Obsessive-Compulsive Disorder (OCD) Treatment:

Currently, the most common treatment method for this disorder is medication with antidepressants from the SRI group, used in conjunction with cognitive behavioral therapy. Despite the proven effectiveness of SRIs and cognitive behavioral therapy, a significant portion of patients benefit only to a limited extent from these standard approaches.

Although controlled studies have shown that SRIs have selective efficacy in OCD, 40 to 60 percent of patients do not achieve satisfactory results.

It is a fact that a large proportion of patients who do not receive an adequate response from standard treatment methods are at risk of clinically significant morbidity.

It is a fact that new treatment methods are needed.

QEEG Findings in Obsessive-Compulsive Disorder Diagnosis:
Simpson et al. recorded the QEEG of OCD patients under symptom provocation (both live and in video). The results showed that significant EEG changes were induced by live contaminants, not hypothetical ones, and that the increase in OCD symptoms was caused by an increase in posterior relative alpha activity (compared to the anterior area).

Prichep et al. found that OCD patients with the same symptomatology were divided into two subgroups by qEEG. One group showed diffuse intense alpha and intense beta in the frontal, central, and mid-temporal regions. The other group appeared to have intense theta activity, particularly in the frontal and posterior temporal regions. Prichep et al. and Hansen et al. were able to identify pathophysiological subgroups within OCD patients based on their responses to serotonin-induced drugs (responders versus non-responders).

While 82% of these patients with high alpha relative power (along with excessive beta in the frontal and central regions) responded positively to serotonergic antidepressants, the second subgroup with increased tetrarelative power (with some alpha minima) showed an 80% failure rate in improving with SRIs.

Neurofeedback Treatment for Obsessive-Compulsive Disorder:
Our case series study on the effectiveness of qEEG-based neurofeedback treatment for Obsessive-Compulsive Disorder published in the journal Clinical EEG and Neuroscience [1]

In the study published by D.C. Hammond (2003), we see that qEEG-based NF treatment also improves MPI scores and is permanent in 13-15 month follow-ups. Hammond (2004) showed a significant reduction in OCD symptoms in a university student after NF treatment, and this was permanent in 10 month follow-ups. We applied QEEG-based neurofeedback therapy to 36 patients with drug-resistant OCD, ranging from 9 to 84 sessions. Of the 36 patients who received neurofeedback training, 33 showed clinical improvement according to the Yale and Brown Obsessive-Compulsive Disorder Scales. Seventeen patients underwent the MMPI (Minnesota Multiphasic Personality Inventory) before and after treatment.

MMPI results showed significant reductions not only in obsessive-compulsive disorder scores but also in all other MMPI scores. As a result, 33 of the 36 patients improved, and all 33 patients were followed for approximately 26 months after the completion of the study. A total of 28 patients recovered without requiring repeat treatment.

Other Obsessive-Compulsive Disorder Neurofeedback Studies:

In a randomized study dividing patients with OCD into three groups (medication, neurofeedback, waiting list), significant improvement was observed in those receiving neurofeedback. (Barzegary L. et al, 2011)

At least 3 placebo-controlled studies have shown that neurofeedback is superior to placebo in Obsessive-Compulsive Disorder (OCD).

In Kopriva’s placebo-controlled study on OCD[2], neurofeedback treatment was shown to be superior to placebo (80% effective). There are 2 placebo-controlled studies[3]-[4] from Yale School of Medicine. In one of these published studies, neurofeedback was found to be superior to placebo.

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[1] Sürmeli T, Ertem A. Obsessive compulsive disorder and the efficacy of qEEG-guided neurofeedback treatment: a case series.

Clin EEG Neurosci. 2011 Jul;42(3):195-201.

[2] Kopřivová J, Congedo M, Raszka M, Praško J, Brunovský M, Horáček J. Prediction of treatment response and the effect of independent component neurofeedback in obsessive-compulsive disorder: a randomized, sham-controlled, double-blind study. Neuropsychobiology. 2013;67(4):210-23. doi: 10.1159/000347087. Epub 2013 Apr 27.

[3] Scheinost D, Stoica T, Saksa J, Papademetris X, Constable RT, Pittenger C, Hampson M.(2013). Orbitofrontal cortex neurofeedback produces lasting changes in contamination anxiety and resting-state connectivity.Transl Psychiatry. Apr 30;3:e250. doi: 10.1038/tp.2013.24.

[4] Hampson M, Stoica T, Saksa J, Scheinost D, Qiu M, Bhawnani J, Pittenger C, Papademetris X, Constable T. Real-time fMRI biofeedback targeting the orbitofrontal cortex for anxiety.J Vis Exp. 2012 Jan 20;(59). pii: 3535. doi: 10.3791/3535.