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Mechanisms of deep brain stimulation for obsessive compulsive disorder: effects upon cells and circuits.
Front Integr Neurosci. 2012; 6:29.FI

Abstract

Deep brain stimulation (DBS) has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive compulsive disorder (OCD), which is characterized by recurrent unwanted thoughts or ideas (obsessions) and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions). Abnormal activity in cortico-striato-thalamo-cortical (CSTC) circuits including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), ventral striatum, and mediodorsal (MD) thalamus has been implicated in OCD. To this end a number of DBS targets including the anterior limb of the internal capsule (ALIC), ventral capsule/ventral striatum (VC/VS), ventral caudate nucleus, subthalamic nucleus (STN), and nucleus accumbens (NAc) have been investigated for the treatment of OCD. Despite its efficacy and widespread use in movement disorders, the mechanism of DBS is not fully understood, especially as it relates to psychiatric disorders. While initially thought to create a functional lesion akin to ablative procedures, it is increasingly clear that DBS may induce clinical benefit through activation of axonal fibers spanning the CSTC circuits, alteration of oscillatory activity within this network, and/or release of critical neurotransmitters. In this article we review how the use of DBS for OCD informs our understanding of both the mechanisms of DBS and the circuitry of OCD. We review the literature on DBS for OCD and discuss potential mechanisms of action at the neuronal level as well as the broader circuit level.

Authors+Show Affiliations

Department of Neurosurgery, Massachusetts General Hospital, Boston MA, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22712007

Citation

Bourne, Sarah K., et al. "Mechanisms of Deep Brain Stimulation for Obsessive Compulsive Disorder: Effects Upon Cells and Circuits." Frontiers in Integrative Neuroscience, vol. 6, 2012, p. 29.
Bourne SK, Eckhardt CA, Sheth SA, et al. Mechanisms of deep brain stimulation for obsessive compulsive disorder: effects upon cells and circuits. Front Integr Neurosci. 2012;6:29.
Bourne, S. K., Eckhardt, C. A., Sheth, S. A., & Eskandar, E. N. (2012). Mechanisms of deep brain stimulation for obsessive compulsive disorder: effects upon cells and circuits. Frontiers in Integrative Neuroscience, 6, 29. https://doi.org/10.3389/fnint.2012.00029
Bourne SK, et al. Mechanisms of Deep Brain Stimulation for Obsessive Compulsive Disorder: Effects Upon Cells and Circuits. Front Integr Neurosci. 2012;6:29. PubMed PMID: 22712007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mechanisms of deep brain stimulation for obsessive compulsive disorder: effects upon cells and circuits. AU - Bourne,Sarah K, AU - Eckhardt,Christine A, AU - Sheth,Sameer A, AU - Eskandar,Emad N, Y1 - 2012/06/14/ PY - 2012/02/01/received PY - 2012/05/24/accepted PY - 2012/6/20/entrez PY - 2012/6/20/pubmed PY - 2012/6/20/medline KW - cortico-striato-thalamocortical circuit KW - deep brain stimulation KW - neuromodulation KW - obsessive compulsive disorder SP - 29 EP - 29 JF - Frontiers in integrative neuroscience JO - Front Integr Neurosci VL - 6 N2 - Deep brain stimulation (DBS) has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive compulsive disorder (OCD), which is characterized by recurrent unwanted thoughts or ideas (obsessions) and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions). Abnormal activity in cortico-striato-thalamo-cortical (CSTC) circuits including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), ventral striatum, and mediodorsal (MD) thalamus has been implicated in OCD. To this end a number of DBS targets including the anterior limb of the internal capsule (ALIC), ventral capsule/ventral striatum (VC/VS), ventral caudate nucleus, subthalamic nucleus (STN), and nucleus accumbens (NAc) have been investigated for the treatment of OCD. Despite its efficacy and widespread use in movement disorders, the mechanism of DBS is not fully understood, especially as it relates to psychiatric disorders. While initially thought to create a functional lesion akin to ablative procedures, it is increasingly clear that DBS may induce clinical benefit through activation of axonal fibers spanning the CSTC circuits, alteration of oscillatory activity within this network, and/or release of critical neurotransmitters. In this article we review how the use of DBS for OCD informs our understanding of both the mechanisms of DBS and the circuitry of OCD. We review the literature on DBS for OCD and discuss potential mechanisms of action at the neuronal level as well as the broader circuit level. SN - 1662-5145 UR - https://www.unboundmedicine.com/medline/citation/22712007/Mechanisms_of_deep_brain_stimulation_for_obsessive_compulsive_disorder:_effects_upon_cells_and_circuits_ L2 - https://doi.org//10.3389/fnint.2012.00029 DB - PRIME DP - Unbound Medicine ER -
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