Can Brain Scans Reveal Different Types of OCD?

What you need to know

• Researchers used brain scans to identify three distinct patterns of brain activity in people with OCD
• The different brain patterns may help explain why people with OCD can have varying symptoms and responses to treatment
• This approach could lead to more personalized treatment for OCD based on a person’s specific brain activity pattern

Different brains, different OCD?

Obsessive-compulsive disorder (OCD) affects about 2-3% of people worldwide. While we know a lot about the symptoms of OCD, less is known about how the brains of people with OCD function differently. A new study used advanced brain imaging and machine learning techniques to look for patterns in brain activity that might reveal different “types” of OCD.

Looking at brain networks

The researchers focused on three important brain networks that are thought to work differently in OCD:

1. The frontoparietal network, which helps with cognitive control and flexible thinking
2. The cingulo-opercular network, which is involved in detecting errors and monitoring performance
3. The default mode network, which is active when our minds are wandering

Previous research has found that these networks don’t always function normally in people with OCD. For example, the frontoparietal network may be less active, making it harder to flexibly adapt behavior. The cingulo-opercular network may be overactive, leading to an excessive focus on errors. And the default mode network may fail to deactivate properly during tasks, potentially contributing to intrusive thoughts.

The brain scan experiment

The study included 128 people with OCD and 64 people without OCD. Participants had their brains scanned while doing two types of tasks:

1. An interference task, where they had to respond to a target letter while ignoring distracting letters
2. An error processing task, where they had to notice when they made mistakes

The researchers then used machine learning to look for patterns in the brain scan data.

Three types of OCD brains

The analysis revealed three distinct patterns of brain activity in people with OCD:

1. A “normative” pattern (about 66% of OCD participants): This group showed brain activity similar to people without OCD.

2. An “interference hyperactivity” pattern (about 15% of OCD participants): This group showed increased activity in the frontoparietal and cingulo-opercular networks during the interference task. Their default mode network also failed to deactivate properly.

3. An “error hyperactivity” pattern (about 19% of OCD participants): This group showed increased activity in the cingulo-opercular network during error processing. They also had less deactivation in part of the default mode network.

What do these patterns mean?

The different brain activity patterns might help explain why people with OCD can have such varying symptoms and responses to treatment. For example:

• The “interference hyperactivity” group might have more trouble ignoring distractions and could be more prone to getting stuck on compulsive behaviors.

• The “error hyperactivity” group might be overly sensitive to making mistakes, leading to excessive checking behaviors.

• The “normative” group might have milder symptoms or respond better to standard treatments.

Interestingly, the researchers found that the “interference hyperactivity” group took longer to respond during the task, suggesting they may have more difficulty with cognitive control.

Implications for treatment

While more research is needed, these findings could eventually lead to more personalized treatment approaches for OCD. For example:

• People with the “interference hyperactivity” pattern might benefit more from treatments that target cognitive flexibility and distraction management.

• Those with the “error hyperactivity” pattern might do better with treatments focused on reducing perfectionism and fear of making mistakes.

• The “normative” group might respond well to standard cognitive-behavioral therapy for OCD.

In the future, brain scans could potentially be used to help determine the best treatment approach for each individual with OCD.

Limitations and future directions

It’s important to note that this study only looked at brain activity during specific tasks. Future research could examine whether these patterns hold true in other situations or during everyday life. Additionally, the study included both adults and adolescents with OCD, and brain development differences might influence the results.

While this research is promising, more work is needed before brain scans could be used to guide OCD treatment in clinical practice. However, this study provides an important step towards understanding the diverse brain patterns that may underlie OCD symptoms.

Conclusions

• Brain scans revealed three distinct patterns of brain activity in people with OCD
• These patterns might help explain differences in OCD symptoms and treatment response
• In the future, this approach could lead to more personalized and effective OCD treatments