Deep brain stimulation for treatment refractory obsessive-compulsive disorder--a case report

Area of Science:

• Neurosurgery
• Neuroscience
• Psychiatry

Background:

• Obsessive-compulsive disorder (OCD) affects many patients refractory to conventional pharmacotherapy and cognitive-behavioral therapy.
• Neurosurgical interventions offer a breakthrough for treatment-resistant OCD cases.

Observation:

• A 3-month follow-up of an obsessive-compulsive patient treated with deep brain stimulation (DBS) targeting the anterior limb of the internal capsule is presented.
• Clinical symptoms were assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).
• Executive functions were evaluated using neuropsychological tests before and after DBS.

Findings:

• Deep brain stimulation led to significant improvement in obsessive-compulsive symptoms.
• Neuropsychological testing revealed enhancements in executive functions, including fluency, set-shifting, and decision-making.
• Severe neurocognitive deficits, particularly in attention skills, were observed in this treatment-refractory OCD patient.

Implications:

• Deep brain stimulation is a viable therapeutic option for severe, treatment-refractory obsessive-compulsive disorder.
• Monitoring executive functions, especially attention, is crucial during DBS therapy for OCD.
• Further research is needed to understand and mitigate potential neurocognitive side effects of DBS in OCD patients.