title: Cognitive effects of deep brain stimulation in patients with obsessive-compulsive disorder.
abstract: BACKGROUND
  Deep brain stimulation (DBS) is a promising treatment for treatment-refractory obsessive-compulsive disorder (OCD). However, the effects of DBS on cognitive functioning remain unclear. Therefore, we aimed to assess cognitive safety of DBS for treatment-refractory OCD and the association between clinical changes and cognitive functioning.
  
  
  METHODS
  Patients with treatment-refractory OCD treated with DBS targeted at the nucleus accumbens (NAcc) were compared with a control group of 14 patients with treatment-refractory OCD treated with care as usual. We assessed cognitive functioning at baseline, 3 weeks postoperatively and following 8 months of DBS. We compared change in clinical symptoms with cognitive changes.
  
  
  RESULTS
  There were 16 patients in the DBS group and 14 patients in the control group. Three weeks postoperatively, the DBS group showed a significantly reduced performance on measures of visual organization and verbal fluency and a trend toward reduced performance on measures of visual memory and abstract reasoning. Cognitive functioning was found to be stable on all other measures. After 8 months of DBS, reduced performances persisted, except for a significant improvement in verbal fluency. Cognitive functioning in all other domains remained unaffected. We found no correlation between improvement of clinical symptoms and cognitive changes.
  
  
  CONCLUSIONS
  A limitation of this study was its relatively small sample size.
  
  
  CONCLUSIONS
  Deep brain stimulation targeted at the NAcc may be considered a safe method in terms of cognition because cognitive functioning was unaffected on most neuropsychological measures. Nevertheless, we observed some minor reduced performance on specific measures of executive functioning that were possibly associated with surgical intervention. Our results suggest that severity of OCD symptoms is independent of cognitive functioning.
authors.affiliation: From the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands ( Mantione, Nieman, Figee, Denys); the Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (van den Munckhof, Schuurman); and the Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands (Denys).
authors.forename: Mariska
authors.initials: M
authors.lastname: Mantione
authors.affiliation: From the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands ( Mantione, Nieman, Figee, Denys); the Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (van den Munckhof, Schuurman); and the Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands (Denys).
authors.forename: Dorien
authors.initials: D
authors.lastname: Nieman
authors.affiliation: From the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands ( Mantione, Nieman, Figee, Denys); the Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (van den Munckhof, Schuurman); and the Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands (Denys).
authors.forename: Martijn
authors.initials: M
authors.lastname: Figee
authors.affiliation: From the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands ( Mantione, Nieman, Figee, Denys); the Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (van den Munckhof, Schuurman); and the Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands (Denys).
authors.forename: Pepijn
authors.initials: P
authors.lastname: van den Munckhof
authors.affiliation: From the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands ( Mantione, Nieman, Figee, Denys); the Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (van den Munckhof, Schuurman); and the Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands (Denys).
authors.forename: Rick
authors.initials: R
authors.lastname: Schuurman
authors.affiliation: From the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands ( Mantione, Nieman, Figee, Denys); the Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands (van den Munckhof, Schuurman); and the Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands (Denys).
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
mesh_terms: D000328:Adult; D003071:Cognition / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009714:Nucleus Accumbens / Q000503:physiopathology*; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome