MRI: Psychologists’ Newest Tool Against Refractory OCDs

Often described as “a disease of doubt,” obsessive-compulsive disorder (OCD) is a potentially disabling psychological illness that traps people in endless cycles of repetitive thoughts and behaviors. It was formerly considered an anxiety disorder, but is now regarded as a unique condition needing of its own category.

Most people with OCD can be treated through therapy and medications, but according to experts, there are some patients who do not respond adequately to these standard therapies. These patients are said to have refractory OCD (treatment resistant). Fortunately, an alternative treatment aside from therapy and medication has been found effective for these patients. The method is a type of brain surgery, referred to as a dorsal anterior cingulotomy. Therefore, the issue now is to identify who among those patients can undergo the brain surgery. The surgery method disables a certain part of the brain that is believed to influence the development of OCD.

U.S. News reports about a new study led by Garrett Banks of Columbia University in New York City, which suggests that there is a way to spot candidates for the brain surgery by using MRI scans focusing on certain regions of the brain believed to be key to the development of OCD.

In the study, the research team conducted MRI scans of 15 refractory OCD patients, who had undergone the cingulotomy surgery. The researchers found that only around half of the patients had responded positively to the procedure. The MRI scans suggest that patients who responded to surgery had different brain structures than those who didn’t.

The researchers stated in the journal release, “These variations may allow us to predict which patients are most likely to respond to cingulotomy, thereby refining our ability to individualize this treatment for refractory psychiatric disorders.”

Dr. Odile van den Heuvel of the VU University Medical Center in Amsterdam, an expert in OCD, said, “If reliable predictive markers are identified… treatments might be offered only to patients with a predicted good outcome, thereby preventing unnecessary costs and [side effects or complications] in the remaining patients.”

MRI is a test that uses radio waves to make pictures of organs and structures inside a person’s body. In many cases, MRI gives different information about structures in the body than cannot be seen with an X-ray, ultrasound, or computed tomography (CT) scan.

[Image from liz west/Flickr]