Neural Noise

Invasive brain mapping for personalized therapeutic neuromodulation targets in OCD

2 min read

  • Invasive brain mapping identifies personalized therapeutic neuromodulation targets that suppress OCD network activity (Nature).1
  • The approach informs closed-loop DBS and therapeutic BCI/neurotech.1 1

Weekly enrichment (2026-07-20)

  • Peer-reviewed report: “Invasive brain mapping identifies personalized therapeutic neuromodulation targets that suppress OCD network activity,” Translational Psychiatry (Nature Portfolio), 2025 (doi:10.1038/s41398-025-03690-z); an earlier preprint appeared on medRxiv (doi:10.1101/2025.03.14.25323348).234
  • Design: a first-in-human, proof-of-concept single-patient case — a woman in her 20s with extreme, treatment-refractory OCD (Yale-Brown Obsessive-Compulsive Scale, Y-BOCS = 34) who had failed serotonin-reuptake inhibitors, augmentation, intensive residential therapy, and TMS — enrolled under FDA IDE G240038 / ClinicalTrials.gov NCT06347978 at UCSF.24
  • Electrode coverage: 12 stereo-EEG electrodes (16 contacts each) were implanted bilaterally across the cortico-striato-thalamo-cortical (CSTC) circuit — orbitofrontal cortex, anterior and dorsal cingulate, VC/NAc, VC/BNST, and anterior medial subthalamic nucleus/zona incerta.24
  • Mapping protocol over a 10-day inpatient stay: Phase 1 safety testing (1–6 mA, 1–30 s trains), Phase 2 five-minute efficacy trains scored on visual-analogue scales, and Phase 3 a 20-minute randomized, double-blind, sham-controlled paradigm.4
  • Result: two right ventral-capsule targets (R VC/NAc and R VC/BNST, adjacent to the globus pallidus externa) acutely and reproducibly reduced OCD symptoms relative to sham.24
  • Biomarker: high-frequency activity (HFA) across the CSTC network correlated with OCD symptom severity (assessed over 174 recording sites); therapeutic VC stimulation suppressed orbitofrontal (and, for R VC/BNST, anterior cingulate) HFA and shifted power to lower frequencies.24
  • Connectivity: single-pulse evoked-potential mapping (N1 response at 10–50 ms) plus diffusion-MRI tractography confirmed dense structural and functional connectivity from the therapeutic VC sites to orbitofrontal cortex, and N1 magnitude correlated with the degree of HFA suppression.25
  • Translation: eight weeks after mapping, four DBS leads were implanted with bilateral Medtronic Percept RC pulse generators at the mapped sites, and combined stimulation produced a rapid therapeutic response — supporting a personalized, multi-site closed-loop DBS strategy for refractory OCD.24

Footnotes

  1. https://news.google.com/rss/articles/CBMiX0FVX3lxTE1QREtQRFdxd3N4cG8td2I1ZkIxbjREZjJOeEc0cWljaUhmYkRRb181Rzd6dldfTzlIMl9UYmpuMS03OUFqMk5oWDB1YlJIOUFmbzdOZ0lYcm9KZGVIdDFj?oc=5 ↩ ↩2 ↩3

  2. https://www.nature.com/articles/s41398-025-03690-z ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7

  3. https://doi.org/10.1038/s41398-025-03690-z ↩

  4. https://doi.org/10.1101/2025.03.14.25323348 ↩ ↩2 ↩3 ↩4 ↩5 ↩6 ↩7

  5. https://link.springer.com/article/10.1038/s41398-025-03690-z ↩

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