Nearly one billion people worldwide suffer from obsessive–compulsive behaviors^1,2, yet our mechanistic understanding of these behaviors is incomplete, and effective therapeutics are unavailable. An emerging perspective characterizes obsessive–compulsive behaviors as maladaptive habit learning^3,4, which may be associated with abnormal beta–gamma neurophysiology of the orbitofrontal–striatal circuitry during reward processing^5,6. We target the orbitofrontal cortex with alternating current, personalized to the intrinsic beta–gamma frequency of the reward network, and show rapid, reversible, frequency-specific modulation of reward- but not punishment-guided choice behavior and learning, driven by increased exploration in the setting of an actor-critic architecture. Next, we demonstrate that chronic application of the procedure over 5 days robustly attenuates obsessive–compulsive behavior in a non-clinical population for 3 months, with the largest benefits for individuals with more severe symptoms. Finally, we show that convergent mechanisms underlie modulation of reward learning and reduction of obsessive–compulsive symptoms. The results contribute to neurophysiological theories of reward, learning and obsessive–compulsive behavior, suggest a unifying functional role of rhythms in the beta–gamma range, and set the groundwork for the development of personalized circuit-based therapeutics for related disorders.

全世界有近 10 亿人患有强迫行为^1,2，但我们对这些行为的机制理解不完整，也没有有效的治疗方法。一种新兴观点将强迫行为描述为适应不良的习惯学习^3,4，这可能与奖赏处理过程中眶额-纹状体回路的异常 β-γ 神经生理学有关^5,6. 我们用交流电瞄准眶额皮质，根据奖励网络的固有 beta-gamma 频率进行个性化设置，并显示奖励的快速、可逆、频率特异性调制，而不是惩罚引导的选择行为和学习，这是由增加的探索驱动的演员-评论家架构的设置。接下来，我们证明长期应用该程序超过 5 天可在 3 个月内有力地减轻非临床人群的强迫行为，对症状更严重的个体的益处最大。最后，我们表明收敛机制是奖励学习调节和强迫症状减少的基础。该结果有助于奖励、学习和强迫行为的神经生理学理论，