title: Six-Nine Year Follow-Up of Deep Brain Stimulation for Obsessive-Compulsive Disorder.
abstract: OBJECTIVE
  Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) region has shown promise as a neurosurgical intervention for adults with severe treatment-refractory obsessive-compulsive disorder (OCD). Pilot studies have revealed improvement in obsessive-compulsive symptoms and secondary outcomes following DBS. We sought to establish the long-term safety and effectiveness of DBS of the VC/VS for adults with OCD.
  
  
  METHODS
  A long term follow-up study (73-112 months) was conducted on the six patients who were enrolled in the original National Institute of Mental Health pilot study of DBS for OCD. Qualitative and quantitative data were collected.
  
  
  RESULTS
  Reduction in OCD symptoms mirrored the one-year follow-up data. The same four participants who were treatment responders after one year of treatment showed a consistent OCD response (greater than 35% reduction in Yale Brown Obsessive Compulsive Scale (YBOCS)). Another subject, classified as a non-responder, achieved a 26% reduction in YBOCS score at long term follow-up. The only patient who did not achieve a 25% or greater reduction in YBOCS was no longer receiving active DBS treatment. Secondary outcomes generally matched the one-year follow-up with the exception of depressive symptoms, which significantly increased over the follow-up period. Qualitative feedback indicated that DBS was well tolerated by the subjects.
  
  
  CONCLUSIONS
  These data indicate that DBS was safe and conferred a long-term benefit in reduction of obsessive-compulsive symptoms. DBS of the VC/VS region did not reveal a sustained response for comorbid depressive symptoms in patients with a primary diagnosis of OCD.
authors.affiliation: Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Fayad
authors.affiliation: Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, United States of America.|Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Guzick
authors.affiliation: Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, United States of America.|Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America.|Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Reid
authors.affiliation: Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Mason
authors.affiliation: Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Agustina
authors.initials: A
authors.lastname: Bertone
authors.affiliation: Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Foote
authors.affiliation: Department of Neurology, College of Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, United States of America.
authors.forename: Wayne K
authors.initials: WK
authors.lastname: Goodman
authors.affiliation: Department of Psychiatry, College of Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Herbert E
authors.initials: HE
authors.lastname: Ward
mesh_terms: D046690:Deep Brain Stimulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D011788:Quality of Life