Obsessive-compulsive disorder (OCD) is a chronic mental health condition affecting roughly 2.2 million adults from all walks of life. People with OCD experience ongoing, troubling thoughts (known as obsessions) and may find short-term relief by performing specific, ritualistic actions (called compulsions). These symptoms often interfere with daily living. About one-third of individuals with OCD don't respond well to conventional treatments. However, there is promising initial evidence that neural activity can be captured from ventral striatal regions associated with OCD to guide such a closed-loop approach. Now, for the first time, a patient has been shown to benefit from a single stimulator implanted in the brain to effectively control two life-altering conditions: seizures caused by epilepsy and compulsive behavior caused by obsessive-compulsive disorder, or OCD. Following the brain implant, the seizures are under better control, but the relief from the psychiatric condition is profound.

The patient had initially undergone a standard surgical procedure at Oregon Health & Science University (OHSU, Portland, OR, USA) in 2018. This operation involved removing a small part of the brain where the seizures originated. While the surgery reduced some seizures, it did not eliminate them entirely. As a result, the patient opted for an implanted responsive neurostimulation system (RNS). This innovative implant continually observes brain activity and sends out small electrical pulses designed to prevent seizures before they start. Interestingly, some users of this implant have reported improvement in mental health conditions, including OCD.

To treat both conditions in the patient, the physicians made sure to position the implant's 32-millimeter electrode in such a way that it covered the nucleus accumbens, a brain region linked to motivation and action, including compulsive urges. This dual targeting proved effective. Within months of receiving the brain implant, the patient reported significant relief from OCD symptoms. Four years down the line, the improvement has been life-altering. The RNS implant's programming now functions seamlessly to manage the compulsive behaviors that had once dominated the patient's daily life. 

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