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Deep brain stimulation in the treatment of obsessive-compulsive disorder.
World Neurosurg. 2013 Dec; 80(6):e245-53.WN

Abstract

BACKGROUND

Deep brain stimulation (DBS) has emerged as a treatment for severe cases of therapy-refractory obsessive-compulsive disorder (OCD), and promising results have been reported. The literature might, however, be somewhat unclear, considering the different targets used, and due to repeated inclusion of individual patients in multiple publications. The aim of this report was to review the literature on DBS for OCD.

METHODS

The modern literature concerning studies conducted on DBS in the treatment of OCD was reviewed.

RESULTS

The results of DBS in OCD have been presented in 25 reports with 130 patients, of which, however, only 90 contained individual patients. Five of these reports included at least 5 individual patients not presented elsewhere. Sixty-eight of these patients underwent implantation in the region of the internal capsule/ventral striatum, including the nucleus accumbens. The target in this region has varied between groups and over time, but the latest results from bilateral procedures in this area have shown a 50% reduction of OCD scores, depression, and anxiety. The subthalamic nucleus has been suggested as an alternative target. Although beneficial effects have been demonstrated, the efficacy of this procedure cannot be decided, because only results after 3 months of active stimulation have been presented so far.

CONCLUSIONS

DBS is a promising treatment for therapy-refractory OCD, but the published experience is limited and the method is at present an experimental therapy.

Authors+Show Affiliations

Department of Pharmacology and Clinical Neuroscience, Section of Neurosurgery, Umeå University, Umeå, Sweden. Electronic address: patric.blomstedt@neuro.umu.se.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

23044000

Citation

Blomstedt, Patric, et al. "Deep Brain Stimulation in the Treatment of Obsessive-compulsive Disorder." World Neurosurgery, vol. 80, no. 6, 2013, pp. e245-53.
Blomstedt P, Sjöberg RL, Hansson M, et al. Deep brain stimulation in the treatment of obsessive-compulsive disorder. World Neurosurg. 2013;80(6):e245-53.
Blomstedt, P., Sjöberg, R. L., Hansson, M., Bodlund, O., & Hariz, M. I. (2013). Deep brain stimulation in the treatment of obsessive-compulsive disorder. World Neurosurgery, 80(6), e245-53. https://doi.org/10.1016/j.wneu.2012.10.006
Blomstedt P, et al. Deep Brain Stimulation in the Treatment of Obsessive-compulsive Disorder. World Neurosurg. 2013;80(6):e245-53. PubMed PMID: 23044000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deep brain stimulation in the treatment of obsessive-compulsive disorder. AU - Blomstedt,Patric, AU - Sjöberg,Rickard L, AU - Hansson,Maja, AU - Bodlund,Owe, AU - Hariz,Marwan I, Y1 - 2012/10/05/ PY - 2012/03/20/received PY - 2012/10/02/accepted PY - 2012/10/10/entrez PY - 2012/10/10/pubmed PY - 2014/2/5/medline KW - CBT KW - Cognitive-behavioral psychotherapy KW - DBS KW - Deep brain stimulation KW - IC KW - ITP KW - Inferior thalamic peduncle KW - Internal capsule KW - NA KW - Nucleus accumbens KW - OCD KW - Obsessive-compulsive disorder KW - PD KW - Parkinson disease KW - STN KW - Stereotaxy KW - Subthalamic nucleus KW - VC/VS KW - Ventral internal capsule/ventral striatum KW - YBOCS KW - Yale-Brown Obsessive Compulsive Scale SP - e245 EP - 53 JF - World neurosurgery JO - World Neurosurg VL - 80 IS - 6 N2 - BACKGROUND: Deep brain stimulation (DBS) has emerged as a treatment for severe cases of therapy-refractory obsessive-compulsive disorder (OCD), and promising results have been reported. The literature might, however, be somewhat unclear, considering the different targets used, and due to repeated inclusion of individual patients in multiple publications. The aim of this report was to review the literature on DBS for OCD. METHODS: The modern literature concerning studies conducted on DBS in the treatment of OCD was reviewed. RESULTS: The results of DBS in OCD have been presented in 25 reports with 130 patients, of which, however, only 90 contained individual patients. Five of these reports included at least 5 individual patients not presented elsewhere. Sixty-eight of these patients underwent implantation in the region of the internal capsule/ventral striatum, including the nucleus accumbens. The target in this region has varied between groups and over time, but the latest results from bilateral procedures in this area have shown a 50% reduction of OCD scores, depression, and anxiety. The subthalamic nucleus has been suggested as an alternative target. Although beneficial effects have been demonstrated, the efficacy of this procedure cannot be decided, because only results after 3 months of active stimulation have been presented so far. CONCLUSIONS: DBS is a promising treatment for therapy-refractory OCD, but the published experience is limited and the method is at present an experimental therapy. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/23044000/Deep_brain_stimulation_in_the_treatment_of_obsessive_compulsive_disorder_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(12)01105-9 DB - PRIME DP - Unbound Medicine ER -