Distinct neural representations encode psychiatric states across timescales
- 1Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
Abstract
Psychiatric states manifest over multiple timescales, from transient fluctuations in disorder-related distress to long-term variations in disease severity, yet whether these expressions share common neural representations remains unknown. We addressed this question in obsessive-compulsive disorder (OCD) by comparing neural activity associated with momentary distress evoked by triggers versus that associated with clinically assessed chronic symptom severity. We analyzed intracranial recordings from the ventral capsule and orbitofrontal cortex spanning more than 4595 patient-days in 8 individuals undergoing deep brain stimulation therapy (NCT03457675, NCT04281134, NCT04806516), together with quantitative facial- and speech-derived behavioral measures. Neural signatures of OCD severity were dissociable from and stronger than signatures of momentary distress, indicating distinct underlying brain states. Integrating behavioral data into a predictive computational model improved neural decoding performance of both momentary distress and OCD severity. These findings show that acute manifestations of psychiatric illness are not simply short-timescale readouts of the same neural states that encode longer-term clinical burden. Instead, transient distress and longitudinal disease severity are represented by dissociable neural processes. This distinction has important implications for how psychiatric biomarkers and adaptive neuromodulation strategies should be designed.
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BibTeX
@misc{merk2026distinct,
title = {{Distinct neural representations encode psychiatric states across timescales}},
author = {T. Merk and G. Bezold and R. Hingorani and A. D. Wiese and B. Robinson and H. Yi and J. Altman and S. V. Rajesh and V. E. Gobo and M. Ochoa and T. Hamre and V. Belavadi and C. P. S. Romain and M. Avendano-Ortega and S. Soubra and G. Reyes and T. M. Fraczek and E. A. Storch and W. K. Goodman and S. A. Sheth and N. R. Provenza},
howpublished = {medRxiv},
year = {2026},
month = jul,
doi = {10.64898/2026.07.30.26359255},
url = {https://www.medrxiv.org/content/10.64898/2026.07.30.26359255v2},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Distinct neural representations encode psychiatric states across timescales
AU - T. Merk
AU - G. Bezold
AU - R. Hingorani
AU - A. D. Wiese
AU - B. Robinson
AU - H. Yi
AU - J. Altman
AU - S. V. Rajesh
AU - V. E. Gobo
AU - M. Ochoa
AU - T. Hamre
AU - V. Belavadi
AU - C. P. S. Romain
AU - M. Avendano-Ortega
AU - S. Soubra
AU - G. Reyes
AU - T. M. Fraczek
AU - E. A. Storch
AU - W. K. Goodman
AU - S. A. Sheth
AU - N. R. Provenza
PY - 2026
DA - 2026/07/30
PB - medRxiv
DO - 10.64898/2026.07.30.26359255
UR - https://www.medrxiv.org/content/10.64898/2026.07.30.26359255v2
AB - Psychiatric states manifest over multiple timescales, from transient fluctuations in disorder-related distress to long-term variations in disease severity, yet whether these expressions share common neural representations remains unknown. We addressed this question in obsessive-compulsive disorder (OCD) by comparing neural activity associated with momentary distress evoked by triggers versus that associated with clinically assessed chronic symptom severity. We analyzed intracranial recordings from the ventral capsule and orbitofrontal cortex spanning more than 4595 patient-days in 8 individuals undergoing deep brain stimulation therapy (NCT03457675, NCT04281134, NCT04806516), together with quantitative facial- and speech-derived behavioral measures. Neural signatures of OCD severity were dissociable from and stronger than signatures of momentary distress, indicating distinct underlying brain states. Integrating behavioral data into a predictive computational model improved neural decoding performance of both momentary distress and OCD severity. These findings show that acute manifestations of psychiatric illness are not simply short-timescale readouts of the same neural states that encode longer-term clinical burden. Instead, transient distress and longitudinal disease severity are represented by dissociable neural processes. This distinction has important implications for how psychiatric biomarkers and adaptive neuromodulation strategies should be designed.
ER -