Functional-imaging and electrophysiological correlates of obsessive-compulsive disorder and their potential use in neurofeedback intervention

Background: Obsessive-compulsive disorder (OCD) is a common mental disorder that may seriously affect quality of life and even the ability to work. Despite advanced medical care there are still patients who do not respond or do not respond sufficiently to treatment. Recently proposed treatment strategies such as deep brain stimulation or repetitive transcranial magnetic stimulation have targeted several levels of fronto-striatal circuits which dysfunction underlies OCD pathophysiology. Likewise, neurofeedback (NFB) could target dysfunctional fronto-striatal networks by providing almost real- time feedback about their activity. As the success of these methods critically depends on good knowledge of dysfunctional loops in OCD, a more detailed investigation of neurobiological basis of this disorder is highly needed. Aims: The aim of the first part of this dissertation was to provide an overview of the current literature related to OCD and NFB. The second section of the thesis is based on five original studies of the author that were conceived to 1) explore anatomical correlate of OCD in our patients, 2) to verify its functional relevance and specificity in electroencephalographic (EEG) studies, and 3) to test the utility of the findings in NFB treatment of OCD. Methods: In our studies we included..