Compulsions, Parkinson's disease, and stimulation.
Pathophysiological models suggest that obsessive compulsive disorder (OCD) might be associated with dysfunctions in cortico-striato-pallido-thalamo-cortical neuronal circuits. We implanted subthalamic electrodes to alleviate parkinsonian symptoms in two patients who had Parkinson's disease and a history of severe OCD. Parkinsonian disability improved postoperatively in both patients, and 2 weeks after the procedure, their compulsions had disappeared and obsessive symptoms improved (58% improvement for patient 1 on the Yale-Brown obsessive compulsive scale, 64% for patient 2). The improvements in these two patients suggest that high-frequency stimulation could improve function in the subcortical-limbic circuitry in patients with severe OCD.
Mallet
Luc
L
CNRS UMR 7593 and Service de Psychiatrie, Pavillon Clérambault, GH Pitié-Salpêtrière, Hôpital de la Salpêtrière, Assistance Publique-Hôpital de Paris, 75651 Cedex 13, Paris, France. lucmallet@free.fr
Mesnage
Valérie
V
Houeto
Jean-Luc
JL
Pelissolo
Antoine
A
Yelnik
Jérôme
J
Behar
Cécile
C
Gargiulo
Marcella
M
Welter
Marie-Laure
ML
Bonnet
Anne-Marie
AM
Pillon
Bernard
B
Cornu
Philippe
P
Dormont
Didier
D
Pidoux
Bernard
B
Allilaire
Jean-François
JF
Agid
Yves
Y
D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000628:therapy*; D010300:Parkinson Disease / Q000150:complications* / Q000628:therapy*; D020531:Subthalamic Nucleus