Systematic review identifies three neuroimaging subtypes of OCD with distinct treatment responses

Three OCD subtypes identified via functional neuroimaging: Limbic-Hyperactive (40%), Fronto-Striatal-Hypoconnected (35%), Global-Disrupted (25%). SVM accuracy 81.5% for subtype assignment; limited generalizability for OCD vs control (AUC 0.567–0.673). Need prospective validation.

• Limbic-Hyperactive (40%): elevated anxiety, contamination/washing symptoms, good CBT response.
• Fronto-Striatal-Hypoconnected (35%): cognitive inflexibility, checking/ordering symptoms, good SSRI response.
• Global-Disrupted (25%): greater symptom severity, poor treatment response.

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