisalTraining.pdf" target="_blank">Please click here to download this File.</a>
Supplementary File 7: IAPS neutral pictures used for the Observe condition of the cognitive reappraisal task. <a href="https://www.jove.com/files/ftp_upload/67217/Supp7_IAPSNeutral.tif" target="_blank">Please click here to download this File.</a>
Supplementary File 8: IAPS negative pictures used for the Maintain condition of the cognitive reappraisal task. <a href="https://www.jove.com/files/ftp_upload/67217/Supp8_IAPSMaintain.tif" target="_blank">Please click here to download this File.</a>
Supplementary File 9: IAPS negative pictures used for the Regulate condition of the cognitive reappraisal task. <a href="https://www.jove.com/files/ftp_upload/67217/Supp9_IAPSRegulate.tif" target="_blank">Please click here to download this File.</a>
Supplementary File 10: Questionnaire used after the MRI session to check that participants adequately performed the task and note which strategies they used, accompanied by a translation to English. <a href="https://www.jove.com/files/ftp_upload/67217/Supp10_Strategies.pdf" target="_blank">Please click here to download this File.</a>
Supplementary File 11: Detailed software steps for the different data analyses included in this study. <a href="https://www.jove.com/files/ftp_upload/67217/67217_JoVE_ER_OCD_Supp11_rev.docx" target="_blank">Please click here to download this File.</a>

We introduce a protocol for exploring the neural correlates of a cognitive emotion regulation task, namely cognitive reappraisal, using functional magnetic resonance imaging. This protocol was used in patients with obsessive-compulsive disorder and healthy controls but can also be used in other clinical samples.

Patients with obsessive-compulsive disorder (OCD) show heightened brain activity in limbic and orbitofrontal regions when confronted with negative ...

exploring-neural-correlates-cognitive-reappraisal-obsessive

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Explore neural correlates of cognitive reappraisal in obsessive-compulsive disorder using task-based fMRI. This protocol compares OCD patients and healthy controls to identify brain networks involved in emotion regulation.

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging (Video) | JoVE Journal

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging

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