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Related Concept Videos

Obsessive-Compulsive Disorder01:28

Obsessive-Compulsive Disorder

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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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Deep Brain Stimulation for Obsessive-Compulsive Disorder: Optimal Stimulation Sites.

Garance M Meyer1, Barbara Hollunder2, Ningfei Li3

  • 1Center for Brain Circuit Therapeutics, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Biological Psychiatry
|December 23, 2023
PubMed
Summary

Deep brain stimulation (DBS) mapping identified two optimal targets for obsessive-compulsive disorder (OCD). These findings refine DBS targeting for improved treatment outcomes in OCD patients.

Keywords:
Anterior limb of the internal capsuleBed nucleus of the stria terminalisDeep brain stimulationObsessive-compulsive disorderSweet-spotVentral striatum

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Area of Science:

  • Neurosurgery
  • Psychiatry
  • Neurology

Background:

  • Deep brain stimulation (DBS) is a potential treatment for refractory obsessive-compulsive disorder (OCD).
  • Current DBS targets are primarily in the anterior limb of the internal capsule and ventral striatum.
  • Optimal stimulation sites within these regions require further definition.

Purpose of the Study:

  • To retrospectively map optimal DBS stimulation sites in patients with OCD.
  • To identify precise "sweet spots" for improved treatment efficacy.
  • To validate findings in an independent patient cohort.

Main Methods:

  • Retrospective analysis of a multicenter cohort of 82 patients with OCD undergoing DBS.
  • Mapping of optimal stimulation sites within the ventral capsule/ventral striatum.
  • Validation of sweet-spot mapping in an independent cohort of 22 patients.

Main Results:

  • Two optimal DBS sweet spots were identified: one in the anterior limb of the internal capsule and another near the inferior thalamic peduncle/bed nucleus of the stria terminalis.
  • The anterior site improved OCD, depression, and anxiety symptoms.
  • The posterior site improved OCD and depression symptoms, but not anxiety.

Conclusions:

  • The study refines DBS targeting strategies for OCD treatment.
  • Findings can guide DBS programming for enhanced patient outcomes.
  • Precise targeting is crucial for maximizing therapeutic benefits in OCD DBS.