ArticleJournal of neurosurgery2026
Deep brain stimulation for obsessive-compulsive disorder: evolution of tractography-based targeting.
Article in Journal of neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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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.
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Who cites it
2 citing papers in PubMed.
- Electrophysiological Biomarkers Reflect Target Engagement and Response Using Deep Brain Stimulation for Obsessive-Compulsive Disorder.Biological psychiatry global open science · 2026Article
- Proceedings of the 13th annual deep brain stimulation think tank: the evolving landscape.Frontiers in human neuroscience · 2026Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
objectiveDeep brain stimulation (DBS) in the anterior limb of the internal capsule (ALIC) for obsessive-compulsive disorder (OCD) can result in large improvements in symptoms and quality of life. However, without a consistent stimulation target within the anatomically variable ALIC region, the therapy has required long and unpredictable trial-and-error periods of parameter optimization to achieve these clinically meaningful benefits. To facilitate scalability and clinical implementation of ALIC DBS for OCD, this study aimed to demonstrate the evolution of prospective DBS targeting using patient-specific tractography.
methodsInitially, the authors targeted a white matter map of ALIC bundles and cortical regions previously implied in DBS for OCD. They then generated a map of the ALIC connection shared by 6 participants with OCD who responded to DBS. This common responder map implicated white matter connections to the ventromedial prefrontal/orbitofrontal cortex (vmPFC/OFC), ventrolateral prefrontal cortex (vlPFC), and midbrain. Next, we prospectively targeted a new series of 7 patients guided by this common map. Finally, we generated a tractography-based predictive model based on individual stimulation-response outcomes to estimate the relative importance of each targeted ALIC pathway.
resultsTargeting a sweet spot in the common responder ALIC map that optimally connected the patient-specific vmPFC/OFC, vlPFC, and midbrain led to a consistent and predictable reduction of OCD symptoms, with 8 of 10 patients attaining a clinically meaningful Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score reduction in symptom severity of at least 35%. Individualized tractography-based targeting improved the primary OCD symptoms independent of hypomania or other changes in mood or anxiety and required minimal parameter changes away from the empirical tractography-based target spot. The tractography-based stimulation model generated a connectivity profile of left and right ALIC pathways that selectively predicted Y-BOCS score reduction and could be used to optimize future targeting further.
conclusionsThe authors' results show how patient-specific tractography can facilitate clinically effective precision targeting in ALIC DBS for OCD.
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Registered trials
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 Socratic graph.