Evidence map›Paper›PMID 40166548›Full record

ArticlemedRxiv : the preprint server for health sciences2025

Invasive Brain Mapping Identifies Personalized Therapeutic Neuromodulation Targets for Obsessive-Compulsive Disorder.

A Moses Lee, Audrey Kist, John Alvarez, Kristin K Sellers, Ankit N Khambhati, Leo P Sugrue, Lee B Reid, Kelly Kadlec, Joline M Fan, Anusha B Allawala and 9 more

Abstract readPreprint
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In one paragraph

Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

A Moses LeeWeill Institute for Neurosciences, University of California, San Francisco.
Audrey KistWeill Institute for Neurosciences, University of California, San Francisco.
John AlvarezWeill Institute for Neurosciences, University of California, San Francisco.
Kristin K SellersWeill Institute for Neurosciences, University of California, San Francisco.
Ankit N KhambhatiWeill Institute for Neurosciences, University of California, San Francisco.
Leo P SugrueWeill Institute for Neurosciences, University of California, San Francisco.
Lee B ReidWeill Institute for Neurosciences, University of California, San Francisco.
Kelly KadlecWeill Institute for Neurosciences, University of California, San Francisco.
Joline M FanWeill Institute for Neurosciences, University of California, San Francisco.
Anusha B AllawalaWeill Institute for Neurosciences, University of California, San Francisco.
Caroline A RacineWeill Institute for Neurosciences, University of California, San Francisco.
Tenzin NorbuWeill Institute for Neurosciences, University of California, San Francisco.
Dani AstudilloWeill Institute for Neurosciences, University of California, San Francisco.
Alexandra G Tremblay-McGawWeill Institute for Neurosciences, University of California, San Francisco.
Natalie BeckerWeill Institute for Neurosciences, University of California, San Francisco.
Ahmad AlhouraniDepartment of Neurological Surgery, University of California, San Francisco.
Philip A StarrWeill Institute for Neurosciences, University of California, San Francisco.
Edward F ChangWeill Institute for Neurosciences, University of California, San Francisco.
Andrew D KrystalWeill Institute for Neurosciences, University of California, San Francisco.

Funding

Direct Intracranial Electrophysiological Mapping of Insular Circuits for Anxiety in the Human BrainK23MH125018 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LEE, ANDREW MOSES · 2021 to 2025
$1.0M
Network dynamics of sleep-wake states in epilepsyK23NS125123 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Joline Fan · 2023 to 2026
$868k
Targeting DBS Therapy to the OCD Network Using fMRI and Intracranial RecordingsR21MH130914 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LEE, ANDREW MOSES, MORRISON, MELANIE A · 2022 to 2023
$444k
Modulation of network dynamics across mood states using closed-loop deep brain stimulation for depressionK00MH138156 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Anusha Allawala · 2024 to 2026
$321k
NIMH NIH HHS K00 MH138156NIMH NIH HHS K23 MH125018NIMH NIH HHS R21 MH130914NINDS NIH HHS K23 NS125123
6 · The paper itself

Abstract

Deep brain stimulation has been used to treat severe, refractory obsessive-compulsive disorder (OCD) with variable outcomes across multiple anatomical targets. To overcome these limitations, we developed an invasive brain mapping paradigm in which electrodes were implanted across the OCD cortico-striato-thalamo-cortical circuit in a single individual. We then performed extensive stimulation mapping during a multi-day inpatient stay to identify personalized therapeutic targets and characterize their downstream circuit effects. We found two targets within the right ventral capsule (VC) that acutely reduced OCD symptoms. Prolonged VC stimulation suppressed high frequency activity within the structurally and functionally connected orbitofrontal cortex, which encoded the severity of OCD symptoms. These VC sites were implanted for DBS and combined stimulation of these targets led to a rapid therapeutic response. This case provides the first proof-of-concept that invasive brain mapping can be used to guide a novel personalized, multi-site neuromodulation approach to treat refractory OCD.

Indexed as

Deep Brain StimulationIntracranial ElectrophysiologyObsessive-Compulsive Disorder

Identifiers

PMID40166548
PMCPMC11957075

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.