2023 Jenike Young Investigator Award

Electrophysiological biomarker characterization in sensing-enabled deep brain stimulation for obsessive-compulsive disorder

Ali Tafreshi, MD & Matteo Vissani, PhD

Massachusetts General Hospital/Harvard Medical School (Boston, MA)

Award Amount: $49,637

Surgery options such as deep brain stimulation (DBS) surgery can provide relief for patients with severe, treatment-resistant OCD. Cutting edge research has led to the development of new devices that not only electrically stimulate the brain, but can also “sense” brain waves with the very same device — allowing for better targeted stimulation of regions associated with OCD. Dr. Tafreshi and his team at Harvard University/Massachusetts General Hospital have already published research identifying an important candidate signal called alpha power that is thought to be a neural marker of OCD. Specifically, they showed that suppression of alpha power in local field potentials in the ventral capsule/ventral striatum brain region correlates with symptom improvement in patients with severe OCD.

The aim of the current study by Drs. Tafreshi and Vissani is to identify changes in brain waves, particularly looking at their candidate alpha power, during symptomatic and asymptomatic periods, as well as before and after stimulation, medication, and any other treatment changes. The team will identify and record relationships between these variables, seeking patterns that correlate with clinical symptoms. They hypothesize that alpha power is a biomarker for OCD symptoms, and that effective therapeutic stimulation reduces alpha power. This project will lay the groundwork for larger-scale clinical trials that will utilize this novel biomarker data to show effectiveness in targeted stimulation and new evidence for a concrete OCD biomarker, which has never been done before.

Overall, this research can lead to the development of “closed-loop” stimulation — adaptive brain stimulation that is highly specific to the patient, reading and reacting to brain waves and directly treating the neurological signature of OCD. Understanding how these brain waves and larger regions function may help establish new neuromodulatory targets, further expanding treatment for OCD and other psychiatric conditions. This model is referred to as a “connectomic” approach, in which distinct brain networks are thought to modulate symptoms in neuropsychological disorders. The goal in the end is to pave the way for the delivery of safe, patient-specific, and effective treatment to patients who are suffering from OCD.