Long-term ecological assessment of intracranial electrophysiology synchronized to behavioral markers in obsessive-compulsive disorder

Detection of neural signatures related to pathological behavioral states could enable adaptive deep brain stimulation (DBS), a potential strategy for improving efficacy of DBS for neurological and psychiatric disorders. This approach requires identifying neural biomarkers of relevant behavioral stat...

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Published inNature medicine Vol. 27; no. 12; pp. 2154 - 2164
Main Authors Provenza, Nicole R., Sheth, Sameer A., Dastin-van Rijn, Evan M., Mathura, Raissa K., Ding, Yaohan, Vogt, Gregory S., Avendano-Ortega, Michelle, Ramakrishnan, Nithya, Peled, Noam, Gelin, Luiz Fernando Fracassi, Xing, David, Jeni, Laszlo A., Ertugrul, Itir Onal, Barrios-Anderson, Adriel, Matteson, Evan, Wiese, Andrew D., Xu, Junqian, Viswanathan, Ashwin, Harrison, Matthew T., Bijanki, Kelly R., Storch, Eric A., Cohn, Jeffrey F., Goodman, Wayne K., Borton, David A.
Format Journal Article
LanguageEnglish
Published New York Nature Publishing Group US 01.12.2021
Nature Publishing Group
Subjects
639/166/985
692/308/575
692/617/375
Adult
Analysis
Biomarkers
Biomarkers - metabolism
Biomedical and Life Sciences
Biomedicine
Brain stimulation
Cancer Research
Care and treatment
Deep brain stimulation
Diagnosis
Electrodes
Electrophysiology
Electrophysiology - methods
Feasibility Studies
Female
Human acts
Human behavior
Humans
Infectious Diseases
Male
Mental disorders
Metabolic Diseases
Methods
Molecular Medicine
Neostriatum
Neurological diseases
Neurosciences
Neuroses
Obsessive compulsive disorder
Obsessive-Compulsive Disorder - physiopathology
Patient outcomes
Risk factors
Ventral Striatum - physiology
United States
Online AccessGet full text
ISSN1078-8956
1546-170X
1546-170X
DOI10.1038/s41591-021-01550-z

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Summary:Detection of neural signatures related to pathological behavioral states could enable adaptive deep brain stimulation (DBS), a potential strategy for improving efficacy of DBS for neurological and psychiatric disorders. This approach requires identifying neural biomarkers of relevant behavioral states, a task best performed in ecologically valid environments. Here, in human participants with obsessive-compulsive disorder (OCD) implanted with recording-capable DBS devices, we synchronized chronic ventral striatum local field potentials with relevant, disease-specific behaviors. We captured over 1,000 h of local field potentials in the clinic and at home during unstructured activity, as well as during DBS and exposure therapy. The wide range of symptom severity over which the data were captured allowed us to identify candidate neural biomarkers of OCD symptom intensity. This work demonstrates the feasibility and utility of capturing chronic intracranial electrophysiology during daily symptom fluctuations to enable neural biomarker identification, a prerequisite for future development of adaptive DBS for OCD and other psychiatric disorders. The identification of candidate neural biomarkers of obsessive-compulsive disorder symptom intensity in ecologically valid environments.
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Co-senior authors
Author contributions statement: WKG, JFC, SAS, and DAB conceived of the study. NRP conceptualized data analysis procedures, performed data analysis, interpreted data, and prepared figures and results with support from EMDVR, MTH, RKM, NP, YD, ABA, SAS, and DAB. EMDVR carried out packet loss correction and artifact removal procedures with support from NRP and MTH. JX optimized the MRI protocol. RKM, NP, KB, and NRP performed MRI analysis, and NP developed the MMVT software. LAJ and IOE developed AFAR analysis methodology. YD and LAJ performed AFAR analysis, and NRP, LAJ, and YD created the supplementary videos. GSV, MAO, NR, and NRP performed data collection in the clinic. ERM supported data collection. NRP, GSV, and MAO guided participant data collection at home. ADW provided clinical ERP sessions, and ADW and NRP collected data during ERP, supervised by EAS. ABA documented SUDs ratings using ERP videos. LFFG and DX created new software to enable the collection of intracranial electrophysiology at home. NRP and SAS wrote the first draft of the manuscript and all authors contributed to the writing and revision of the manuscript. WKG, SAS, AV, and EAS performed the clinical care aspects of the study. SAS and AV performed the study surgical procedures. WKG, SAS, JFC, EAS, and DAB oversaw the collection of data, analysis, and manuscript completion.
ISSN:1078-8956
1546-170X
1546-170X
DOI:10.1038/s41591-021-01550-z