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New research shows the brains of OCD patients can get stuck in compulsive 'loops,' and the finding could lead to better treatment



  • New research has pinpointed areas of the brain involved in obsessive-compulsive disorder, or OCD.

  • Researchers analyzed brain scans from nearly 500 people with and without OCD.

  • They found that, compared to those without OCD, people with the condition had more activity in the brain areas involved in recognizing errors, but less activity in the brain areas that help stop errors.

  • The finding could lay the groundwork for better OCD treatment, the authors said.


New research analyzing the brains of almost 500 people may provide clues to help better treat patients obsessive-compulsive disorder (OCD), the mental health condition characterized by uncontrollable, recurring thoughts and behaviors.

Researchers pooled the results of 10 previous studies that compared people with and without OCD. In those studies, participants underwent functional MRI scans that looked at their brain activity during two functions: processing errors and inhibitory control, a process that allows control of behaviors and thoughts.

Their results, published Thursday in the journal Biological Psychiatry, showed that people with OCD had more activity in the brain involved in recognizing errors, compared to people without the condition, but less activity in the brain areas involved in stopping actions, according to a statement from the University of Michigan about the research.

"These results show that, in OCD, the brain responds too much to errors, and too little to stop signals," said University of Michigan postdoctoral research fellow, Luke Norman, PhD, lead author of the study, said in the statement.


Read more:
The most common myths about OCD – and why they're wrong

The research focused on the cingulo-opercular network, a collection of brain areas that acts as a "monitor" for errors and the need to stop actions, the statement added. The new analysis suggests that the brains of OCD patients may get stuck in compulsive "loops," the study authors wrote. Even if the brain flags an OCD thought or behaviour as wrong, it may not have the power to stop it.

Generally, those with OCD lack control over their obsessions and compulsions, even though they recognize those thoughts and behaviors are excessive, according to the National Institute of Health Mental. (For example, a common obsession is a fear of germs or contamination, and common compulsions include excessive handwashing or cleaning.)

The causes of OCD are still not known, but the new research suggests that specific error-processing abnormalities deep within the brain could play a role in the condition.

Experts had suspected these abnormalities were involved in OCD, Norman said in the statement, but this had not been "conclusively shown" because individual studies had small numbers of participants.

"By combining data from ten studies, and nearly 500 patients and healthy volunteers, we could see how brain circuits long hypothesized to be crucial to OCD are indeed involved in the disorder," he added.

Read more: 13 things you should not say to someone who is struggling with their mental health

The new research does not prove that the observed brain differences in OCD patients are a definitive cause of the condition. The data used by the researchers does not show whether those differences could be a cause or a result of OCD, the university statement explained.

"More work is needed to further our understanding of how these performance and brain function abnormalities relate to OCD symptoms," the authors wrote in the paper.

But knowing more about the brains of OCD patients could help point future researchers toward better treatment.

For now, OCD treatment typically includes psychotherapy, medications, or a combination of the two, but some patients continue to struggle with symptoms, according to the NIMH.

Read more: 5 myths about OCD that you need to stop believing

"In cognitive behavioral therapy sessions for OCD, we work to help patients identify, confront and resist their compulsions … but it only works in about half of patients," Professor of Psychiatry at the University of Michigan, Kate Fitzgerald, a co-author of the new paper, said in the statement. "Through findings like these, we hope we can make CBT more effective, or guide new treatments."

"This is not some deep dark problem of behaviour," she added. "OCD is a medical problem, and not anyone's fault. With brain imaging we can study it just like heart specialists study EKGs of their patients – and we can use that information to improve care and the lives of people with OCD. "

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