Distinct striatal targets in treating obsessive-compulsive disorder and major depression.
The ventral striatum, including the head of the caudate nucleus and the nucleus accumbens, is a putative target for deep brain stimulation (DBS) in the treatment of obsessive-compulsive disorder (OCD) and major depression (MD). However, the respective roles of these structures in the pathophysiology of OCD and MD remain to be clarified. To address this issue, DBS of the ventral striatum was tested in 2 patients with severely distressing and intractable forms of OCD and MD. Comparisons of clinical outcomes and anatomical data on electrode positioning showed that caudate nucleus stimulation preferentially alleviated OCD manifestations, whereas nucleus accumbens stimulation improved depressive symptoms. These findings suggest that the caudate nucleus and nucleus accumbens participate differently in the pathogenesis of both of these psychiatric conditions.
Aouizerate
Bruno
B
Service de Psychiatrie, Université Victor Segalen Bordeaux 2, Centre Hospitalier Charles Perrens, Centre Carreire, France. bruno.aouizerate@u-bordeaux2.fr
Cuny
Emmanuel
E
Bardinet
Eric
E
Yelnik
Jerome
J
Martin-Guehl
Corinne
C
Rotge
Jean-Yves
JY
Rougier
Alain
A
Bioulac
Bernard
B
Tignol
Jean
J
Mallet
Luc
L
Burbaud
Pierre
P
Guehl
Dominique
D
D001479:Basal Ganglia / Q000473:pathology*; D002421:Caudate Nucleus / Q000473:pathology; D046690:Deep Brain Stimulation; D003865:Major Depressive Disorder / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008839:Microelectrodes; D008875:Middle Aged; D009714:Nucleus Accumbens / Q000473:pathology; D009771:Obsessive-Compulsive Disorder / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome