Document Detail


Deep brain stimulation for refractory obsessive-compulsive disorder.
MedLine Citation:
PMID:  15737666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Neurosurgery (anterior capsulotomy) has been beneficial to many patients with debilitating, refractory obsessive-compulsive disorder (OCD), but the irreversibility of the procedure is an important limitation to its use. Nondestructive, electrical stimulation (deep brain stimulation; DBS) has proven an effective alternative to ablative surgery for neurological indications, suggesting potential utility in place of capsulotomy for OCD. METHODS: The effects of DBS for OCD were examined in four patients in a short-term, blinded, on-off design and long-term, open follow-up. The patients had incapacitating illness, refractory to standard treatments. Hardware developed for movement disorder treatment was surgically implanted, with leads placed bilaterally in the anterior limbs of their internal capsules. Patients received stimulation in a randomized "on-off" sequence of four 3-week blocks. Ongoing, open stimulation was continued in consenting patients after the controlled trial. RESULTS: Patients tolerated DBS well. Dramatic benefits to mood, anxiety, and OCD symptoms were seen in one patient during blinded study and open, long-term follow-up. A second patient showed moderate benefit during open follow-up. CONCLUSIONS: It appears that DBS has potential value for treating refractory psychiatric disorders, but additional development work is needed before the procedure is utilized outside of carefully controlled research protocols.
Authors:
James L Abelson; George C Curtis; Oren Sagher; Ronald C Albucher; Mark Harrigan; Stephan F Taylor; Brian Martis; Bruno Giordani
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Biological psychiatry     Volume:  57     ISSN:  0006-3223     ISO Abbreviation:  Biol. Psychiatry     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-01     Completed Date:  2005-05-16     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0213264     Medline TA:  Biol Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  510-6     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, University of Michigan, Trauma, Stress and Anxiety Research Group, Ann Arbor, Michigan, USA. jabelson@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain Mapping
Deep Brain Stimulation*
Double-Blind Method
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neuropsychological Tests / statistics & numerical data
Obsessive-Compulsive Disorder / pathology,  physiopathology,  surgery*
Positron-Emission Tomography / methods
Psychiatric Status Rating Scales
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
M01RR00042/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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