Feb 16, 2026
3 min read
Researchers identify abnormal activity of the orbitofrontal cortex in OCD and show that brief brain stimulation can reduce compulsive behavior.
Frontal brain activity related to compulsive behavior in obsessive compulsive disorder
Disruption of certain brain signals can quickly eliminate severe OCD symptoms.
New research from the Perelman School of Medicine at the University of Pennsylvania shows that a specific pattern of brain activity in the frontal lobes of the brain is associated with compulsive behaviors such as excessive hand washing, chronic hair pulling and skin picking in people with obsessive compulsive disorder.But briefly interrupting that signal can quickly relieve symptoms in people with severe and treatment-resistant OCD, according to a study published in Cell.
"Compulsive thoughts and behaviors can vary greatly among people with OCD," said lead author Casey Halpern, MD, professor of neurosurgery and chief of the Department of Functional and Stereotactic Surgery."Identifying consistent brain activity even though people have different symptoms is a big step forward in developing new treatments to manage OCD symptoms."
What happens in the brain
Abnormally strong high-frequency brain circuit activity occurs in a region of the frontal cortex called the anteromedial orbitofrontal cortex (amOFC) during OCD symptoms.The amOFC is thought to be involved in decision-making about risk and reward, which is inhibited in people with OCD.
In three OCD patients who did not get relief with medication or psychotherapy, researchers implanted electrodes to stimulate a deep brain region on the right side of the brain - called the nucleus accumbens-ventral pallidum.After conducting the investigation, a team of neuroscientists and psychiatrists provided patients with verbal and visual cues designed to elicit OCD symptoms.For example, a participant who was often aroused by dirt was encouraged to touch various dirty objects, such as the bottom of a shoe.During the exercise, the team monitored his brain activity when he was stressed.They found signals significantly related to OCD symptoms in all three patients in the right amOFC.They also found that when the amOFC was stimulated, the activity decreased and the symptoms disappeared.
New strategies for managing OCD
OCD currently affects approximately two percent of the United States population and involves obsessive, intrusive thoughts that lead to repetitive, compulsive behaviors such as cleaning, checking objects, and psychotic activities that disrupt daily life.The disorder can cause significant emotional distress or interfere with social interaction.Although OCD often responds to antidepressants and/or psychotherapy, at least 30 percent of patients are not helped by either of these strategies.
Since 2009, deep brain stimulation (DBS) has been approved by the Food and Drug Administration under the Human Device Exemption to treat severe and treatment-resistant OCD in adults.This type of DBS provides continuous stimulation to several brain structures deep in the brain but connected to the frontal cortex.It works for about sixty percent of patients who receive it, and it works in the brain circuit between the basal ganglia and the frontal cortex, which is responsible for motivation, learning, and habit formation.It is thought to work by disrupting abnormal OCD-related activity patterns.
"In this study, we are focusing on specific brain structures and circuits involved in OCD symptoms so that we can optimize electrode placement for future patients," said the study's first author, Dr. Yonghun Noh, research associate in the Department of Neurosurgery. "Our overall goal is to use this signal to develop a responsive DBS system that monitors brain activity but only provides stimulation when OCD symptoms are triggered, which our previous research has shown to be an effective strategy for treating OCD."
According to co-author Katherine Scangos, MD, PhD, associate professor of Psychiatry, researchers hope that sensitive DBS will lead to more precise treatments tailored to each patient's symptoms.
Siv: Nho YH, Qiu L, Seilheimer RL, et al.Human orbitofrontal neural activated in obsessive-compulsive behavioural dynamics.Cell.2026;189(3):739-747.e8.doi: 10.1012020/j.3.
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