Obsessive-compulsive disorder is among the most disabling psychiatric disorders. Although deep brain stimulation is considered an effective treatment, its use in clinical practice is not fully established. This is, at least in part, due to ambiguity about the best suited target and insufficient knowledge about underlying mechanisms. Recent advances suggest that changes in broader brain networks are responsible for improvement of obsessions and compulsions, rather than local impact at the stimulation site. These findings were fueled by innovative methodological approaches using brain connectivity analyses in combination with neuromodulatory interventions. Such a connectomic approach for neuromodulation constitutes an integrative account that aims to characterize optimal target networks. In this critical review, we integrate findings from connectomic studies and deep brain stimulation interventions to characterize a neural network presumably effective in reducing obsessions and compulsions. To this end, we scrutinize methodologies and seemingly conflicting findings with the aim to merge observations to identify common and diverse pathways for treating obsessive-compulsive disorder. Ultimately, we propose a unified network that—when modulated by means of cortical or subcortical interventions—alleviates obsessive-compulsive symptoms.

强迫症是最致残的精神疾病之一。尽管深部脑刺激被认为是一种有效的治疗方法，但其在临床实践中的应用尚未完全确立。这至少部分是由于对最合适的目标的模糊性以及对潜在机制的了解不足。最近的进展表明，更广泛的大脑网络的变化是改善强迫观念和强迫行为的原因，而不是刺激部位的局部影响。这些发现得到了创新方法学方法的推动，该方法将大脑连接分析与神经调节干预相结合。这种用于神经调节的连接组学方法构成了一个综合帐户，旨在表征最佳目标网络。在这篇批判性评论中，我们整合了连接组学研究和深部脑刺激干预的结果，以描述可能有效减少强迫症和强迫症的神经网络。为此，我们仔细审查了方法和看似矛盾的发现，旨在合并观察结果，以确定治疗强迫症的常见和多样化途径。最终，我们提出了一个统一的网络——当通过皮层或皮层下干预进行调节时——可以减轻强迫症状。我们仔细检查方法和看似矛盾的发现，旨在合并观察结果，以确定治疗强迫症的常见和多样化途径。最终，我们提出了一个统一的网络——当通过皮层或皮层下干预进行调节时——可以减轻强迫症状。我们仔细检查方法和看似矛盾的发现，旨在合并观察结果，以确定治疗强迫症的常见和多样化途径。最终，我们提出了一个统一的网络——当通过皮层或皮层下干预进行调节时——可以减轻强迫症状。