Deep brain stimulation for obsessive-compulsive disorders: long-term analysis of quality of life

Ooms, Pieter; Mantione, Mariska; Figee, Martijn; Schuurman, P. Richard; Munckhof, Pepijn van den; Denys, Damiaan

doi:10.1136/jnnp-2012-302550

Cited by 73 publications

(54 citation statements)

References 28 publications

(28 reference statements)

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“…Ooms et al (2014) found an overall QoL improvement of 90% measured with the brief version of the WHO Qualityof-Life Scale, with improvements of the physical (39.5%), psychological (39.5%), and environmental (16%) domains. QoL improved for both responders and non-responders, suggesting that DBS improves QoL independently of OCD symptom improvement.…”

Section: Introductionmentioning

confidence: 99%

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The application of deep brain stimulation in the treatment of psychiatric disorders

Graat

Figee

Denys

2017

International Review of Psychiatry

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Deep brain stimulation (DBS) is a last-resort treatment for neurological and psychiatric disorders that are refractory to standard treatment. Over the last decades, the progress of DBS in psychiatry has been slower than in neurology, in part owing to the heterogenic symptomatology and complex neuroanatomy of psychiatric disorders. However, for obsessive-compulsive disorder (OCD) DBS is now an accepted treatment. This study first reviews clinical outcomes and mechanisms of DBS for OCD, and then discusses these results in an overview of current and future psychiatric applications, including DBS for mood disorders, Tourette's syndrome, addiction, anorexia nervosa, autism, schizophrenia, and anxiety disorders. In addition, it will focus on novel techniques that may enhance the application of DBS in psychiatry.ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

“…Some studies assessed the impact of DBS on quality-of-life (QoL), showing an increase of QoL Ooms et al 2014). Ooms et al (2014) found an overall QoL improvement of 90% measured with the brief version of the WHO Qualityof-Life Scale, with improvements of the physical (39.5%), psychological (39.5%), and environmental (16%) domains.…”

Section: Introductionmentioning

confidence: 99%

The application of deep brain stimulation in the treatment of psychiatric disorders

Graat

Figee

Denys

2017

International Review of Psychiatry

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“…Although measures of anxiety and depression also worsened following discontinuation, these did not correlate with changes in cortisol excretion. Recently, long-term open data from 16 patients were reported, and significant changes were noted in quality of life measures [95].…”

Section: Deep Brain Stimulationmentioning

confidence: 99%

Neuromodulation for Obsessive–Compulsive Disorder

et al. 2014

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Neuromodulation shows increasing promise in the treatment of psychiatric disorders, particularly obsessivecompulsive disorder (OCD). Development of tools and techniques including deep brain stimulation, transcranial magnetic stimulation, and electroconvulsive therapy may yield additional options for patients who fail to respond to standard treatments. This article reviews the motivation for and use of these treatments in OCD. We begin with a brief description of the illness followed by discussion of the circuit models thought to underlie the disorder. These circuits provide targets for intervention. Basal ganglia and talamocortical pathophysiology, including cortico-striato-thalamo-cortical loops is a focus of this discussion. Neuroimaging findings and historical treatments that led to the use of neuromodulation for OCD are presented. We then present evidence from neuromodulation studies using deep brain stimulation, electroconvulsive therapy, and transcranial magnetic stimulation, with targets including nucleus accumbens, subthalamic nucleus inferior thalamic peduncle, dorsolateral prefrontal cortex, supplementary motor area, and orbitofrontal cortex. Finally, we explore potential future neuromodulation approaches that may further refine and improve treatment.

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“…A recent study in this same group of patients showed that DBS had a positive impact on patients' perception of their quality of life. 46 In the present study, patients rated their cognitive problems as mild side effects, and none requested that stimulation be discontinued. This supports our assumption that the advantages in daily life resulting from the clinical effects of DBS outweigh the reduced cognitive performances.…”

Section: J Psychiatry Neurosci 2015;40(6)mentioning

confidence: 99%

Cognitive effects of deep brain stimulation in patients with obsessive–compulsive disorder

Mantione

Nieman

Figee

et al. 2015

J Psychiatry Neurosci

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IntroductionRecently, several studies have shown that deep brain stimulation (DBS) targeting the anterior limbs of the internal capsule, the ventral striatum, the nucleus accumbens (NAcc), the inferior thalamic peduncle and the subthalamic nucleus is effective in patients with treatment-refractory obsessivecompulsive disorder (OCD). [1][2][3][4][5][6][7][8][9] To date, the results of 7 controlled studies have been published worldwide and have reported that 34 of 63 patients experienced a reduction of at least 35% of OCD symptoms. Consequently, half of the treated patients can be considered responders, indicating that DBS is a promising technique. 10Neuropsychological evaluation in DBS treatment plays a vital role in preoperative neuropsychological screening of potential DBS candidates, in evaluation of outcome and in research.11 The contribution of neuropsychological assessment in research is 2-fold: it may establish the cognitive safety of DBS treatment and it may demonstrate whether DBS alters the underlying cognitive deficits in individuals with OCD. Presently, there is evidence that the clinical effectiveness of DBS in patients with OCD is achieved with stable [3][4][5][6][7][8]12,13 and even improved 14 cognitive functioning. However, since small sample sizes, lack of a control group and the use of a limited range of tests hinder the interpretation of the results, the effect of DBS on cognitive functioning in patients with OCD is still unknown.We conducted a prospective, controlled study investigating the cognitive effects of bilateral DBS targeted at the NAcc 3 weeks and 8 months postoperatively to examine its shortand long-term effects. In addition we investigated whether clinical changes after DBS treatment were associated with changes in cognitive functioning. Changes were compared at 3 time points with a matched control group of patients with treatment-refractory OCD who received conventional therapy. Background: Deep brain stimulation (DBS) is a promising treatment for treatment-refractory obsessive-compulsive disorder (OCD). However, the effects of DBS on cognitive functioning remain unclear. Therefore, we aimed to assess cognitive safety of DBS for treatment-refractory OCD and the association between clinical changes and cognitive functioning. Methods: Patients with treatmentrefractory OCD treated with DBS targeted at the nucleus accumbens (NAcc) were compared with a control group of 14 patients with treatment-refractory OCD treated with care as usual. We assessed cognitive functioning at baseline, 3 weeks postoperatively and following 8 months of DBS. We compared change in clinical symptoms with cognitive changes. Results: There were 16 patients in the DBS group and 14 patients in the control group. Three weeks postoperatively, the DBS group showed a significantly reduced performance on measures of visual organization and verbal fluency and a trend toward reduced performance on measures of visual memory and abstract reasoning. Cognitive functioning was found to be stable on all other measures. Afte...

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Deep brain stimulation for obsessive-compulsive disorders: long-term analysis of quality of life

Abstract: http://isrctn.org identifier: ISRCTN23255677.

Cited by 73 publications

References 28 publications

The application of deep brain stimulation in the treatment of psychiatric disorders

The application of deep brain stimulation in the treatment of psychiatric disorders

Neuromodulation for Obsessive–Compulsive Disorder

Cognitive effects of deep brain stimulation in patients with obsessive–compulsive disorder

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