title: Intraoperative functional magnetic resonance imaging for monitoring the effect of deep brain stimulation in patients with obsessive-compulsive disorder.
abstract: OBJECTIVE
  To investigate the effects of low- and high-frequency deep brain stimulation (DBS) on the nucleus accumbens (ACC) and the adjacent internal capsule in 3 patients with obsessive-compulsive disorder (OCD) using blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) under intraoperative conditions.
  
  
  METHODS
  After placement of the electrode in the right ACC, the patients underwent an MR scan inside the operating room. BOLD imaging was performed and interpreted using a boxcar paradigm with alternating high-frequency stimulation of the ACC and the internal capsule versus rest. Correlation maps were calculated employing SPM99.
  
  
  RESULTS
  During high-frequency stimulation of the right ACC, focal activation could be found in the right striatum, the right frontal lobe and the right hippocampus, whereas low-frequency stimulation was correlated to right insular activation.
  
  
  CONCLUSIONS
  Intraoperative BOLD-fMRI is feasible during DBS surgery of OCD patients. Our results support the existence of an ipsilateral hemispheric circuit involving the frontal lobe, anterior cingulate, parahippocampal gyrus and striatum. Intraoperative fMRI may be used to acquire additional information regarding the pathophysiology of OCD that can be used to improve the results of DBS in OCD.
authors: Department of Radiology, University Hospital of Cologne, Cologne, Germany.
authors: Sonja
authors: S
authors: Hiss
authors: Volker
authors: V
authors: Hesselmann
authors: Stefan
authors: S
authors: Hunsche
authors: Harald
authors: H
authors: Kugel
authors: Volker
authors: V
authors: Sturm
authors: David
authors: D
authors: Maintz
authors: Veerle
authors: V
authors: Visser-Vandewalle
authors: Thomas
authors: T
authors: Liebig
authors: Mohammad
authors: M
authors: Maarouf
mesh_terms: D000328:Adult; D046690:Deep Brain Stimulation; D004567:Electrodes, Implanted; D005240:Feasibility Studies; D005260:Female; D059907:Functional Neuroimaging / Q000379:methods*; D006801:Humans; D020772:Internal Capsule / Q000503:physiopathology*; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009714:Nucleus Accumbens / Q000503:physiopathology*; D009771:Obsessive-Compulsive Disorder / Q000473:pathology / Q000628:therapy*; D013238:Stereotaxic Techniques