- 作者：Wolfgang Huff ; Doris Lenartz ; Michael Schormann ; Sun-Hee Lee ; Jens Kuhn ; Anastosious Koulousakis ; Juergen Mai ; Joerg Daumann ; Mohammad Maarouf ; Joachim Klosterkö ; tter ; Volker Sturm
- 关键词：Deep brain stimulation ; Obsessive-compulsive disorder ; Nucleus accumbens
- 刊名：Clinical Neurology and Neurosurgery
- 出版年：2010
- 出版时间：February 2010
- 年：2010
- 卷：112
- 期：2
- 页码：137-143
- 全文大小：190 K
ObjectiveTo investigate the effects of unilateral deep brain stimulation (DBS) in the right nucleus accumbens in patients with obsessive-compulsive disorder (OCD). Predominantly bilateral stimulation of the anterior limb of the internal capsule was utilized.Methods
The study was designed as a double-blind sham-controlled crossover study. Patients received 3 months of deep brain stimulation followed by 3 months of sham stimulation, or vice versa. Subsequently, stimulation was continued unblinded for all patients. The primary outcome measure was the severity level of OCD, measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Secondary outcome measures were depressive symptoms, anxiety, psychological symptom severity, global functioning, quality of life, and cognitive function.
Results
The mean Y-BOCS scores decreased significantly from 32.2 (±4.0) at baseline to 25.4 (±6.7) after 12 months (p = 0.012). Five out of ten patients showed a decrease of more than 25 % , indicating at least a partial response. One patient showed a decrease in Y-BOCS severity greater than 35 % . Similarly, depression, global functioning and quality of life improved within one year. In contrast, anxiety, global symptom severity and cognitive function showed no significant changes. In general, DBS was well-tolerated.
Conclusions
DBS of the unilateral right nucleus accumbens showed encouraging results in patients with treatment-resistant OCD. Five out of ten patients reached at least a partial response after the first year.