Deep Brain Stimulation Effective for Treatment-Resistant OCD

An open study of 70 consecutive patients treated with deep brain stimulation for refractory obsessive-compulsive disorder (OCD) confirms the treatment’s effectiveness and safety in a clinical setting, researchers concluded in a study published online in The American Journal of Psychiatry.

“Deep brain stimulation is an effective treatment option for patients with refractory obsessive-compulsive disorder. However, clinical experience with deep brain stimulation for obsessive-compulsive disorder remains limited,” researchers wrote, explaining the impetus for their study.

The 70 patients included in the analysis received bilateral deep brain stimulation of the ventral anterior limb of the internal capsule between April 2005 and October 2017. The study followed each patient for 12 months.

OCD Linked to Educational Underachievement

Between baseline and 12-month follow-up, participants’ average scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HAM-D) showed significant drops: 40% on the Y-BOCS, 55% on the HAM-A, and 54% on the HAM-D, according to the study.

 

At the 12-month follow-up, 52% of patients were categorized as responders, with a 35% or greater Y-BOCS score decrease from baseline, researchers reported. Another 17% of patients had their Y-BOCS score decrease between 25% and 34% and were considered partial responders. Meanwhile, 31% of patients were categorized as nonresponders because their Y-BOCS score decreased by less than 25%.

Common side effects included transient symptoms of hypomania, agitation, impulsivity, and sleeping disorders, according to the study.

—Jolynn Tumolo

References

Denys D, Graat I, Mocking R, et al. Efficacy of deep brain stimulation of the ventral anterior limb of the internal capsule for refractory obsessive-compulsive disorder: a clinical cohort of 70 patients. The American Journal of Psychiatry. 2020 January 7;[Epub ahead of print].

Patients with treatment-resistant OCD found to improve after deep brain stimulation. Psychiatric News Alert. January 7, 2020.