Universität zu Köln

Huys, Daniel, Kohl, Sina, Baldermann, Juan Carlos, Timmermann, Lars, Sturm, Volker, Visser-Vandewalle, Veerle and Kuhn, Jens (2019). Open-label trial of anterior limb of internal capsule-nucleus accumbens deep brain stimulation for obsessive-compulsive disorder: insights gained. J. Neurol. Neurosurg. Psychiatry, 90 (7). S. 805 - 813. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-330X

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Abstract

Background For more than 15 years, deep brain stimulation (DBS) has served as a last-resort treatment for severe treatment-resistant obsessive-compulsive disorder (OCD). Methods From 2010 to 2016, 20 patients with OCD (10 men/10 women) were included in a single-centre trial with a naturalistic open-label design over 1 year to evaluate the effects of DBS in the anterior limb of the internal capsule and nucleus accumbens region (ALIC-NAcc) on OCD symptoms, executive functions, and personality traits. Results ALIC-NAcc-DBS significantly decreased OCD symptoms (mean Yale-Brown Obsessive Compulsive Scale reduction 33%, 40% full responders) and improves global functioning without loss of efficacy over 1 year. No significant changes were found in depressive or anxiety symptoms. Our study did not show any effect of ALIC-NAcc-DBS on personality traits or executive functions, and no potential outcome predictors were identified in a post hoc analysis. Other than several individual minor adverse events, ALIC-NAcc-DBS has been shown to be safe, but 35% of patients reported a sudden increase in anxiety and anhedonia after acute cessation of stimulation. Conclusions We conclude that ALIC-NAcc-DBS is a well-tolerated and promising last-resort treatment option for OCD. The cause of variability in the outcome remains unclear, and the aspect of reversibility must be examined critically. The present data from one of the largest samples of patients with OCD treated with DBS thus far support the results of previous studies with smaller samples.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Huys, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kohl, Sina UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldermann, Juan Carlos UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturm, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-137038
DOI:	10.1136/jnnp-2018-318996
Journal or Publication Title:	J. Neurol. Neurosurg. Psychiatry
Volume:	90
Number:	7
Page Range:	S. 805 - 813
Date:	2019
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-330X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OCD Multiple languages Clinical Neurology; Psychiatry; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13703