Early Feasibility Study of Sensing-enabled Ventral Capsule Deep Brain Stimulation in 10 Participants with Intractable...

Area of Science:

• Neurosurgery
• Neurology
• Psychiatry

Background:

• Refractory obsessive-compulsive disorder (OCD) presents significant treatment challenges.
• Current deep brain stimulation (DBS) programming relies on subjective feedback, limiting efficacy.
• Objective biomarkers are needed to guide DBS therapy for OCD.

Purpose of the Study:

• To evaluate the feasibility and efficacy of sensing-capable DBS in patients with treatment-resistant OCD.
• To identify neural biomarkers for objective feedback during DBS therapy.
• To assess the clinical response to ventral internal capsule (VC) DBS.

Main Methods:

• An early feasibility study involving 10 patients with severe, treatment-resistant OCD.
• Bilateral DBS leads targeting the ventral internal capsule (VC) were implanted.
• Investigational, bidirectional DBS devices were used, with some patients receiving additional orbitofrontal cortex strip electrodes for recording.

Main Results:

• A mean reduction of 60% in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was observed.
• Eight out of ten patients achieved a significant therapeutic response (>35% Y-BOCS decrease).
• All participants experienced a reduction in depressive symptoms.

Conclusions:

• Ventral internal capsule (VC) DBS demonstrates excellent clinical efficacy in patients with refractory OCD.
• Sensing-capable, bidirectional DBS devices are feasible for recording neural data in clinical and home settings.
• Objective neural data acquisition can potentially enhance DBS programming and therapeutic outcomes.