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Potential QEEG Markers of Obsessive-Compulsive Disorder (OCD) and Their Implications for Neurofeedback

brainmap_alphaUsing QEEG technology, researchers have identified a left frontotemporal dysfunction in persons who suffer from Obsessive-Compulsive Disorder, better known as OCD*. Persons with OCD have disturbing recurrent thoughts, as well as compulsive behaviors that are difficult to suppress and provide temporary relief from anxiety. The authors note that previous research has generally suggested a frontal lobe disturbance in OCD, but that these studies have only assessed specific brain regions without regard to the subjects’ sex. The researchers hoped to overcome these previous limitations.

The current study used a match control design to record the QEEG of unmedicated patients (n=22) with OCD (free of medication and depression) and healthy controls (n=20) in resting and hyperventilation conditions. QEEG consisted of 30 minutes of eyes closed recordings referenced to Cz. Frequency bands were defined as follows: delta (.5-3.0Hz), theta (3.5-8.0Hz) alpha (8.5-12Hz), beta (12.5-30 Hz). Hemispheric asymmetry and regional differences (frontal F3, F4, F7, F8; temporal T3, T4, T5, T6; parietal P3, P4) were assessed.

Participants in the OCD group were predominately female (n=17) with an average age of 28 (SD=7; range 14 to 47), while those in the control group were also mostly female (n=14) with mean age of 30 (SD=2; range 18 to 39). Subjects were further assess with the Hamilton Depression Rating Scale (HDRS) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Patients with OCD then received pharmacotherapy (11=fluvoxamine; 4=fluoxetine; and 5=sertraline) after the initial QEEG assessment.

QEEG analysis of relative power revealed that those with OCD had a significant increase in 2-4Hz (delta) and 5-7Hz (theta) activity in the frontotemporal areas and a decrease in 8-12Hz (alpha) activity in the left frontal region in resting states, as well as significantly deficit beta activity in left frontal recordings during hyperventilation. Excessive delta in the left hemisphere appeared to be the most prominent overall finding. Researchers further found that heightened left temporal theta activity in resting state conditions correlated with increased illness duration, that left frontotemporal dysfunction best characterized females with OCD and those who responded to pharmacotherapy, and that the severity of left frontotemporal dysfunction was positively associated with OCD severity.

The obvious implications for neurofeedback include inhibiting the excessive slow wave activity found in the fronto-temporal areas based on the patient’s QEEG. Enhancing deficient alpha represent an additional protocol; however, I often utilize inhibit protocols first and only enhance when needed. I am also uneasy about increasing alpha in the temporal lobes.

Of course, the above neurotherapy protocols are speculative and need further research to support their use. Responsible neurotherapy should only be conducted based on the patient’s presenting symptoms and personal EEG, not generic protocols found on a website.

A few comments about this study. The data was somewhat difficult to interpret, although I believe the summary above is accurate. I would like know more about the mens’ brain maps. One potential confound I recognized in this study was that participants underwent 30 minutes of eyes closed recordings. This is a fairly long recording that likely introduced some drowsiness, and I am interested to know if the above findings persist if only the first few minutes of the EEG recording were used.

Enjoy.

CFisher

Reference:
*Tot, S., Ozege, A., Comelekoglu, U., Yazici, K., & Bal, N. (2002). Association of QEEG Findings With Clinical Characteristics of OCD: Evidence of Left Frontotemporal Dysfunction. Canadian Journal of Psychiatry, 47(6), August, 538-545.

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