Neural activity recordings could help clinicians provide a precise prognosis to patients being treated for obsessive-compulsive disorder (OCD) with deep brain stimulation (DBS).
OCD is a common, yet in some instances, debilitating disorder in which patients engage in repetitive thoughts or behaviors to varying extents throughout their lifetime. Conventional OCD treatment involves psychotherapy or medication to manage symptoms and usually takes months for symptom improvements to manifest. And 10-20% of patients with OCD have treatment-resistant OCD—OCD that hasn’t responded to conventional therapies.
Using advanced DBS technology with the ability to both stimulate and record brain activity, BRAIN-funded researchers sought to identify specific patterns of brain activity that might provide objective biomarkers of treatment-resistant OCD. The study, led by Drs. Sameer Sheth and Wayne Goodman along with co-lead authors, Drs. Nicole Provenza, Sandy Reddy, and Anthony Allam, was published in Nature Medicine. This approach aligns with the National Institute of Mental Health’s Research Domain Criteria, a research framework to precisely understand mental disorders beyond the categorizing of symptom clusters. The commercially available DBS device has the ability to stimulate, record brain electrical activity, store recordings in memory, and wirelessly transmit the recordings to clinicians.
In the study, 12 patients who had severe OCD for more than five years and were non-responsive to conventional therapeutic interventions were enrolled. Two DBS electrodes were bilaterally implanted into the ventral capsule/ventral striatum region of the brain that impacts cognitive and affective behavior regulation. Brain neural activity recordings were obtained prior to stimulation, which provided a baseline, symptomatic, OCD brain signature. This recorded baseline brain signature could then be objectively monitored throughout the study with and without stimulation.
Throughout the study, most of the patients showed improvements, transitioning from a period of being unwell to a period of being well, a difference the recordings could decipher. Specifically, in patients who were unwell with persistent OCD symptoms, the recordings identified a distinct, predictable neural activity pattern characteristic of seizures. In contrast, when patients were well, neural activity recordings were variable, a pattern characteristic in healthy people. This study gives an in-depth view into the neurological activity of a human brain experiencing severe OCD symptoms and the ability of advanced DBS neurotechnology to capture this brain signature. By revealing a neural activity signature that can predict whether an individual will respond to DBS treatments, these findings may be applied to inform personalized therapies for individuals living with treatment-resistant OCD.
This BRAIN-funded study exemplifies the mission of the BRAIN Initiative in revolutionizing our understanding of the human brain through the use of innovative neurotechnologies. To read more, visit the Baylor College of Medicine press release or the published study in Nature Medicine.