For a while, psychiatrists have suspected that OCD is a nasty side effect of evolution — a sort of prehistoric tendency toward situational awareness and hygiene gone out of control in some of us. Instead of working as a functional warning system, in those of us with OCD and related anxiety disorders, it goes out of control, short circuiting our flight or fight response.

But knowing (or at least having an idea) why some people develop OCD doesn’t really explain the mechanics behind it. Where exactly in the brain is this short circuit? How does it work (or not work)?

But psychiatrists are doing more research into where in the brain OCD originates and what processes might be behind it. Researchers have already found that deep brain stimulation and other brain surgeries can help those with treatment resistant OCD. They’ve also isolated biomarkers of OCD in canines.

Now, the New York State Psychiatric Institute is using video games and MRI testing to try to isolate the areas of the brain affected by OCD in humans.

Just as a car depends on a well-oiled transmission, the brain relies on smooth-running neural circuits. Experts think that in OCD, misfiring occurs across those circuits, especially in the frontal and mid-brain regions. Core neural functions are then disrupted, including goal-directed vs. habit-driven behavior, fear control, error detection and reward processing.

This breakdown triggers the symptoms of OCD, as well as a kind of feedback loop from which patients are unable to escape.

Marsh’s previous imaging research indicated when OCD patients played a virtual-reality game, their brains’ reward circuits were not activated the way they were in control subjects. Her hypothesis for the current work is that she will see the same pattern but that it will return to normal after treatment.

That makes a lot of sense to me. I know that when I’m stuck in a cycle of nasty intrusive thoughts, seeking reassurance or checking behaviors will relieve it at first. Then, after a few hours, the thoughts creep back in, so I repeat whatever behavior brought relief the first time. But the relief doesn’t last as long, and that cycle continues until seeking reassurance, checking, or other compulsions have no effect at all. Then I’m stuck until my brain wears itself out on whatever I’m obsessing about and moves on to something else, which can take months.
Whether that’s because OCD is a result of messed up reward centers or OCD trains the brain to be less dependent on rewards, I don’t know. But research like the studies going on in New York may be able to shed light on this process, or at least give therapists and psychiatrists a better idea of how to reroute our OCD brains so our reward cycles and flight or fight responses work more like everyone else’s.
I love science, don’t you?

Photo by Muffet