Invasive brain mapping identifies personalized therapeutic neuromodulation targets that suppress OCD network activity
Year: 2025
Type: article
Abstract: Deep brain stimulation has been used to treat severe, refractory obsessive-compulsive disorder (OCD) with variable outcomes across multiple anatomical targets. To overcome these limitations, we developed an invasive brain mapping paradigm in which electrodes were implanted across the OCD cortico-striato-thalamo-cortical circuit in a single individual. We then performed extensive stimulation mapping during a multi-day inpatient stay to identify personalized therapeutic targets and characterize their downstream circuit effects. We found two targets within the right ventral capsule (VC) that acutely reduced OCD symptoms. Prolonged VC stimulation suppressed high frequency activity within the structurally and functionally connected orbitofrontal cortex, which encoded the severity of OCD symptoms. These VC sites were implanted for DBS and combined stimulation of these targets led to a rapid therapeutic response. This case provides the first proof-of-concept that invasive brain mapping can be used to guide a novel personalized, multi-site neuromodulation approach to treat refractory OCD.
Source: Translational Psychiatry
Authors: A. Moses Lee, Audrey Kist, John Alvarez, Kristin K. Sellers, Ankit N. Khambhati, Leo P. Sugrue, Lee B. Reid, Kelly Kadlec, Sneha Ray, Joline M. Fan, Anusha B. Allawala, Caroline A. Racine, Tenzin Norbu, Dani Astudillo, Alexandra G. Tremblay-McGaw, Natalie Becker, Jessica Verhein, Ahmad Alhourani, Philip A. Starr, Edward F. Chang, Andrew D. Krystal
Institution: University of California, San Francisco
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $5,290
Awards: Targeting DBS Therapy to the OCD Network Using fMRI and Intracranial Recordings, G630110978, G7659895438, G8032102672, G8554826760, Modulation of network dynamics across mood states using closed-loop deep brain stimulation for depression, Network dynamics of sleep-wake states in epilepsy, Direct Intracranial Electrophysiological Mapping of Insular Circuits for Anxiety in the Human Brain, TRAINING THE NEXT GENERATION OF MENTAL HEALTH RESEARCHERS
OpenAlex ID: W4415725643