Nav: Home

Deep brain stimulation sites for OCD target distinct symptoms

March 07, 2019

Philadelphia, March 7, 2019 -- Deep brain stimulation (DBS) reduces symptoms of severe obsessive-compulsive disorder (OCD) during stimulation of either the ventral capsule (VC) or anteromedial subthalamic nucleus (amSTN), according to a study in Biological Psychiatry. DBS of the regions reduced OCD symptoms to a similar extent, but produced distinct effects on specific symptoms--VC stimulation drastically improved mood, whereas amSTN stimulation in the same patients improved cognitive flexibility. The findings suggest that both regions are effective DBS sites for treating OCD, and that unique brain networks targeted in each region underlie specific symptoms of the disorder.

"This is the first study to compare directly the effects of DBS at two brain sites and has discovered important information about the brain changes in OCD responsible for obsessions and compulsions, depressed mood and cognitive inflexibility and how they might be alleviated," said senior author Eileen Joyce, PhD, The Institute of Neurology, University College London, London, UK.

Using tractography to map the brain regions that were activated by DBS, Dr. Joyce and colleagues found that the different effects of VC and amSTN stimulation appeared to arise from DBS modulation of different brain networks. This finding provides clues as to the roles that those specific brain regions play in OCD, and has potentially important implications for treatment.

"The notion that particular OCD symptom clusters might particularly benefit from stimulation of distinct brain sites raises the possibility of bringing a precision medicine approach to deep brain stimulation," said John Krystal, MD, Editor of Biological Psychiatry. "It also raises the question of whether multiple brain stimulation sites might be required to produce the broadest profile of efficacy," he added. However, in the study, combined DBS of both sites did not produce substantially greater effects than either of the sites individually.

"Deep brain stimulation is an emerging treatment for a small number of individuals with extremely severe OCD whose condition has not responded to multiple courses of currently available treatments such as medication or cognitive behavioral therapy," said Dr. Joyce. Cognitive behavioral therapy is an effective treatment for many people with OCD, but when combined with DBS in the study, it did not further enhance the symptom improvements produced by DBS.

For people with severe OCD whose symptoms don't improve with the standard treatment methods, the findings show that DBS of VC or amSTN are equally effective and have unique effects for specific symptoms.

The study was supported by UK Medical Research Council and The Wellcome Trust.
-end-
Notes for editors
The article is "A Randomized Trial Directly Comparing Ventral Capsule and Anteromedial Subthalamic Nucleus Stimulation in Obsessive-Compulsive Disorder: Clinical and Imaging Evidence for Dissociable Effects," by Himanshu Tyagi, Annemieke M. Apergis-Schoute, Harith Akram, Tom Foltynie, Patricia Limousin, Lynne M. Drummond, Naomi A. Fineberg, Keith Matthews, Marjan Jahanshahi, Trevor W. Robbins, Barbara J. Sahakian, Ludvic Zrinzo, Marwan Hariz, and Eileen M. Joyce (https://doi.org/10.1016/j.biopsych.2019.01.017). It appears in Biological Psychiatry, published by Elsevier.

This study is published open access and can be downloaded by following the DOI link above.

Journalists wishing to interview the authors may contact Eileen Joyce, PhD, at e.joyce@ucl.ac.uk or +44 203 448 3524.

The authors' affiliations and disclosures of financial and conflicts of interests are available in the article.

John H. Krystal, MD, is Chairman of the Department of Psychiatry at the Yale University School of Medicine, Chief of Psychiatry at Yale-New Haven Hospital, and a research psychiatrist at the VA Connecticut Healthcare System. His disclosures of financial and conflicts of interests are available here.

AboutBiological Psychiatry
Biological Psychiatry is the official journal of the Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal publishes both basic and clinical contributions from all disciplines and research areas relevant to the pathophysiology and treatment of major psychiatric disorders.

The journal publishes novel results of original research which represent an important new lead or significant impact on the field, particularly those addressing genetic and environmental risk factors, neural circuitry and neurochemistry, and important new therapeutic approaches. Reviews and commentaries that focus on topics of current research and interest are also encouraged.

Biological Psychiatry is one of the most selective and highly cited journals in the field of psychiatric neuroscience. It is ranked 6th out of 142 Psychiatry titles and 9th out of 261 Neurosciences titles in the Journal Citations Reports® published by Clarivate Analytics. The 2017 Impact Factor score for Biological Psychiatry is 11.982. http://www.sobp.org/journal

About Elsevier
Elsevier is a global information analytics business that helps institutions and professionals advance healthcare, open science and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support and professional education, including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 38,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. http://www.elsevier.com

Media contact
Rhiannon Bugno, Editorial Office
Biological Psychiatry
+1 214 648 0880
Biol.Psych@sobp.org

Elsevier

Related Brain Articles:

Scientists predict the areas of the brain to stimulate transitions between different brain states
Using a computer model of the brain, Gustavo Deco, director of the Center for Brain and Cognition, and Josephine Cruzat, a member of his team, together with a group of international collaborators, have developed an innovative method published in Proceedings of the National Academy of Sciences on Sept.
BRAIN Initiative tool may transform how scientists study brain structure and function
Researchers have developed a high-tech support system that can keep a large mammalian brain from rapidly decomposing in the hours after death, enabling study of certain molecular and cellular functions.
Wiring diagram of the brain provides a clearer picture of brain scan data
In a study published today in the journal BRAIN, neuroscientists led by Michael D.
Blue Brain Project releases first-ever digital 3D brain cell atlas
The Blue Brain Cell Atlas is like ''going from hand-drawn maps to Google Earth'' -- providing previously unavailable information on major cell types, numbers and positions in all 737 brain regions.
Landmark study reveals no benefit to costly and risky brain cooling after brain injury
A landmark study, led by Monash University researchers, has definitively found that the practice of cooling the body and brain in patients who have recently received a severe traumatic brain injury, has no impact on the patient's long-term outcome.
More Brain News and Brain Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...