Obsessive-compulsive disorder (OCD) is an anxiety-related disorder characterized by persistent thoughts and ritualistic behaviors that in more advanced cases, can cause significant disability and adverse effects on quality of life. Even with available treatments such as exposure and response prevention therapy and pharmacotherapy with selective serotonin reuptake inhibitors, approximately 10% of patients remain unresponsive and experience treatment-refractory OCD. A proportion of these intractable OCD patients qualify for treatment with deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule and ventral striatum (VC/VS), a neurosurgical approach that utilizes electrodes implanted in the brain. While this therapy has shown significant therapeutic efficacy, the response rates across patients have been variable, likely due to challenges in selecting optimal stimulation settings given the heterogeneous presentation of the disorder and variability in human brain anatomy. To improve clinical outcomes of DBS therapy targeting the VC/VS, it is imperative to elucidate the precise axonal fiber tracts traversing the surgical target that when stimulated improve OCD symptoms or generate unintended side effects.
PhD student Karianne Sretavan Wong (Neuroscience), in a project called “Developing patient-specific biophysical models of ventral capsule/ventral striatum deep brain stimulation for treating obsessive-compulsive disorder,” is combining high-resolution neuroimaging and computational modeling to develop novel patient-specific computational models of DBS to predict the axonal pathways, proximal to the electrodes, that are modulated by DBS and correlate those activated pathways with clinical outcomes in patients. These models will contribute to a greater understanding of the neural circuits implicated in OCD as well as provide a framework for optimizing DBS treatment for individuals living with OCD.
Some funding for this project was provided by a 2023 Research Computing-MnDRIVE PhD Graduate Assistantship. The RC-MnDRIVE Graduate Assistantship program supports U of M PhD candidates pursuing research at the intersection of informatics and any of the five MnDRIVE areas:
- Robotics
- Global Food
- Environment
- Brain Conditions
- Cancer Clinical Trials
This project is part of the Brain Conditions MnDRIVE area. See the complete list of the RC-MnDRIVE Graduate Assistantships for 2023.
Image description: (A) Preoperative 7 Tesla MRI showing lead location for deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule and ventral striatum B) Example of a finite element model visualizing DBS-induced electrical fields using patient-specific brain conductivities
