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Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging

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Decrease of prefrontal metabolism after subthalamic stimulation in obsessive-compulsive disorder: a positron emission

Florence Le Jeune¹, Marc Vérin, Karim N'Diaye

¹Department of Nuclear Medicine, Centre Eugène Marquis, Rennes, France. f.lejeune@rennes.fnclcc.fr

Biological Psychiatry

|October 19, 2010

Summary

This summary is machine-generated.

High-frequency bilateral subthalamic nucleus deep brain stimulation (DBS) significantly improved obsessive-compulsive disorder (OCD) symptoms. This treatment reduced frontal lobe metabolism, suggesting a key mechanism for therapeutic effects in OCD patients.

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Published on: November 27, 2019

Area of Science:

Neuroscience
Neurosurgery
Psychiatry

Background:

Refractory obsessive-compulsive disorder (OCD) presents a significant clinical challenge.
High-frequency bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) is an emerging therapeutic option for severe OCD.
Understanding the neural mechanisms underlying STN DBS in OCD is crucial for optimizing treatment.

Purpose of the Study:

To investigate the neural substrates associated with high-frequency bilateral STN DBS in patients with refractory OCD.
To correlate metabolic changes observed via PET imaging with clinical symptom improvement.

Main Methods:

Employed a crossover, randomized, double-blind design (STOC study).
10 patients with refractory OCD received high-frequency bilateral STN DBS.
18-fluorodeoxyglucose positron emission tomography (PET) was used to assess cerebral metabolism.

Main Results:

Significant reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores from 31 (Off-Stimulation) to 19 (On-Stimulation) (p = .05).
Off-Stimulation showed hypermetabolism in the right frontal middle/superior gyri, right parietal lobe, postcentral gyrus, and bilateral putamen compared to controls.
On-Stimulation revealed decreased metabolism in the left cingulate gyrus and left frontal medial gyrus, correlating with Y-BOCS score improvements and orbitofrontal/medial prefrontal cortex activity.

Conclusions:

High-frequency bilateral STN DBS effectively alleviates OCD symptoms.
The therapeutic benefits of STN DBS in OCD are associated with reduced prefrontal cortex metabolism.
Metabolic changes in specific frontal regions are linked to clinical outcomes in STN DBS for OCD.