Scientists have been able to observe brain activity linked with obsessive-compulsive disorder in more detail than ever before, and if these neural signals can be identified, it opens up the possibility of being able to change them as well.
25-40 percent of people with OCD don't get any sustained benefits from their treatment, and it's estimated that up to two in every 100 adults have OCD. The disorder can affect daily life and cause distress.
Five volunteers with severe OCD were monitored at home and in the lab, with the collected data including brain activity, facial expressions, body movements, heart rate, and self-reported OCD symptom intensity.
The researchers were able to see associations between behavioral activity and signals in the brain with the help of this suite of information. The sample size for the experiment was small, but it could point the way to a new field of treatment.
"This is the first time brain signals from participants with a mental illness have been recorded at home," says Nicole Provenza, a biomedical engineer.
This technique made it possible to record this diversity of behavior and brain activity, and it may be able to differentiate between when someone is experiencing OCD symptoms and not.
The devices used to chart brain activity can also provide brain simulation, using planted electrodes to cause electrical stimulation in the brain. In people who haven't responded to other measures, DBS has shown promise.
The only way to be easily adapted as symptoms change is to use a constant level of stimulation that can be adjusted by doctors. An adaptive DBS system that could be even more effective was part of the thinking behind the new study.
The goal is to create adaptive devices that can modify the electrical pulse they give out without patients needing to visit a doctor. If the treatment was only being applied when symptoms were at their worst, it would limit the effects of headaches and difficulty concentrating.
David Borton, a biomedical engineer from Brown University, says thatOCD is a disorder in which symptom severity is variable over time and can be elicited by the environment.
We need to identify the brain biomarkers associated with OCD symptoms in order to enable a DBS system that can adjust stimulation intensity in response to symptoms, which may provide more relief and fewer side effects for patients.
The team was able to identify brain patterns that might be related to OCD, but it's not clear what those signals mean or how they might be manipulated.
The researchers say that future research would need more participants and more information collected over a longer period of time.
A personalized approach to treatment is the best way to deal with OCD, which is a complex disorder that affects different people in a lot of different ways. Studies like this could show how the brain is affected by OCD and suggest how the disorder could be alleviated.
Sameer Sheth is a neuroscientist at the Baylor College of Medicine in Texas.
The better we understand the neural signatures of health and disease, the more likely we are to successfully treat challenging brain disorders like OCD.
Nature Medicine has published the research.
