Key result
OCD is linked to sympathetic hyperactivation marked by reduced mean NN intervals during video viewing.
Why the study?
The study was conducted to provide a detailed, dynamic portrait of autonomic dysregulation in individuals with obsessive-compulsive disorder.
Does viewing triggering videos alter autonomic responses (HRV, GSR, oculomotor) in individuals with OCD compared to healthy controls?
Cross-Sectional (n=77)
No
Does viewing triggering videos alter autonomic responses (HRV, GSR, oculomotor) in individuals with OCD compared to healthy controls?
p-value: p=0.023
Individuals with OCD exhibit reduced autonomic flexibility and sympathetic hyperactivation in response to emotional stimuli, suggesting autonomic inflexibility is a core feature of the disorder.
Autonomic hyperactivation during emotional stimuli may mark inflexibility in OCD; hypothesis-generating for targeted therapies, should not yet change practice.
Background: The autonomic nervous system (ANS) in individuals with obsessive–compulsive disorder (OCD) is often characterized by heightened sympathetic tone and reduced parasympathetic flexibility. This exploratory pilot study aimed to provide a detailed, dynamic portrait of autonomic dysregulation. Methods: Heart rate variability (HRV), galvanic skin response (GSR), and oculomotor measures (pupil size, fixations, saccade velocity) were recorded in 31 participants with OCD (obsessive–compulsive disorder) and 46 healthy controls while viewing 18 videos, half of them designed to trigger specific OCD dimensions and half neutral or positive. Results: The OCD group exhibited a state of sympathetic hyperactivation, evidenced by significantly lower mean NN intervals (average interval between normal heartbeats) and a distinct GSR (galvanic skin response) pattern marked by a rising tonic component across the experiment. Healthy controls exhibited increases in SDNN (standard deviation of NN intervals) and RMSSD (root mean square of successive differences) following pleasant videos, whereas this response was less pronounced and emerged later in the OCD group, suggesting reduced autonomic flexibility. Oculomotor data revealed faster saccade velocities during video viewing in the OCD group; however, unlike controls, their eye movements did not correlate with the pleasantness of the content. Conclusions: These results support the theory that individuals with OCD may exhibit greater sympathetic activation and delayed parasympathetic engagement. The findings suggest that autonomic inflexibility may be a core, measurable feature of OCD.
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Portnova et al. (2026) conducted a cross-sectional in Obsessive-compulsive disorder (OCD) (n=77). Obsessive-compulsive disorder vs. Healthy controls was evaluated on Mean NN interval (heart rate variability) (p=0.023). Individuals with obsessive-compulsive disorder exhibited sympathetic hyperactivation, evidenced by significantly lower mean NN intervals and faster saccade velocities during video viewing compared to healthy controls.
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