Deep Brain Stimulation Reduces Conflict-Related Theta and Error-Related Negativity in Patients With Obsessive-Compulsive Disorder

Sildatke, Elena, Gruendler, Theo O. J., Ullsperger, Markus, Dembek, Till A., Baldermann, Juan Carlos, Kohl, Sina, Visser-Vandewalle, Veerle, Huys, Daniel ORCID: 0000-0002-9124-4128, Kuhn, Jens and Schueller, Thomas . Deep Brain Stimulation Reduces Conflict-Related Theta and Error-Related Negativity in Patients With Obsessive-Compulsive Disorder. Neuromodulation. HOBOKEN: WILEY. ISSN 1525-1403

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DOI:10.1111/ner.13493

Abstract

Objectives Obsessive-compulsive disorder (OCD) is a psychiatric disorder with alterations of cortico-striato-thalamo-cortical loops and impaired performance monitoring. Electrophysiological markers such as conflict-related medial frontal theta (MFT) and error-related negativity (ERN) may be altered by clinically effective deep brain stimulation (DBS) of the anterior limb of the internal capsule and nucleus accumbens (ALIC/NAc). We hypothesized that ALIC/NAc DBS modulates electrophysiological performance monitoring markers. Materials and Methods Fifteen patients (six male) with otherwise treatment-refractory OCD receiving ALIC/NAc DBS performed a flanker task with EEG recordings at three sessions: presurgery, and at follow-up with DBS on and off. We examined MFT, ERN, and task performance. Furthermore, we investigated interrelations with clinical efficacy and the explored the influence of the location of individual stimulation volumes on EEG modulations. Results MFT and ERN were significantly attenuated by DBS with differences most pronounced between presurgery and DBS-on states. Also, we observed reaction time slowing for erroneous responses during DBS-off. Larger presurgery ERN amplitudes were associated with decreased clinical efficacy. Exploratory anatomical analyses suggested that stimulation volumes encompassing the NAc were associated with MFT modulation, whereas ALIC stimulation was associated with modulation of the ERN and clinical efficacy. Conclusion ALIC/NAc DBS diminished MFT and ERN, demonstrating modulation of the medial frontal performance monitoring system in OCD. Furthermore, our findings encourage further studies to explore the ERN as a potential predictor for clinical efficacy.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Sildatke, Elena	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Gruendler, Theo O. J.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Ullsperger, Markus	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Dembek, Till A.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Baldermann, Juan Carlos	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Kohl, Sina	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Visser-Vandewalle, Veerle	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Huys, Daniel	UNSPECIFIED	orcid.org/0000-0002-9124-4128	UNSPECIFIED
Kuhn, Jens	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Schueller, Thomas	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED