Publication year: 2012
Source:World Neurosurgery
Patric Blomstedt, Rickard L. Sjöberg, Maja Hansson, Owe Bodlund, Marwan I. Hariz
Objective Deep brain stimulation (DBS) has emerged as a treatment for severe cases of therapy refractory obsessive compulsive disorder (OCD) and promising results have been reported. The literature might however be somewhat unclear, considering the different targets used, and due to repeated inclusion of individual patients in multiple publications. The aim of the present paper was to review the literature on DBS for OCD. Method The modern literature concerning studies conducted on DBS in the treatment of OCD was reviewed. Results The results of DBS in OCD have been presented in 25 papers with 130 patients, of which however only 90 constituted of individual patients. Five of these papers included at least five individual patients not presented elsewhere. Sixty-eight of these patients were implanted in the region of the internal capsule/ventral striatum, including the nucleus Accumbens. The target in this region has varied between groups and over time, but the latest results from bilateral procedures in this area have demonstrated a 50 % reduction of OCD-scores, depression and anxiety. The Subthalamic nucleus has been suggested as an alternative target. Even if beneficial effects have been demonstrated the efficacy of this procedure cannot be decided, since only results after 3 months of active stimulation have been presented so far. Conclusion DBS is a promising treatment for therapy-refractory OCD, but the published experience is limited and the method is at present an experimental therapy.
Júlio Leonardo B. Pereira
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