The Obsessive-Compulsive Disorder Response Tract (ORT) refers to a specific subset of white matter fibers identified through connectomic_analysis as being strongly associated with clinical improvement in patients undergoing deep_brain_stimulation (DBS) for treatment-resistant OCD.
The ORT was defined retrospectively from aggregated stimulation data in multiple DBS cohorts, correlating fiber engagement with positive treatment outcomes. It represents a reproducible bundle of fibers modulated in successful responders, particularly across different DBS targets.
The tract connects subcortical regions to cortical areas such as the dorsomedial_prefrontal_cortex (dmPFC).
It traverses key limbic structures involved in affective regulation and cognitive control.
It overlaps anatomically with parts of the superolateral_medial_forebrain_bundle (slMFB), particularly its medial and ventral components.
The ORT serves as a predictive biomarker for therapeutic response to DBS in OCD.
It offers a network-based framework for targeting, moving beyond traditional nucleus-based stimulation.
Precise engagement of the ORT during DBS programming may enhance efficacy and reduce side effects.
In the 2025 study by Coenen et al. (Mol Psychiatry), the ORT is:
Shown to be entirely embedded within the slMFB.
Identified as a “fiber selection” within a broader and more distributed connectomic target.
De-emphasized as a singular pathway, supporting the idea that different OCD sub-networks converge via slMFB and structures like the anteromedial_subthalamic_nucleus.
Definition is based on retrospective data; prospective validation and standardization across centers are needed.
May vary in structure and cortical projections depending on individual anatomy.