Deep brain stimulation targeting the ventral basal ganglia successfully modulated a dynamic neural biomarker in the anterior medial orbitofrontal cortex (amOFC) that correlates with obsessive-compulsive behaviors. The biomarker represents abnormal oscillatory patterns that appear to drive repetitive thoughts and actions characteristic of OCD. This breakthrough in understanding OCD's neural circuitry could revolutionize treatment personalization for the 2-3% of adults affected by this often-debilitating condition. Current treatments—primarily SSRIs and cognitive behavioral therapy—help only 60-70% of patients achieve meaningful improvement. The ability to target specific neural oscillations represents a precision medicine approach that could dramatically improve outcomes for treatment-resistant cases. However, the invasive nature of deep brain stimulation means this approach would likely be reserved for severe, refractory OCD. The real significance lies in mapping the exact neural circuits underlying compulsive behaviors, which could inform less invasive interventions like transcranial magnetic stimulation or novel pharmacological targets. This work builds on decades of research implicating cortico-striatal-thalamic loops in OCD, but provides the first real-time evidence of how targeted stimulation can normalize pathological brain activity patterns.