Supported by a $750,000 K23 Career Development Award from the National Institutes of Health, Butler Hospital neuropsychologist Nicole McLaughlin, PhD, is conducting a first-of-its-kind study of patients with obsessive-compulsive disorder (OCD) undergoing gamma knife radiosurgery. For a small proportion of individuals with severe, intractable OCD, one available treatment option is gamma knife radiosurgery. This is a non-invasive procedure that targets an area deep in the brain, called the anterior limb of the internal capsule. Though this procedure has been used to treat OCD for decades, the mechanisms of action remain virtually unstudied.
Dr. McLaughlin's research, which is currently underway, plans to change that through focusing on measuring the connectivity between targeted brain regions before and after the procedure. The study will recruit 24 patients who have already been identified to undergo gamma knife radiosurgery for severe, intractable OCD from the longstanding Psychiatric Neurosurgery Program at Butler Hospital. These participants will be compared to a control group of 24 healthy control participants who do not suffer from OCD and will not receive the surgery.
The gamma knife will be used to generate lesions that are thought to disrupt connections between brain regions believed to be involved in the pathogenesis of OCD. The study will have several aims including using human neural models, informed by known monkey neuroanatomy, to delineate regions and pathways affected by ventral capsulotomy gamma knife surgery for severe OCD. This will generate regions of interest for the second aim of the study, which is to analyze changes in structural (diffusion tensor imaging) connectivity post-surgery. The final aim will examine resting state and task-based (response inhibition) effective connectivity changes post-surgery. This study represents an unparalleled opportunity to test hypotheses of the relationship between connectivity and therapeutic improvement after gamma knife radiosurgery.
A key component of the K23 Career Development Award is mentorship opportunities. Through this grant, Dr. McLaughlin will collaborate with and receive mentorship from leading internationally-known researchers in this field. She will receive training in neuroimaging and neuroanatomy from experts at Butler Hospital, Brown University, Massachusetts General Hospital, and the University of Rochester.
Dr. McLaughlin is hopeful that understanding the neural mechanisms of therapeutic change will provide a blueprint for refining novel neurocircuitry-based therapies for OCD and related anxiety and affective disorders, as well as for determining predictors of treatment outcome to individualize treatment. In addition to her role as a researcher, Dr. McLaughlin works as a neuropsychologist in the Psychiatric Neurosurgery Program at Butler Hospital, one of the few sites in the world that facilitates the use of gamma knife radiosurgery to treat patients with OCD: butler.org/gammaforODC.