Deep brain stimulation for treatment-refractory obsessive-compulsive disorder: psychopathological and neuropsychological outcome in three cases.
OBJECTIVE
Investigation of deep brain stimulation (DBS) as a last-resort treatment alternative to capsulotomy in treatment-refractory obsessive-compulsive disorder (OCD).


METHODS
Prospective single-case based design with evaluation of DBS impact on emotions, behaviour, personality traits and executive function in three patients with OCD.


RESULTS
Two patients experienced sustained improvement of OCD symptoms with DBS. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) dropped 12 points and 23 points to baseline and Y-BOCS self-rating scale (Y-BOCS-SRS) and Profile of Mood States (POMS) for depression and tension decreased with increasing stimulation amplitude. Total Maladjustment Score on the Brief Psychiatric Rating Scale reduced with 44 and 59% to baseline. Reduction in psychopathology was sustained under continuous stimulation. No deleterious impact of DBS on neuropsychological testing or personality traits measured on a self-rated personality inventory was detected.


CONCLUSIONS
These preliminary findings demonstrate that DBS may have important therapeutic benefits on psychopathology in OCD. No harmful side-effects were detected during follow-up (33/33/39 months, respectively).
Gabriëls
L
L
University of Antwerpen, University Hospital Antwerpen, Department of psychiatry, Edegem, Belgium. loes.gabriels@uza.be
Cosyns
P
P
Nuttin
B
B
Demeulemeester
H
H
Gybels
J
J
D000328:Adult; D000339:Affect; D001921:Brain / Q000473:pathology / Q000601:surgery; D003863:Depression; D004599:Electric Stimulation Therapy; D004566:Electrodes; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000523:psychology* / Q000628:therapy*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011612:Psychosurgery; D012008:Recurrence; D016896:Treatment Outcome