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Electrophysiological Biomarkers Reflect Target Engagement and Response Using Deep Brain Stimulation for

Tine Van Bogaert1,2, Martijn Figee1,3,4,5, Brian H Kopell1,3,4,5,6

  • 1Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York.

Biological Psychiatry Global Open Science
|November 14, 2025
PubMed
Summary
This summary is machine-generated.

Intraoperative electroencephalography (EEG) recorded deep brain stimulation evoked potentials (EPs) can help optimize lead placement for obsessive-compulsive disorder (OCD) treatment. These EPs may predict patient response to anterior limb of the internal capsule (ALIC) deep brain stimulation (DBS).

Keywords:
Anterior limb of the internal capsule (ALIC)BiomarkerCcepDeep brain stimulationObsessive-compulsive disorderTractography

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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 effective for treatment-resistant obsessive-compulsive disorder (OCD).
  • Optimizing lead placement and stimulation parameters for ALIC DBS remains a challenge.
  • Intraoperative DBS evoked potentials (EPs) recorded via electroencephalography (EEG) may serve as biomarkers for target engagement and clinical efficacy.

Purpose of the Study:

  • To investigate the utility of intraoperative EEG-recorded EPs as biomarkers for ALIC DBS in OCD.
  • To correlate EP characteristics with lead placement, white matter connectivity, and clinical response.

Main Methods:

  • Intraoperative EEG recordings were obtained from 10 patients undergoing ALIC DBS for OCD.
  • Monopolar stimulation was delivered, and EEG EPs were analyzed in relation to stimulation contact, white matter connectivity (probabilistic tractography), and symptom severity (Yale-Brown Obsessive Compulsive Scale).

Main Results:

  • Consistent DBS EPs with three oscillatory peaks were observed across all patients.
  • EP amplitude correlated with the overlap of stimulation location with the tractographic target and white matter connectivity to prefrontal regions.
  • Nonresponders showed less consistent EP waveforms.

Conclusions:

  • Intraoperative EPs offer valuable insights into ALIC DBS target engagement for OCD.
  • EP characteristics can potentially refine DBS targeting and predict clinical response.
  • This approach may optimize DBS therapy for OCD patients.