Brain Variations Can Predict Effectiveness of OCD Treatment

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Brain variations in patients with refractory obsessive-compulsive disorder (OCD) may predict whether they will respond to neurosurgical treatment, according to a study published in JAMA Psychiatry.

The researchers identified features of the brain's anterior cingulate cortex and connectivity that are related to patients’ response to dorsal anterior cingulotomy, a procedure that involves making a lesion on a part of the brain that is thought to play a part in causing OCD.

Approximately 10% of patients with OCD have symptoms that do not respond to medication or cognitive-behavioral therapies. In these cases, neurosurgical intervention can be effective, though not all patients will respond to the procedure.

The study included 15 patients who underwent dorsal anterior cingulomoty. Eight of the patients responded to the procedure. The researchers looked at their preoperative MRI scans to identify variations in the patients’ brains.

The researchers found a gray matter cluster in the right anterior cingulated cortex that was associated with surgical outcome. Decreased gray matter in this area predicted better response to the procedure.

Hemispheric asymmetry in connectivity between the eventual lesion and the brain regions caudate, putamen, thalamus, pallidum, and hippocampus was also associated with clinical response. Increased right-side connectivity predicted better response.

Brain Variations Can Predict Effectiveness of OCD Treatment
Brain Variations Can Predict Effectiveness of OCD Treatment

Identifying brain variations may help physicians predict which patients will respond to a neurosurgical procedure to treat obsessive-compulsive disorder (OCD) that does not respond to medication or cognitive-behavioral therapies, according to a report published by JAMA Psychiatry.

OCD is a debilitating disorder characterized by repetitive intentional behaviors and intrusive thoughts. About 10 percent to 20 percent of patients have refractory OCD, which does not respond to medication or therapy to achieve symptom relief, and therefore the patients may be candidates for surgical treatment. The dorsal anterior cingulotomy is such a procedure and involves lesioning (causing damage to) a region of the brain that is believed to play a role in the neural network that causes OCD, according to the study background.

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