Deep brain stimulation for refractory obsessive-compulsive disorder (original) (raw)
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Acta Psychiatrica Scandinavica, 2003
Investigation of deep brain stimulation (DBS) as a last-resort treatment alternative to capsulotomy in treatment-refractory obsessive-compulsive disorder (OCD). Prospective single-case based design with evaluation of DBS impact on emotions, behaviour, personality traits and executive function in three patients with OCD. Two patients experienced sustained improvement of OCD symptoms with DBS. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) dropped 12 points and 23 points to baseline and Y-BOCS self-rating scale (Y-BOCS-SRS) and Profile of Mood States (POMS) for depression and tension decreased with increasing stimulation amplitude. Total Maladjustment Score on the Brief Psychiatric Rating Scale reduced with 44 and 59% to baseline. Reduction in psychopathology was sustained under continuous stimulation. No deleterious impact of DBS on neuropsychological testing or personality traits measured on a self-rated personality inventory was detected. These preliminary findings demonstrate that DBS may have important therapeutic benefits on psychopathology in OCD. No harmful side-effects were detected during follow-up (33/33/39 months, respectively).
Deep brain stimulation in obsessive-compulsive disorder
2009
Obsessive-compulsive disorder (OCD) is a psychiatric disorder that often runs a chronic, fluctuating course. A minority of patients do not improve by any available psychopharmacological and/or psychotherapeutic treatment. Treatment-refractory OCD patients considered for stereotactic neurosurgery have a longstanding history of persistent and extremely incapacitating intrusive obsessions and repetitive compulsions. This disorder creates tremendous suffering and a deep sense of shame, resulting in social isolation and often depression. Although a specific brain abnormality has not been identified, a growing number of brain imaging studies have accumulated evidence for a neurobiological basis for OCD. Eleven patients with severe, treatment refractory OCD were included in a double blind randomised crossover protocol. Electrical stimulation in the anterior limbs of the internal capsules and striatal gray matter inferiorly induced clinically significant therapeutic benefit in this patient group, not only in severity of OCD symptoms but also on the patient's mood scores. Technical aspects currently limit the use of capsular stimulation as a therapeutic option. This treatment option remains investigational for OCD patients and is not considered standard therapy.
Six-Nine Year Follow-Up of Deep Brain Stimulation for Obsessive-Compulsive Disorder
PloS one, 2016
Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) region has shown promise as a neurosurgical intervention for adults with severe treatment-refractory obsessive-compulsive disorder (OCD). Pilot studies have revealed improvement in obsessive-compulsive symptoms and secondary outcomes following DBS. We sought to establish the long-term safety and effectiveness of DBS of the VC/VS for adults with OCD. A long term follow-up study (73-112 months) was conducted on the six patients who were enrolled in the original National Institute of Mental Health pilot study of DBS for OCD. Qualitative and quantitative data were collected. Reduction in OCD symptoms mirrored the one-year follow-up data. The same four participants who were treatment responders after one year of treatment showed a consistent OCD response (greater than 35% reduction in Yale Brown Obsessive Compulsive Scale (YBOCS)). Another subject, classified as a non-responder, achieved a 26% reduction in YBOCS...
Deep brain stimulation for obsessive-compulsive disorders: long-term analysis of quality of life
Journal of Neurology, Neurosurgery & Psychiatry, 2014
Deep brain stimulation (DBS) has been proposed as an alternative to ablative neurosurgery for severe treatment-resistant Obsessive-Compulsive Disorder (OCD), although with partially discrepant results probably related to differences in anatomical targetting and stimulation conditions. We sought to determine the efficacy and tolerability of DBS in OCD and the existence of clinical predictors of response using meta-analysis.
BMC Research Notes, 2010
Deep brain stimulation (DBS) has been proposed as an alternative to ablative neurosurgery for severe treatment-resistant Obsessive-Compulsive Disorder (OCD), although with partially discrepant results probably related to differences in anatomical targetting and stimulation conditions. We sought to determine the efficacy and tolerability of DBS in OCD and the existence of clinical predictors of response using meta-analysis.
DEEP BRAIN STIMULATION FOR OBSESSIVE COMPULSIVE DISORDER: THE FIRST THREE AUSTRALIAN CASES
Deep brain stimulation (DBS) has been proposed as an alternative to ablative neurosurgery for severe treatment-resistant Obsessive-Compulsive Disorder (OCD), although with partially discrepant results probably related to differences in anatomical targetting and stimulation conditions. We sought to determine the efficacy and tolerability of DBS in OCD and the existence of clinical predictors of response using meta-analysis.
Deep brain stimulation for obsessive-compulsive disorder: past, present, and future
Neurosurgical Focus, 2010
Background Deep brain stimulation (DBS) has been proposed as an alternative to ablative neurosurgery for severe treatment-resistant Obsessive-Compulsive Disorder (OCD), although with partially discrepant results probably related to differences in anatomical targetting and stimulation conditions. We sought to determine the efficacy and tolerability of DBS in OCD and the existence of clinical predictors of response using meta-analysis. Methods We searched the literature on DBS for OCD from 1999 through January 2014 using PubMed/MEDLINE and PsycINFO. We performed fixed and random-effect meta-analysis with score changes (pre-post DBS) on the Yale-Brown Obsessive Compulsive Scale