Assessing the Pharmacotherapy and Clinical Outcomes After Deep Brain Stimulation for Treatment-Refractory...

Area of Science:

• Neurology
• Psychiatry
• Neurosurgery

Background:

• Refractory obsessive-compulsive disorder (OCD) poses treatment challenges.
• Deep brain stimulation (DBS) is an invasive neuromodulation technique considered for treatment-resistant cases.
• Limited data exists on DBS for OCD, highlighting the need for comparative studies.

Purpose of the Study:

• To compare pharmacotherapy utilization and treatment outcomes in patients with treatment-refractory OCD who received DBS versus a matched cohort without DBS.
• To evaluate the impact of DBS on medication burden and symptom severity in refractory OCD.

Main Methods:

• Retrospective, single-center, case-cohort study.
• Compared five treatment-refractory OCD patients who underwent DBS with a matched cohort treated conventionally.
• Primary endpoint: change in psychotropic medication count at two years. Secondary endpoints: Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) changes, medication class duration, and symptom scales (HAM-A, HAM-D).

Main Results:

• Patients receiving DBS were prescribed fewer medications post-treatment.
• One of five DBS patients achieved responder status on Y-BOCS.
• DBS cohort showed reductions in anxiety (HAM-A) and depression (HAM-D) symptoms.

Conclusions:

• DBS implantation may lead to reduced polypharmacy in refractory OCD.
• DBS shows potential for improving comorbid anxiety and depression symptoms.
• Small sample size necessitates larger, prospective trials to establish DBS efficacy for OCD.