ACC Connectivity Changes during ALIC Deep Brain Stimulation for Obsessive Compulsive Disorder

Chronic deep brain stimulation (DBS) of the anterior limb of the internal capsule (ALIC) is an emergent therapy for severe cases of obsessive-compulsive disorder (OCD), however patient response is variable with only 50-60% of patients classified as responders. Toward optimizing therapy for the individual patient and improving overall treatment efficacy, here we used fMRI during ALIC stimulation to evaluate changes in OCD network functional connectivity. In 5 patients, we found that DBS, when in a therapeutic configuration for the patient, may be reducing abnormal hyperconnectivity to improve symptoms, while nontherapeutic configurations may be disrupting fronto-posterior connections causing unwanted symptoms.