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Related Concept Videos

Obsessive-Compulsive Disorder01:28

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by recurrent obsessions, compulsions, or both, which consume significant time and interfere with daily functioning. Obsessions involve persistent, intrusive, and unwanted thoughts, images, or urges that evoke anxiety. Common examples include irrational fears of contamination or harm. Compulsions are repetitive behaviors or mental acts performed to reduce the anxiety caused by obsessions. For instance, individuals...

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Related Experiment Video

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Protocol for Repetitive Transcranial Magnetic Stimulation with Symptom Provocation to Treat Obsessive-compulsive Disorder
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Subthalamic nucleus stimulation in severe obsessive-compulsive disorder.

Luc Mallet1, Mircea Polosan, Nematollah Jaafari

  • 1The authors' affiliations are listed in the Appendix.

The New England Journal of Medicine
|November 14, 2008
PubMed
Summary

Deep brain stimulation of the subthalamic nucleus shows promise for treating severe obsessive-compulsive disorder (OCD). However, this novel OCD treatment carries significant risks of serious adverse events.

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Area of Science:

  • Neurosurgery
  • Psychiatry
  • Neurology

Background:

  • Severe, refractory obsessive-compulsive disorder (OCD) is a debilitating condition.
  • Subthalamic nucleus stimulation, a validated treatment for movement disorders, is explored for OCD.
  • Current treatment options for severe OCD are limited, necessitating novel therapeutic approaches.

Purpose of the Study:

  • To assess the efficacy and safety of subthalamic nucleus stimulation in patients with severe, refractory OCD.
  • To evaluate the impact of subthalamic nucleus stimulation on OCD symptom severity and overall functioning.
  • To investigate potential adverse events associated with subthalamic nucleus stimulation for OCD.

Main Methods:

  • A 10-month, crossover, double-blind, multicenter study design.
  • Eight patients with refractory OCD were randomly assigned to active or sham subthalamic nucleus stimulation.
  • Primary outcome: Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores; secondary outcomes: Global Assessment of Functioning (GAF) scale, psychiatric scales, and neuropsychological tests.

Main Results:

  • Active subthalamic nucleus stimulation significantly reduced Y-BOCS scores compared to sham stimulation (19 vs. 28; P=0.01).
  • Global Assessment of Functioning (GAF) scores significantly improved with active stimulation (56 vs. 43; P=0.005).
  • No significant changes were observed in neuropsychological measures, depression, or anxiety; however, 15 serious adverse events occurred.

Conclusions:

  • Subthalamic nucleus stimulation may effectively reduce symptoms in severe OCD.
  • The procedure is associated with a substantial risk of serious adverse events, including hemorrhage and infection.
  • Further research is needed to optimize safety and efficacy for this OCD treatment.