Surgical neuroanatomy and programming in deep brain stimulation for obsessive compulsive disorder
Takashi Morishita1, Sarah M Fayad, Wayne K Goodman
1Department of Neurosurgery, University of Florida College of Medicine/Shands Hospital, Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, Gainesville, FL, USA.
Neuromodulation : Journal of the International Neuromodulation Society
|December 19, 2013
Summary
Deep brain stimulation (DBS) is an experimental treatment for obsessive-compulsive disorder (OCD). Optimal targets and programming methods for DBS in OCD are not yet standardized, requiring further research.
Area of Science:
- Neurosurgery
- Psychiatry
- Neuroscience
Background:
- Deep brain stimulation (DBS) is a proven therapy for movement disorders.
- Its application is expanding to neuropsychiatric conditions like obsessive-compulsive disorder (OCD).
- Existing studies suggest DBS efficacy for severe OCD, but optimal targeting and programming remain unclear.
Purpose of the Study:
- To review current approaches to targeting and programming for DBS in OCD.
- To discuss clinical experiences with proposed targets.
- To examine the relevant neuroanatomy for OCD DBS.
Main Methods:
- A PubMed literature review was conducted for studies on OCD DBS published before March 2012.
- Studies included had clear descriptions of anatomic targets, programming details, and outcomes.
Main Results:
- Six distinct DBS approaches for OCD were identified.
- Most cases utilized high-frequency, high-voltage stimulation.
- Predictive factors for successful outcomes were discussed.
Conclusions:
- DBS is currently an experimental treatment for medication-refractory OCD.
- Standardization of target selection and programming paradigms is needed.
- Understanding DBS lead-neuroanatomy relationships is crucial for improving OCD DBS.
- A registry for OCD DBS cases is proposed to facilitate future research.
