Chronic intracranial neural dynamics forecast treatment response and therapeutic engagement during deep brain stimulation for OCD
- 1Baylor College of Medicine
Abstract
Clinical improvement following psychiatric neuromodulation often requires weeks to months, creating prolonged uncertainty during treatment optimization. Neural biomarkers could reduce this uncertainty by forecasting treatment outcome, providing early evidence of therapeutic engagement, and objectively tracking clinical response. We analyzed nearly 120,000 patient-hours of chronic intracranial recordings from 24 patients undergoing ventral capsule/ventral striatum deep brain stimulation for treatment-resistant obsessive-compulsive disorder. Before stimulation initiation, circadian neural features distinguished eventual responders from non-responders. Within the first two weeks of therapy, reductions in neural predictability differentiated eventual responders from non-responders and correlated with the magnitude of subsequent symptom improvement, months before stable clinical response was achieved. During chronic treatment, neural predictability tracked clinical response state. Together, these findings establish a framework for neural biomarkers spanning the course of DBS therapy: forecasting treatment response before stimulation, detecting early therapeutic engagement after activation, and longitudinally monitoring clinical response.
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BibTeX
@misc{zhou2026chronic,
title = {{Chronic intracranial neural dynamics forecast treatment response and therapeutic engagement during deep brain stimulation for OCD}},
author = {J. Zhou and R. R. Hanish and T. Merk and R. Bao and S. Soubra and A. K. Allam and S. Reddy and V. R. Gates and V. Allam and M. Libowitz and D. L. Paulo and K. A. Katlowtiz and B. J. Mickey and B. M. Kious and J. A. Herron and T. M. Fraczek and B. Shofty and A. B. Patel and S. R. Heilbronner and E. A. Storch and W. K. Goodman and S. A. Sheth and N. R. Provenza},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.18.26363320},
url = {https://www.medrxiv.org/content/10.64898/2026.09.18.26363320v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Chronic intracranial neural dynamics forecast treatment response and therapeutic engagement during deep brain stimulation for OCD
AU - J. Zhou
AU - R. R. Hanish
AU - T. Merk
AU - R. Bao
AU - S. Soubra
AU - A. K. Allam
AU - S. Reddy
AU - V. R. Gates
AU - V. Allam
AU - M. Libowitz
AU - D. L. Paulo
AU - K. A. Katlowtiz
AU - B. J. Mickey
AU - B. M. Kious
AU - J. A. Herron
AU - T. M. Fraczek
AU - B. Shofty
AU - A. B. Patel
AU - S. R. Heilbronner
AU - E. A. Storch
AU - W. K. Goodman
AU - S. A. Sheth
AU - N. R. Provenza
PY - 2026
DA - 2026/09/18
PB - medRxiv
DO - 10.64898/2026.09.18.26363320
UR - https://www.medrxiv.org/content/10.64898/2026.09.18.26363320v1
AB - Clinical improvement following psychiatric neuromodulation often requires weeks to months, creating prolonged uncertainty during treatment optimization. Neural biomarkers could reduce this uncertainty by forecasting treatment outcome, providing early evidence of therapeutic engagement, and objectively tracking clinical response. We analyzed nearly 120,000 patient-hours of chronic intracranial recordings from 24 patients undergoing ventral capsule/ventral striatum deep brain stimulation for treatment-resistant obsessive-compulsive disorder. Before stimulation initiation, circadian neural features distinguished eventual responders from non-responders. Within the first two weeks of therapy, reductions in neural predictability differentiated eventual responders from non-responders and correlated with the magnitude of subsequent symptom improvement, months before stable clinical response was achieved. During chronic treatment, neural predictability tracked clinical response state. Together, these findings establish a framework for neural biomarkers spanning the course of DBS therapy: forecasting treatment response before stimulation, detecting early therapeutic engagement after activation, and longitudinally monitoring clinical response.
ER -