BRIEF RESEARCH REPORT article
Front. Hum. Neurosci.
Sec. Brain Imaging and Stimulation
Volume 19 - 2025 | doi: 10.3389/fnhum.2025.1587644
This article is part of the Research TopicWomen in Brain Imaging and Stimulation in the Era of Artificial IntelligenceView all articles
Personalized non-invasive neuromodulation for sensory-based urge suppression in individuals with OCD: a proof-of-concept investigation
Provisionally accepted
Goi Khia Eng1,2*
Arielle Tambini1,2
Molly S. Hermiller3
Nicolette Recchia1,2
Jeanmarie Harvey1,2
Dan V Iosifescu1,2
Russell H Tobe1,2,4
Emily R Stern1,2,5- 1Department of Psychiatry, New York University Grossman School of Medicine, New York, United States
- 2Nathan S. Kline Institute for Psychiatric Research, Orangeburg, North Carolina, United States
- 3Department of Psychology, Florida State University, Tallahassee, Florida, United States
- 4Center for the Developing Brain, Child Mind Institute, New York, United States
- 5Neuroscience Institute, New York University Grossman School of Medicine, New York, United States
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Obsessive-compulsive disorder (OCD) is chronic and impairing. While OCD often involves fear of harm or bad events, many patients experience "sensory phenomena", which are aversive sensory experiences that drive repetitive behaviors regardless of specific fears. Standard treatments do not effectively address sensory phenomena, and novel approaches are needed. Transcranial magnetic stimulation (TMS) is a safe and noninvasive neuromodulation technique increasingly used in psychiatric disorders, including OCD. This work presents a data-driven approach to identifying TMS brain targets for modulating sensory urges in OCD incorporating both behavioral and clinical criteria (Study 1) for a proof-of-concept investigation (Study 2). Study 1 included 69 individuals with OCD and 23 controls who completed an urges-for-action fMRI task involving instructed eyeblink suppression as an experimental model for sensory-based urges. Data-driven conjunction analysis revealed several brain regions, including the right postcentral gyrus, that were associated with more blink suppression failure (behavioral), more severe sensory phenomena (clinical), and were hyperactivated in OCD patients compared to controls. Study 2 administered single-session inhibitory TMS on 4 returning OCD patients using individualized targets within the postcentral gyrus identified from Study 1. Compared to sham, inhibitory TMS delivered to individualized postcentral gyrus targets resulted in fewer blink suppression failures, reduced activation in the target (postcentral gyrus) and key urge-related areas (insula, mid-cingulate), and greater reduction in self-reported urge to engage in OCD-related compulsions, with medium to large effect sizes. These findings demonstrate the potential of utilizing data-driven approaches incorporating behavioral and clinical criteria to target hard-to-treat sensory phenomena in OCD.
Keywords: Min.5-Max. 8): Transcranial magnetic stimulation, Obsessive-Compulsive Disorder, sensory phenomena, sensory urges, urges-for-action, fMRI, Individualized, postcentral gyrus
Received: 04 Mar 2025; Accepted: 04 Jun 2025.
Copyright: © 2025 Eng, Tambini, Hermiller, Recchia, Harvey, Iosifescu, Tobe and Stern. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Goi Khia Eng, Department of Psychiatry, New York University Grossman School of Medicine, New York, United States
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