A brain implant the size of a Band-Aid has cured a woman’s obsessive-compulsive disorder (OCD) and epilepsy.
Amber Pearson, 34, from Albany, New York, had suffered from severe obsessive-compulsive disorder since high school and spent eight hours a day making sure her doors and windows were locked and her stove was off, plus a hand washing procedure that left them raw and bleeding. She also developed epilepsy in her 20s.
The implant sits in the skull and has wires that connect to the brain. When it detects brain patterns that signal the onset of a seizure or obsessive thoughts, the device sends electrical pulses to the regions, shutting down unwanted neural activity.
The treatment is thought to reset abnormal brain circuits, similar to how a pacemaker regulates a heart.
Neurosurgeon Dr. Ahmed Raslan of Oregon Health & Science University and patient Amber Pearson
DBS is not a new treatment and was first approved by the FDA in 1997 to control tremors in people with Parkinson’s disease.
In 2019, Ms. Pearson underwent experimental brain surgery at Oregon Health & Science University.
OCD affects 2.5 million American adults. The term is overused in everyday life, but the clinical definition is when a person experiences uncontrollable and recurring thoughts, known as obsessions, and engages in repetitive behaviors, known as compulsions, or both.
It usually starts in late childhood or early adolescence. Experts are unsure of the specific cause of OCD, but both genetic and environmental factors are believed to play a role.
The OCD made Ms Pearson struggle to live a normal life as she was so afraid of food contamination that she could not eat next to other people, even with her family.
In her twenties, after developing epilepsy, she suffered a particularly severe seizure that caused her to lose consciousness.
People with epilepsy are more likely to be affected by OCD, but experts aren’t entirely sure why this is so. It is thought that seizures can cause damage to the brain that can lead to changes in behavior patterns, potentially causing OCD.
Doctors then decided to treat her with deep brain stimulation (DBS) after trying therapy and medication, which had no effect.
Deep brain stimulation is a procedure that involves implanting a device that delivers electrical pulses to the brain.
The U.S. Food and Drug Administration (FDA) allows DBS to be used as a last resort for OCD.
Reports indicate that up to 2021, more than 300 OCD patients had undergone surgery for DBS implantation.
Mrs. Pearson told it Wired: ‘Every decision I made was based on my OCD. It was always in the back of my mind.”
The research, published in the journal Neuron this month documented how a medical team used a single 3.5cm-long electrode modified to detect her unique brain signals to control both her epilepsy and obsessive-compulsive disorder.
The device they used on Ms. Pearson is responsive, meaning it only delivers electric shocks when it detects irregular patterns in her brain that signal the onset of a seizure or obsessive thoughts.
Responsive DBS has already been used to treat epilepsy, but Ms Pearson’s case marks the first time it has been used for OCD, and to treat two conditions at the same time.
Ms Pearon’s seizures were caused in a part of the brain called the insula.
Her neurosurgeon, Dr. Ahmed Raslan, wanted to target a small area in the insula, as well as the ventral striatum, which is located just above and behind the eyes.
The ventral striatum includes the nucleus accumbens – a part of the brain related to motivation and action, and compulsive drives.
Dr. Raslan said, “It was an area where the same electrode could be targeted.”
The device is manufactured by a company called NeuroPace, based in California.
While other electrodes used for deep brain stimulation only emit electrical pulses, NeuroPace collects brain signals and emits electricity only when programmed to respond to a trigger.
Ms Pearson spent up to eight hours a day performing compulsions such as washing hands and checking her stove was off. Now she said it’s more than 30 minutes.
Mrs Pearson said: ‘Now I rarely worry about what happens in my house while I’m away. I notice fewer and fewer obsessions and compulsions.
“I’ve been able to build healthier relationships with the people in my life.”