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

doi:10.1016/j.neuroimage.2020.117138

A brief demonstration of frontostriatal connectivity in OCD patients with intracranial electrodes

Neuroimage. 2020 Oct 15:220:117138. doi: 10.1016/j.neuroimage.2020.117138. Epub 2020 Jul 4.

Authors

Affiliations

¹ Division of Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA; Department of Psychology, University of Arizona, Tucson, AZ, USA. Electronic address: ezra.e.smith@gmail.com.
² University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany.
³ 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.
⁴ University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne, Germany.
⁵ Department of Psychology, University of Arizona, Tucson, AZ, USA.
⁶ Otto von Guericke University, Institute of Psychology, Magdeburg, Germany; Center for Behavioral Brain Sciences, Magdeburg, Germany.
⁷ Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany.
⁸ 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.

PMID: 32634597
DOI: 10.1016/j.neuroimage.2020.117138

Abstract

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.

Keywords: Deep brain stimulation; Functional connectivity EEG; LFP; Obsessive-compulsive disorder; Ventral capsule; Ventral striatum.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Corpus Striatum / physiopathology*
Deep Brain Stimulation / methods
Electrodes, Implanted
Female
Frontal Lobe / physiopathology*
Humans
Male
Neural Pathways / physiopathology
Obsessive-Compulsive Disorder / physiopathology*