Can OCD be treated with brain surgery

Researchers discover the cause of obsessive-compulsive disorder in the brain

Obsessive-compulsive disorder is usually treated with psychotherapy. This method is not always successful, so that sometimes drugs such as antidepressants have to be used. These drugs can help relieve symptoms; however, their effects are not tailored to the trigger of the respective form of the disease and sometimes have unpleasant side effects.

Scientists have now taken a step further in researching the cause in the brain, which is of great importance for more effective treatment, and may have paved the way for new therapeutic options.

Obsessive-compulsive disease has many faces

Obsessive-compulsive disorder is a neuropsychiatric illness that is classified as a psychological disorder. Affected people have an inner compulsion to perform certain actions or to think certain things. In doing so, they know that their actions and thoughts are pointless, but they cannot resist them - the fear that otherwise something bad could happen prevails.

Obsessive-compulsive disorder is one of various forms. The most common are compulsory checks, in which you check several times whether the door is locked, compulsory counting, which is expressed by the fact that a person counts various everyday things again and again, and compulsory washing, in which there is excessive hygienic behavior . Less common are, for example, the constant urge to give other people a gift (doromania) or the compulsion to pull the hair out of the head (trichotillomania).

Depending on whether they are thoughts or actions, a distinction is made between obsessive thoughts and compulsive actions. However, not every one of these thoughts or actions has to be necessarily pathological, it can also be a rather harmless quirk or a tic. According to experts, compulsion is considered to be pathological if the person concerned suffers from it emotionally and his compulsions restrict him in his everyday life. (Paradisi, 2009)

The disease is by no means only widespread among adolescents and adults: around 20 percent of all those affected develop the disorder as early as ten years of age; boys are affected somewhat more often than girls. However, the disease is often only diagnosed many years later. (Deutsches Ärzteblatt, 2011)

Lack of protein as the cause

Research is looking for therapeutic options that are more targeted and have fewer side effects. In this context, it is important to decipher the triggering factors that are sometimes suspected to be in the disruption of certain brain functions. Scientists at the University of Würzburg have made great progress in this regard: Even the lack of a certain protein can trigger a certain compulsive action.

It is about a protein that occurs in all body cells, but is represented in particularly large quantities in the brain. There it is responsible for inhibiting a certain signal path in its activity. This signaling pathway is called "receptor tyrosine kinase TrkB". If the protein is missing, the activity increases and an excessive reaction occurs, which can be shown in humans by performing compulsive acts.

In their experiment, which was carried out with mice, the scientists discovered that excessive cleaning behavior can occur as soon as the SPRED2 protein is no longer available. This normally occurs in a particularly concentrated form in the amygdala region and in the basal ganglia in the brain, where it takes on the task of inhibiting the Ras / ERK-MAP kinase cascade, the said signaling pathway. In animals lacking SPRED2, the cascade became more active and led to forceful behavior, in this case the compulsion to clean.

Common treatment and new opportunities

Obsessive-compulsive disorder is usually treated with cognitive behavioral therapy. Sometimes this is combined with a drug treatment. (DGZ, 2007)

But there are also cases in which neither psychotherapy nor medication have an effect; deep brain stimulation, in which electrodes (so-called brain pacemakers) are implanted in the patient's brain, then proves to be useful. (World, 2015)

In an attempt by the researchers to inhibit the signal cascade, treatment with an antidepressant, which is also administered to people with this disease, was successful. The next step is to find out whether other remedies might not be just as effective without causing side effects. Because drugs that could inhibit the triggering cascade already exist, in the form of cancer drugs. (University of Würzburg, 2017)

(, 15.05.2017 – )

15th May 2017