Deep brain stimulation for OCD performed for first time in St. Louis – St …

Posted: Friday, July 24, 2015 10:13 am

Deep brain stimulation for OCD performed for first time in St. Louis

For the first time in the region, neurosurgeons at Saint Louis University Hospital are using deep brain stimulation (DBS) to treat obsessive compulsive disorder (OCD), an anxiety issue affecting two million Americans.

SLUCare physicians Richard Bucholz, MD, Pratap Chand, MD, and the operating room team at SLU Hospital performed the first case for OCD in St. Louis July 6.

In deep brain stimulation, leads are surgically implanted into the brain through dime sized incisions and connected to a neurostimulator placed in the chest or abdomen. Those leads bring electric current from the neurostimulator into brain tissue at carefully mapped locations.

Thought of most often for use in treating patients with movement disorders like Parkinson’s disease, DBS is approved by the U.S. Food and Drug Administration (FDA) for treating OCD. In 2014, a group of experts published a clinical guideline in the journal Neurosurgery recommending deep brain stimulation for cases of obsessive compulsive disorder that do not respond to medication.

“Psychiatric disease is a true condition and OCD can be terribly debilitating,” said Dr. Bucholz, vice chairman in the department of neurosurgery and K. R. Smith Endowed Chair in Neurosurgery at Saint Louis University. “This procedure helps these people overcome their compulsions and rejoin society.”

OCD is an anxiety disorder in which a person has unreasonable thoughts or worries, often managed through ritualized activities to reduce the anxiety.

“A tremor from Parkinson’s is an excess motor activity in the brain. Similarly, compulsions from OCD are excess thoughts in the brain,” said Dr. Bucholz. “Suppressing those thoughts through DBS is very similar to what we have done for years in treating movement disorders.”

The technology necessary to place these devices in the brain was pioneered and invented at Saint Louis University Hospital. Many centers performing deep brain stimulation use a surgical system called StealthStation, an image guided system allowing surgeons to insert electrodes into the brain with a high degree of precision. StealthStation was developed by Dr. Bucholz at SLU and is now used in operating rooms all over the world.

“This is a culmination of thirty years of work,” said Dr. Bucholz. “It has never been a more exciting time for patients and neurosurgery.”


Friday, July 24, 2015 10:13 am.