Study Gathers Brain Recordings to Improve Deep Brain Simulation for OCD

In a small study, investigators gathered more than 1000 hours of brain recordings in a clinic at home from individuals with obsessive-compulsive disorder (OCD).

These data are a key first step toward designing improved deep brain simulation (DBS) treatments for neuropsychiatric disorders. DBS has shown great potential for improving the lives of individuals with neurological disorders, such as Parkinson disease and is gaining traction in treating OCD.

The study was funded by the National Institutes of Health Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) Initiative, and the results were published in Nature Medicine.

"By combining at-home and in-clinic brain recordings, this study could aid in the development of adaptive DBS treatments, which could be transformative for people living with OCD," John Ngai, PhD, director of the NIH BRAIN Initiative, said in a statement.

Investigators collected brain recordings form 3 individuals who were already receiving DBS treatment for OCD. These recordings occurred in the clinic, during teletherapy sessions, and at the participants’ homes.

These data will be used to correlate specific brain patterns with OCD symptoms, with the goal being the identification of neural signatures and related behaviors to help predict the onset of symptoms. The hope is this can be used to further refine DBS treatment.

The at-home component is particularly important, given that the environment is where individuals are being exposed to triggers in their everyday lives, according to the statement.

"Currently, DBS therapy for OCD involves implanting the electrodes, turning on the stimulation, and then fine-tuning that stimulation as best as possible in the clinic," David Borton, PhD, associate professor of biomedical engineering at Brown University, said in the statement. "But because symptoms can be triggered by many factors, the clinician is tuning the DBS system for the patient at that moment in the clinic, but their needs could change significantly once they leave the clinic.”

OCD and other neuropsychiatric disorders are challenging to treat with DBS because the symptoms fluctuate over time. OCD symptoms can come and go over time and can be triggered by an individual’s environment, unlike motor disorders such as Parkinson disease.

Another challenge is the lack of biomarkers for OCD symptoms. Changes in the symptoms in response to DBS can take weeks or even months to occur once treatment begins.

Clinical programing for the DBS system must rely on secondary behavioral changes, such as positive affect responses, when individuals feel happier or more talkative when stimulation is turned on.

In the new study, brain recordings were taken from the same electrodes responsible for delivering the DBS therapy and time-synched to EEG, other physiological recordings, and facial changes when recorded in the clinic; to efforts to evoke symptom responses during teletherapy sessions; and to self-reported symptoms during everyday life and during prescribed tasks at home. Investigators were able to begin identifying candidates for neurological signatures of OCD, such as brain activity changes that occurred over time in correlation with clinical scores for OCD symptoms.

They also plan to tweak the simulation in response to the candidate biomarkers to confirm that they can be used to affect the onset of symptoms.

Recordings from the cortical surface of the individuals will be added to provide an more information.

Reference

Better deep brain stimulation therapy for OCD. ScienceDaily. News release. December 9, 2021. Accessed December 14, 2021. https://www.sciencedaily.com/releases/2021/12/211209124220.htm