Study on Deep Brain Stimulation Effects on Brain Activity in Adults with Treatment-Resistant Obsessive-Compulsive Disorder Aged 22 to 64

What this Trial Is About

This research aims to understand brain activity related to approach and avoidance behaviors in adults with treatment-resistant obsessive-compulsive disorder OCD. The study will recruit 10 patients who meet criteria for surgical evaluation and will investigate deep brain stimulation DBS effects on brain activity using a device capable of recording neural signals. Researchers hope to identify common neural patterns underlying decision-making and symptom relief in OCD across different testing environments. Participants will be implanted with permanent DBS leads and a rechargeable Medtronic Percept RC implantable pulse generator that records neural activity. The study includes evaluations in both clinical and home settings. In the clinic, patients will complete behavioral tasks and exposure trials at seven key visits before and after DBS initiation over 12 months. At home, continuous neural recordings will be paired with wearable data and video diaries to observe natural behavior and symptom changes over longer periods. During the study, participants will undergo clinical assessments, perform specific tasks like the Probabilistic Approach Avoidance Task PAAT, and engage in psychologist-guided exposure trials. Researchers will collect detailed neurobehavioral data synchronized with neural recordings at multiple timepoints before implant, before and immediately after DBS activation, and at 2 weeks, 3 months, 6 months, and 12 months post-activation. The primary outcome is changes in OCD symptoms measured over 14 months. This comprehensive data aims to provide insights that could guide future therapeutic decisions.

Neurophysiological Investigation of the Approach-avoidance Axis in OCD: Applications to Neuromodulation