Multiple surgical targets for treating obsessive-compulsive disorder with deep brain stimulation (DBS) have been proposed. However, different targets may modulate the same neural network responsible for clinical improvement. We analyzed data from four cohorts of patients (N = 50) that underwent DBS to the anterior limb of the internal capsule (ALIC), the nucleus accumbens or the subthalamic nucleus (STN). The same fiber bundle was associated with optimal clinical response in cohorts targeting either structure. This bundle connected frontal regions to the STN. When informing the tract target based on the first cohort, clinical improvements in the second could be significantly predicted, and vice versa. To further confirm results, clinical improvements in eight patients from a third center and six patients from a fourth center were significantly predicted based on their stimulation overlap with this tract. Our results show that connectivity-derived models may inform clinical improvements across DBS targets, surgeons and centers. The identified tract target is openly available in atlas form.

已经提出了用深部脑刺激 (DBS) 治疗强迫症的多个手术靶点。然而，不同的目标可能会调节负责临床改善的相同神经网络。我们分析了来自四组患者的数据（N = 50) 接受 DBS 到内囊前肢 (ALIC)、伏隔核或丘脑底核 (STN)。在针对任一结构的队列中，相同的纤维束与最佳临床反应相关。该束将额叶区域连接到 STN。当根据第一个队列告知管道目标时，可以显着预测第二个队列的临床改善，反之亦然。为了进一步证实结果，基于与该束的刺激重叠，显着预测了来自第三中心的 8 名患者和来自第四中心的 6 名患者的临床改善。我们的结果表明，连接衍生模型可以为 DBS 目标、外科医生和中心的临床改进提供信息。已识别的区域目标以图集形式公开提供。