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ALTHOUGH SCANS CAN TELL YOU THE landscape of the obsessive-compulsive brain, they can't tell you how it got to be that way. As with many other psychological disorders, research is revealing that ocd has a powerful genetic component. Having any blood relative with ocd puts your risk of the disorder at 12%, and while that seems low, it's still more than four times as high as that of the U.S. population as a whole...
Located on the ninth chromosome, that gene--discovered in two studies by researchers at several universities including the University of Michigan and the University of Toronto--appears to regulate a brain chemical known as glutamate. One of a number of substances that stimulate signaling among neurons, glutamate works fine unless you've got too much on hand. Then the signals just keep coming. In the case of the alarm centers in the brain, that means the warning bell just keeps on ringing. "Glutamate has to be taken up quickly because otherwise it becomes toxic to the brain cells," says Vladimir...
...tics and OCD are probably the result of an autoimmune response, in which the body begins attacking its own healthy tissue. Blood tests of kids with strep-related tics and OCD have turned up antibodies hostile to neural tissue, particularly in the brain's caudate nucleus and putamen, regions associated with reinforcement learning. "There certainly seems to be an epidemiological relationship there," says Dr. Cathy Budman, associate professor of psychiatry and neurology at New York University, "but what it means needs to be further investigated...
Coric, of Yale, is among the growing group of investigators experimenting with drugs targeting the glutamate problem. The best medication so far, riluzole, was originally developed for Lou Gehrig's disease and works simply by turning down the glutamate spigot, reducing the amount that's available in the brain. In Coric's admittedly small studies and clinical observations, half of about 50 subjects experienced at least a 35% remission, and almost all the rest improved at least a little...
Much more invasively, investigators are looking into deep-brain stimulation (DBS), in which electrodes are implanted in the brain and connected by wires embedded in the skin to a pacemaker-like device in the chest. Low doses of current can then be applied as needed to calm the turmoil in the regions of the brain that cause OCD. The procedure sounds extreme--and it is--but it's already been used in about 35,000 people worldwide to treat Parkinson's disease, and FDA approval to use DBS for OCD as well is pending. "Many of our OCD patients...