title: Electrical stimulation in the bed nucleus of the stria terminalis alleviates severe obsessive-compulsive disorder.
abstract: In 1998, we proposed deep brain stimulation as a last-resort treatment option for patients suffering from severe, treatment-resistant obsessive-compulsive disorder (OCD). Here, 24 OCD patients were included in a long-term follow-up study to evaluate the effects of electrical stimulation in the anterior limbs of the internal capsule (ALIC) and bed nucleus of the stria terminalis (BST). We find that electrical stimulation in the ALIC/BST area is safe and significantly decreases obsessions, compulsions, and associated anxiety and depressive symptoms, and improves global functioning in a blinded crossover trial (n=17), after 4 years (n=18), and at last follow-up (up to 171 months, n=24). Moreover, our data indicate that BST may be a better stimulation target compared with ALIC to alleviate OCD symptoms. We conclude that electrical stimulation in BST is a promising therapeutic option for otherwise treatment-resistant OCD patients.
authors: KU Leuven Research Group Experimental Neurosurgery and Neuroanatomy, Leuven, Belgium.|KU Leuven Research Group Psychology of Learning and Experimental Psychopathology, Leuven, Belgium.
authors: L
authors: L
authors: Luyten
authors: KU Leuven Research Group Experimental Neurosurgery and Neuroanatomy, Leuven, Belgium.
authors: S
authors: S
authors: Hendrickx
authors: KU Leuven Research Group Psychiatry, Leuven, Belgium.
authors: S
authors: S
authors: Raymaekers
authors: UPC-KU Leuven University Center for OCD, Leuven, Belgium.
authors: L
authors: L
authors: Gabriëls
authors: KU Leuven Research Group Experimental Neurosurgery and Neuroanatomy, Leuven, Belgium.|UZ Leuven Department of Neurosurgery, Leuven, Belgium.
authors: B
authors: B
authors: Nuttin
mesh_terms: D000328:Adult; D001007:Anxiety / Q000628:therapy; D018592:Cross-Over Studies; D046690:Deep Brain Stimulation / Q000379:methods* / Q000523:psychology*; D003863:Depression / Q000628:therapy; D004311:Double-Blind Method; D004558:Electric Stimulation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020772:Internal Capsule / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012686:Septal Nuclei / Q000502:physiology; D016896:Treatment Outcome