Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder

Current Behavioral Neuroscience Reports
Maarten van WestenDamiaan Denys

Abstract

Clinical outcome of deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) shows robust effects in terms of a mean Yale-Brown Obsessive-Compulsive Scale (YBOCS) reduction of 47.7 % and a mean response percentage (minimum 35 % YBOCS reduction) of 58.2 %. It appears that most patients regain a normal quality of life (QoL) after DBS. Reviewing the literature of the last 4 years, we argue that the mechanisms of action of DBS are a combination of excitatory and inhibitory as well as local and distal effects. Evidence from DBS animal models converges with human DBS EEG and imaging findings, in that DBS may be effective for OCD by reduction of hyperconnectivity between frontal and striatal areas. This is achieved through reduction of top-down-directed synchrony and reduction of frontal low-frequency oscillations. DBS appears to counteract striatal dysfunction through an increase in striatal dopamine and through improvement of reward processing. DBS affects anxiety levels through reduction of stress hormones and improvement of fear extinction.

References

Apr 3, 2001·Nature Reviews. Neuroscience·F VarelaJ Martinerie
Jul 24, 2002·The International Journal of Neuropsychopharmacology·Stefano PallantiUNKNOWN International Treatment Refractory OCD Consortium
Nov 5, 2002·Lancet·Luc MalletYves Agid
May 24, 2003·Neurosurgery·Bart J NuttinHilde G Demeulemeester
Jan 20, 2004·Journal of Chemical Neuroanatomy·Volker SturmJoachim Klosterkötter
Apr 21, 2004·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Brian Harris KopellAli R Rezai
Jul 22, 2004·Neurosurgical Focus·Erwin B Montgomery
Mar 2, 2005·Biological Psychiatry·James L AbelsonBruno Giordani
May 3, 2006·The Psychiatric Clinics of North America·Damiaan Denys
Jul 21, 2006·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Benjamin D GreenbergSteven A Rasmussen
Aug 21, 2007·Neuroscience and Biobehavioral Reviews·Erwin B Montgomery, John T Gale
Aug 14, 2008·The International Journal of Neuropsychopharmacology·Christian PlewniaDirk Freudenstein
Nov 14, 2008·The New England Journal of Medicine·Luc MalletUNKNOWN STOC Study Group
Sep 18, 2009·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Benjamin D GreenbergSuzanne N Haber
Feb 4, 2010·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Angelo FranziniGiovanni Broggi
Oct 6, 2010·Archives of General Psychiatry·Damiaan DenysRick Schuurman
Oct 19, 2010·Biological Psychiatry·Florence Le JeuneUNKNOWN French Stimulation dans le trouble obsessionnel compulsif (STOC) study group
Jan 29, 2011·Biological Psychiatry·Martijn FigeeDamiaan Denys
Apr 30, 2011·Neuroscience and Biobehavioral Reviews·Noa Albelda, Daphna Joel
May 14, 2011·Journal of Neuroscience Methods·Addy van DijkDamiaan Denys
Apr 4, 2012·World Neurosurgery·Stéphan ChabardèsAlim Louis Benabid
May 16, 2012·Proceedings of the National Academy of Sciences of the United States of America·Jose Rodriguez-RomagueraGregory J Quirk
May 25, 2012·The Journal of Neuroscience : the Official Journal of the Society for Neuroscience·Shaun R PatelEmad N Eskandar
May 26, 2012·Psychiatry and Clinical Neurosciences·Hsin-Chi TsaiShin-Yuan Chen
Jul 13, 2012·Psychiatry Research·Daeyoung RohChan-Hyung Kim
Jan 1, 2011·Translational Psychiatry·M-L WelterUNKNOWN French Stimulation dans Trouble Obsessionnel Compulsif (STOC) Study Group
Jan 22, 2013·Psychoneuroendocrinology·Pelle P de KoningDamiaan Denys
Feb 12, 2013·Behavioural Brain Research·Marianne KlankerDamiaan Denys

❮ Previous
Next ❯

Citations

Aug 19, 2016·Brain Sciences·Adam Basiago, Devin K Binder
Oct 21, 2016·World Neurosurgery·Dirk De RidderPaul Glue
May 10, 2017·British Journal of Neurosurgery·Kejia HuZiv Williams
Aug 4, 2016·Journal of Neurophysiology·Max-Philipp StennerMircea Ariel Schoenfeld
Jan 6, 2018·Current Medicinal Chemistry·Leonardo F FontenelleMurat Yücel
May 6, 2017·Current Medicinal Chemistry·Bernardo Dell'OssoA Carlo Altamura
Oct 11, 2017·European Psychiatry : the Journal of the Association of European Psychiatrists·A RasgonS Frangou
May 20, 2017·International Review of Psychiatry·Ilse GraatDamiaan Denys
Mar 3, 2020·The American Journal of Psychiatry·Wayne K GoodmanSameer A Sheth
Apr 8, 2017·Frontiers in Behavioral Neuroscience·Maria C SchippersTommy Pattij
Sep 22, 2018·International Journal of Molecular Sciences·Han-Fang WuHui-Ching Lin

❮ Previous
Next ❯

Related Concepts

Related Feeds

Anxiety Disorders

Discover the latest research on anxiety disorders including agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder here.