A very interesting study was recently published in JAMA Psychiatry stating that brain inflammation in those with obsessive-compulsive disorder is significantly elevated (by more than 30 percent) compared to those without the disorder.
Dr. Jeffrey Meyer, senior author of the study and Head of the Neuroimaging Program in Mood & Anxiety at the Centre for Addiction and Mental Health (CAMH) Campbell Family Mental Health Research Institute, says:1
“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.”
Another very interesting finding from the study is that researchers found a connection between resisting compulsions and brain inflammation. Those with OCD who experienced the greatest stress or anxiety when they tried to avoid acting out their compulsions also had the highest levels of inflammation in one particular brain area. This factor could prove helpful in determining who might benefit the most when and if new treatments are developed targeting inflammation.
I do think it’s worth mentioning that while this study seems to hold great promise, so much more work needs to be done. There were only twenty participants with OCD in the study, and twenty in the comparison group. Perhaps the study will be replicated with a larger number of participants.
And as often happens with research, new findings generate more questions. Where does this inflammation come from? Could it be a major factor in the development of OCD? How will this information lead to better treatments for those with OCD? Does everyone with OCD have some type of brain inflammation?
Another question that comes to my mind, is “Where (if anywhere) does PANDAS fit into this equation? PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus) is typically characterized by a sudden onset of OCD-like symptoms and is usually believed to be caused by streptococcal bacteria. Unfortunately, PANDAS is also characterized by a good deal of controversy within the medical community, and some doctors believe PANDAS does not really exist. However, a wealth of research and information from reputable sources does indeed indicate that PANDAS is very real. For example, the National Institute of Mental Health provides a good deal of information on the disorder, and you can read more about PANDAS on their website. It is interesting to note that while exposure and response prevention (the evidence-based Cognitive Behavioral Therapy used to treat OCD) might sometimes be helpful for those with PANDAS, the main treatment is antibiotics.
While I’m always excited and heartened to learn of new research and discoveries related to obsessive-compulsive disorder, there is still so much we don’t know. Certainly the study discussed here, as well as the existence of PANDAS, indicate that brain inflammation plays an important role in OCD. I am thankful for all the dedicated researchers who continue to work tirelessly to unlock the mysteries of this potentially devastating disorder. And I am hopeful that the more we understand, the closer we will get to not only better treatment, but also a cure for OCD.
- Attwells, S., Setiawan, E., Wilson, A.A., Rusjan, P.M., Mizrahi, R., Miler, L., Xu, C., Richter, M.A., Kahn, A., Kish, S.J., Houle, S., Ravindran, L., Meyer, J.H. Inflammation in the Neurocircuitry of Obsessive-Compulsive Disorder. JAMA Psychiatry. Published online June 21, 2017. doi:10.1001/jamapsychiatry.2017.1567