title: The anteromedial GPi as a new target for deep brain stimulation in obsessive compulsive disorder.
abstract: Deep brain stimulation (DBS) is now well established in the treatment of intractable movement disorders. Over the past decade the clinical applications have expanded into the realm of psychosurgery, including depression and obsessive compulsive disorder (OCD). The optimal targets for electrode placement in psychosurgery remain unclear, with numerous anatomical targets reported for the treatment of OCD. We present four patients with Tourette's syndrome and prominent features of OCD who underwent DBS of the anteromedial globus pallidus internus (GPi) to treat their movement disorder. Their pre-operative and post-operative OCD symptoms were compared, and responded dramatically to surgery. On the basis of these results, we propose the anteromedial (limbic) GPi as a potential surgical target for the treatment of OCD, and furnish data supporting its further investigation as a DBS target for the treatment of psychiatric conditions.
authors: Department of Neurosurgery, Royal Melbourne Hospital, Parkville, Melbourne, VIC, Australia.
authors: Girish
authors: G
authors: Nair
authors: Department of Neurology, Royal Melbourne Hospital, Parkville, Melbourne, VIC, Australia.
authors: Andrew
authors: A
authors: Evans
authors: Faculty of Health, Deakin University, Clayton, Melbourne, VIC, Australia.
authors: Renee E
authors: RE
authors: Bear
authors: Department of Psychiatry, Royal Melbourne Hospital, Parkville, Melbourne, VIC, Australia.
authors: Dennis
authors: D
authors: Velakoulis
authors: Department of Neurosurgery, Royal Melbourne Hospital, Parkville, Melbourne, VIC, Australia; Faculty of Health, Deakin University, Clayton, Melbourne, VIC, Australia. Electronic address: profbittar@precisionhealth.com.au.
authors: Richard G
authors: RG
authors: Bittar
mesh_terms: D000293:Adolescent; D000328:Adult; D046690:Deep Brain Stimulation / Q000379:methods*; D005917:Globus Pallidus / Q000473:pathology*; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D011612:Psychosurgery / Q000379:methods; D005879:Tourette Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D055815:Young Adult
keywords: DBS; Deep brain stimulation; OCD; Obsessive compulsive disorder; Psychosurgery; Tourette’s syndrome