Obsessive Compulsive Disorder, or OCD, is a neurobiological condition where a person is driven to do things in a very specific way. Deviating from certain rigid routines is sometimes impossible for sufferers. Accompanying anxiety can be crippling as well and the compulsive behaviors that some patients have can seriously impact their daily lives. Controlling their environment becomes almost a constant struggle for some with OCD, and it’s much more than just a quirk of wanting things arranged a certain way. It affects men and women equally and as much as 2% of the population will deal with it at some point.
A new brain imaging study from researchers in Canada could be helpful however, because it shows for the first time that inflammation in the brain is a factor in patients with OCD. Levels of brain inflammation are more than 30% higher in patients with the disorder than those without. The study is published in the journal JAMA Psychiatry and given that it contains actual images of inflammation in those with OCD as compared to those without, it’s a significant step forward in looking for treatments and reducing the stigma that OCD is a personality flaw or a person just being difficult.
Jeffrey Meyer, senior author of the study and Head of the Neuroimaging Program in Mood & Anxiety at Toronto’s Centre for Addiction and Mental Health (CAMH) Campbell Family Mental Health Research Institute stated, “Our research showed a strong relationship between brain inflammation and OCD, particularly in the parts of the brain known to function differently in OCD. This finding represents one of the biggest breakthroughs in understanding the biology of OCD, and may lead to the development of new treatments.”
Inflammation, which is any kind of swelling in the body tissues, is a normal immune response to injury or disease. The problem becomes one of balance. The response is necessary if the body is to fight off infections, but any disruption in it, for instance an over active inflammatory response, and other issues could result. The imaging results in the CAMH study bear this out, showing that higher levels of brain inflammation are associated with OCD. Inflammation has been linked in other studies to depression, which is often found along with OCD.
Meyer’s team conducted positron emission tomography (PET) scans of 20 patients who had an OCD diagnosis and a control group of 20 patients who were healthy and neurotypical. The scans were enhanced with a proprietary technology developed at CAMH to visualize inflammation. A chemical dye, which can show activity in immune cells known as microglia, was used. These cells are known to be active players in the immune response of inflammation. Looking at six areas in the brain that are involved in OCD, the team calculated that inflammation was, on average, 32% higher in patients with OCD. The team was also able to see that in 9 out of 10 patients with OCD, the stress of trying to resist compulsive behaviors such as excessive hand washing or other compulsions was a factor as well. The patients with the highest reported levels of stress when struggling not to give in to the compulsive behaviors, also had the highest levels of inflammation.
Going forward, the team hopes to find out more about the specifics of the brain inflammation in hopes of finding biomarkers that could predict which patients will respond to treatment. One of the most frustrating factors of OCD and other mental illnesses like depression and anxiety is that medication does not work for as many as one-third of patients who seek treatment. Finding a way to understand the biology of the disorder is key to coming up with more effective treatments. Check out the video below to learn more about this new research.