A brief demonstration of frontostriatal connectivity in OCD patients with intracranial electrodes
Ezra E. Smith,
Thomas Schüller,
Daniel Huys,
Juan Carlos Baldermann,
Pablo Andrade,
John JB. Allen,
Veerle Visser-Vandewalle,
Markus Ullsperger,
Theo O.J. Gruendler,
Jens Kuhn
Affiliations
Ezra E. Smith
Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychology, University of Arizona, Tucson, AZ, USA; Corresponding author. Division of Translational Epidemiology, New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
Thomas Schüller
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
Daniel Huys
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
Juan Carlos Baldermann
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, University Hospital Cologne, Cologne, Germany
Pablo Andrade
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne, Germany
John JB. Allen
Department of Psychology, University of Arizona, Tucson, AZ, USA
Veerle Visser-Vandewalle
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne, Germany
Markus Ullsperger
Otto von Guericke University, Institute of Psychology, Magdeburg, Germany; Center for Behavioral Brain Sciences, Magdeburg, Germany
Theo O.J. Gruendler
Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
Jens Kuhn
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany; Department of Psychiatry, Psychotherapy, and Psychosomatics, Johanniter Hospital Oberhausen, Oberhausen, Germany
Closed-loop neuromodulation is presumed to be the logical evolution for improving the effectiveness of deep brain stimulation (DBS) treatment protocols (Widge et al., 2018). Identifying symptom-relevant biomarkers that provide meaningful feedback to stimulator devices is an important initial step in this direction. This report demonstrates a technique for assaying neural circuitry hypothesized to contribute to OCD and DBS treatment outcomes. We computed phase-lag connectivity between LFPs and EEGs in thirteen treatment-refractory OCD patients. Simultaneous recordings from scalp EEG and externalized DBS electrodes in the ventral capsule/ventral striatum (VC/VS) were collected at rest during the perioperative treatment stage. Connectivity strength between midfrontal EEG sensors and VC/VS electrodes correlated with baseline OCD symptoms and 12-month posttreatment OCD symptoms. Results are qualified by a relatively small sample size, and limitations regarding the conclusiveness of VS and mPFC as neural generators given some concerns about volume conduction. Nonetheless, findings are consistent with treatment-relevant tractography findings and theories that link frontostriatal hyperconnectivity to the etiopathogenesis of OCD. Findings support the continued investigation of connectivity-based assays for aiding in determination of optimal stimulation location, and are an initial step towards the identification of biomarkers that can guide closed-loop neuromodulation systems.
