Obsessive-compulsive disorder: development of demand-controlled deep brain stimulation with methods from stochastic phase resetting.
Synchronization of neuronal firing is a hallmark of several neurological diseases. Recently, stimulation techniques have been developed which make it possible to desynchronize oscillatory neuronal activity in a mild and effective way, without suppressing the neurons' firing. As yet, these techniques are being used to establish demand-controlled deep brain stimulation (DBS) techniques for the therapy of movement disorders like severe Parkinson's disease or essential tremor. We here present a first conceptualization suggesting that the nucleus accumbens is a promising target for the standard, that is, permanent high-frequency, DBS in patients with severe and chronic obsessive-compulsive disorder (OCD). In addition, we explain how demand-controlled DBS techniques may be applied to the therapy of OCD in those cases that are refractory to behavioral therapies and pharmacological treatment.
Tass
Peter A
PA
Institute of Medicine, Research Center Jülich, 52425 Jülich, Germany. P.Tass@fz-juelich.de
Klosterkötter
Joachim
J
Schneider
Frank
F
Lenartz
Doris
D
Koulousakis
Anastasios
A
Sturm
Volker
V
D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D009474:Neurons / Q000502:physiology; D009714:Nucleus Accumbens / Q000502:physiology*; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology / Q000628:therapy*; D012648:Self Care / Q000295:instrumentation / Q000379:methods*; D013269:Stochastic Processes