Deep brain stimulation and treatment-resistant obsessive-compulsive disorder: A systematic review

Vázquez‐Bourgon, Javier; Martino, Juan; Peña, María Sierra; Ceberio, Jon Infante; Martínez, Miguel S. Vallés; Ocon, Roberto; Menchón, José M.; Facorro, Benedicto Crespo; Vázquez-Barquero, Alfonso

doi:10.1016/j.rpsmen.2017.05.015

Cited by 8 publications

(5 citation statements)

References 63 publications

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“…For example, for defining the neural correlates of tics, the involuntary movements and/or sounds, to be used for responsive stimulation in patients with Tourette's syndrome (Shute et al, 2016;Molina et al, 2018) and for bidirectional neurostimulation via fully implantable neural interfaces in Parkinson's disease (Swann et al, 2018). The applicability of our proposed approach extends as well toward the fields of developmental disorders (e.g., autism) (Sturm et al, 2013;Sinha et al, 2015), psychiatry (e.g., major depression (Coenen et al, 2018) and obsessive-compulsive disorder (Vázquez-Bourgon et al, 2017), addiction (Wang et al, 2018), eating disorders and obesity (Val-Laillet et al, 2015;Oterdoom et al, 2018), where neurostimulation can be potentially utilized to provide treatment and improve patients' quality of life.…”

Section: Discussion and Concluding Remarksmentioning

confidence: 92%

Deep Learning Provides Exceptional Accuracy to ECoG-Based Functional Language Mapping for Epilepsy Surgery

et al. 2020

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The success of surgical resection in epilepsy patients depends on preserving functionally critical brain regions, while removing pathological tissues. Being the gold standard, electro-cortical stimulation mapping (ESM) helps surgeons in localizing the function of eloquent cortex through electrical stimulation of electrodes placed directly on the cortical brain surface. Due to the potential hazards of ESM, including increased risk of provoked seizures, electrocorticography based functional mapping (ECoG-FM) was introduced as a safer alternative approach. However, ECoG-FM has a low success rate when compared to the ESM. In this study, we address this critical limitation by developing a new algorithm based on deep learning for ECoG-FM and thereby we achieve an accuracy comparable to ESM in identifying eloquent language cortex. In our experiments, with 11 epilepsy patients who underwent presurgical evaluation (through deep learning-based signal analysis on 637 electrodes), our proposed algorithm obtained an accuracy of 83.05% in identifying language regions, an exceptional 23% improvement with respect to the conventional ECoG-FM analysis (∼60%). Our findings have demonstrated, for the first time, that deep learning powered ECoG-FM can serve as a stand-alone modality and avoid likely hazards of the ESM in epilepsy surgery. Hence, reducing the potential for developing post-surgical morbidity in the language function.

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Section: Discussion and Concluding Remarksmentioning

confidence: 92%

Deep Learning Provides Exceptional Accuracy to ECoG-Based Functional Language Mapping for Epilepsy Surgery

et al. 2020

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“…For example, for defining the neural correlates of tics to be used for responsive stimulation in patients with Tourette's syndrome 42,43 and for bidirectional neurostimulation via fully implantable neural interfaces in Parkinson's disease 44 . The applicability of our proposed approach extends as well towards the fields of developmental disorders (e.g., autism) 45,46 , psychiatry (e.g., major depression 47 and obsessive-compulsive disorder (OCD) 48 , addiction 49 , eating disorders and obesity 50,51 , where neurostimulation can be potentially utilized to provide treatment and improve patients' quality of life.…”

Section: Discussion and Concluding Remarksmentioning

confidence: 92%

Deep Learning provides exceptional accuracy to ECoG-based Functional Language Mapping for epilepsy surgery

RaviPrakash

Korostenskaja

Castillo

et al. 2018

Preprint

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AbstractThe success of surgical resection in epilepsy patients depends on preserving functionally critical brain regions, while removing pathological tissues. Being the gold standard, electro-cortical stimulation mapping (ESM) helps surgeons in localizing the function of eloquent cortex through electrical stimulation of electrodes placed directly on the cortical brain surface. Due to the potential hazards of ESM, including increased risk of provoked seizures, electrocorticography based functional mapping (ECOG-FM) was introduced as a safer alternative approach. However, ECoG-FM has a low success rate when compared to the ESM. In this study, we address this critical limitation by developing a new algorithm based on deep learning for ECoG-FM and thereby we achieve an accuracy comparable to ESM in identifying eloquent language cortex. In our experiments, with 11 epilepsy patients who underwent presurgical evaluation (through deep learning-based signal analysis on 637 electrodes), our proposed algorithm made an exceptional 23% improvement with respect to the conventional ECoG-FM analysis (∼60%). We obtained the state-of-the-art accuracy of 83.05% in identifying language regions, which has never been achieved before. Our findings have demonstrated, for the first time, that deep learning powered ECoG-FM can serve as a stand-alone modality and avoid likely hazards of the ESM in epilepsy surgery. Hence, reducing the potential for developing post-surgical morbidity in the language function.

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“…Deep brain stimulation (DBS) has emerged as an effective therapy for patients with severe treatment refractory obsessive-compulsive disorder (OCD) [1,2]. Deep brain stimulation was initially proposed as an alternative to capsulotomies in 1999, which had been the only surgical option for patients with treatment-resistant OCD for several decades [3].…”

Section: Brief Historymentioning

confidence: 99%

“…We searched the literature using PubMed and Google Scholar for all studies documenting the effectiveness of DBS for individuals with OCD, as well as reference sections from recent reviews of DBS for OCD [1,2]. We excluded single case studies in the present review, but due to the relatively few reports on DBS for OCD, case series were included.…”

Section: Efficacy and Safety Of Deep Brain Stimulationmentioning

confidence: 99%

Improving long term patient outcomes from deep brain stimulation for treatment-refractory obsessive-compulsive disorder

Guzick

Hunt

Bijanki

et al. 2019

Expert Review of Neurotherapeutics

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Introduction: Deep brain stimulation (DBS) has emerged as an effective treatment for patients with severe treatment-refractory obsessive-compulsive disorder (OCD). Over the past two decades, several clinical trials with multiple years of follow-up have shown that DBS offers long-term symptom relief for individuals with severe OCD, though a portion of patients do not achieve an adequate response. Areas covered: This review sought to summarize the literature on the efficacy and long-term effectiveness of DBS for OCD, and to identify strategies that have the potential to improve treatment outcomes. Expert opinion: Although this literature is just emerging, a small number of DBS enhancement strategies have shown promising initial results. More posterior targets along the striatal axis and at the bed nucleus of the stria terminalis appear to offer greater symptom relief than more anterior targets. Research is also beginning to demonstrate the feasibility of maximizing treatment outcomes with target selection based on neural activation patterns during symptom provocation and clinical presentation. Finally, integrating DBS with post-surgery exposure and response prevention therapy appears to be another promising approach. Definitive conclusions about these strategies are limited by a low number of studies with small sample sizes that will require multisite replication.

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Deep brain stimulation and treatment-resistant obsessive-compulsive disorder: A systematic review

Cited by 8 publications

References 63 publications

Deep Learning Provides Exceptional Accuracy to ECoG-Based Functional Language Mapping for Epilepsy Surgery

Deep Learning Provides Exceptional Accuracy to ECoG-Based Functional Language Mapping for Epilepsy Surgery

Deep Learning provides exceptional accuracy to ECoG-based Functional Language Mapping for epilepsy surgery

Improving long term patient outcomes from deep brain stimulation for treatment-refractory obsessive-compulsive disorder

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