Current Psychiatry Reports

, Volume 13, Issue 4, pp 274–282

Current Status of Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Clinical Review of Different Targets

  • Pelle P. de Koning
  • Martijn Figee
  • Pepijn van den Munckhof
  • P. Richard Schuurman
  • Damiaan Denys
Article

Abstract

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that affects 2% of the general population. Despite optimal cognitive-behavioral and pharmacologic therapy, approximately 10% of patients remain treatment resistant. Currently, deep brain stimulation (DBS) is being investigated as an experimental therapy for treatment-refractory OCD. This review focuses on the efficacy and adverse events of all published DBS targets for OCD: anterior limb of the internal capsule, ventral striatum/ventral capsule, nucleus accumbens, nucleus subthalamicus, and inferior thalamic peduncle. Small studies with various designs indicate an overall average Yale-Brown Obsessive Compulsive Scale score decrease ranging from 6.8 to 31 points. The average overall responder rate is ±50%. The frequency of adverse events seems to be limited. Larger prospective studies including neuroimaging are needed to estimate adequately the true potential of DBS in treatment of OCD and to elucidate its underlying mechanism of action and optimal brain target. We conclude that DBS may be a promising and safe therapy for treatment-resistant OCD.

Keywords

Deep brain stimulation Obsessive-compulsive disorder Neurosurgery Nucleus accumbens Internal capsule Ventral capsule Ventral striatum Subthalamic nucleus Inferior thalamic peduncle Neuroimaging PET MRI SPECT Parkinson Adverse events Cognitive function CTSC Responder Y-BOCS 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Pelle P. de Koning
    • 1
  • Martijn Figee
    • 1
  • Pepijn van den Munckhof
    • 2
  • P. Richard Schuurman
    • 2
  • Damiaan Denys
    • 3
    • 4
  1. 1.Department of Psychiatry, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Neurosurgery, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Psychiatry, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  4. 4.The Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and SciencesAmsterdamThe Netherlands

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