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Related Concept Videos

Obsessive-Compulsive Disorder01:28

Obsessive-Compulsive Disorder

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Obsessive-compulsive disorder (OCD) is a mental health condition characterized by recurrent obsessions, compulsions, or both, which consume significant time and interfere with daily functioning. Obsessions involve persistent, intrusive, and unwanted thoughts, images, or urges that evoke anxiety. Common examples include irrational fears of contamination or harm. Compulsions are repetitive behaviors or mental acts performed to reduce the anxiety caused by obsessions. For instance, individuals...
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Operant conditioning serves as a foundational principle in therapeutic interventions aimed at modifying maladaptive behaviors. Central to this approach is the notion that behaviors, both adaptive and maladaptive, are learned through reinforcement. By analyzing the environmental factors that reinforce problematic behaviors, clinicians can design interventions to weaken these reinforcements and replace maladaptive behaviors with healthier alternatives.
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Related Experiment Video

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Combining Transcranial Magnetic Stimulation and fMRI to Examine the Default Mode Network
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Therapeutic DBS for OCD Suppresses the Default Mode Network.

Natalya Slepneva1,2, Genevieve Basich-Pease1,2, Lee Reid2,3

  • 1Weill Institute for Neurosciences, University of California, San Francisco, California, USA.

Human Brain Mapping
|December 25, 2024
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Summary

Deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) may work by suppressing the default mode network (DMN). This circuit-based treatment for OCD may interrupt brain network communication via structural white matter connections.

Keywords:
DTIOCDanterior limb of the internal capsuledeep brain stimulationdefault mode networkfMRItractography

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Area of Science:

  • Neuroscience
  • Neurosurgery
  • Psychiatry

Background:

  • Deep brain stimulation (DBS) of the anterior limb of the internal capsule (ALIC) is a circuit-based treatment for severe, refractory obsessive-compulsive disorder (OCD).
  • The precise mechanism by which DBS alleviates OCD symptoms is not fully understood, though it is hypothesized to involve modulation of cortico-striato-thalmo-cortical networks.

Purpose of the Study:

  • To investigate the network effects of ALIC DBS in patients with severe OCD.
  • To explore the relationship between functional brain activity changes and structural connectivity during DBS treatment.

Main Methods:

  • Functional MRI (fMRI) with an On/Off cycling paradigm was used in five participants (3 responders, 2 non-responders) undergoing ALIC DBS for OCD.
  • Diffusion-weighted imaging (DWI) and tractography were employed to assess structural connectivity between active DBS contacts and brain networks.

Main Results:

  • Therapeutic ALIC DBS configurations suppressed BOLD activity in regions including the orbitofrontal cortex, dorsomedial prefrontal cortex, and subthalamic nuclei.
  • Many suppressed regions were part of the default mode network (DMN).
  • The stimulation field from therapeutic configurations showed significant structural connectivity to core DMN nodes.

Conclusions:

  • ALIC DBS for OCD may exert therapeutic effects by suppressing the DMN.
  • This suppression is hypothesized to occur through the interruption of communication along structural white matter tracts connected to the DBS electrodes.