Deep brain stimulation of the nucleus accumbens for treatment-refractory obsessive-compulsive disorder.
Damiaan Denys,Mariska Mantione,Martijn Figee,Pepijn van den Munckhof,Frank Koerselman,Herman G.M. Westenberg,Andries Bosch,Rick Schuurman +7 more
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In this paper, the authors evaluated the effect of bilateral deep brain stimulation of the nucleus accumbens on treatment-resistant treatment of treatment-refractory OCD using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).Abstract:
Context Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that affects 2% of the general population. Even when the best available treatments are applied, approximately 10% of patients remain severely afflicted and run a long-term deteriorating course of OCD. Objective To determine whether bilateral deep brain stimulation of the nucleus accumbens is an effective and safe treatment for treatment-refractory OCD. Design The study consisted of an open 8-month treatment phase, followed by a double-blind crossover phase with randomly assigned 2-week periods of active or sham stimulation, ending with an open 12-month maintenance phase. Setting Academic research. Patients Sixteen patients (age range, 18-65 years) with OCD according to DSM-IV criteria meeting stringent criteria for refractoriness to treatment were included in the study. Interventions Treatment with bilateral deep brain stimulation of the nucleus accumbens. Main Outcome Measures Primary efficacy was assessed by score change from baseline on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Responders were defined by a score decrease of at least 35% on the Y-BOCS. Results In the open phase, the mean (SD) Y-BOCS score decreased by 46%, from 33.7 (3.6) at baseline to 18.0 (11.4) after 8 months ( P P = .004). Depression and anxiety decreased significantly. Except for mild forgetfulness and word-finding problems, no permanent adverse events were reported. Conclusion Bilateral deep brain stimulation of the nucleus accumbens may be an effective and safe treatment for treatment-refractory OCD. Clinical Trial Registration isrctn.org Identifier:ISRCTN23255677read more
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Deep brain stimulation.
TL;DR: Deep brain stimulation is clinically effective in improving motor function of essential tremor, Parkinson's disease and primary dystonia and in relieving obsessive-compulsive disorder.
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Deep brain stimulation: current challenges and future directions
Andres M. Lozano,Nir Lipsman,Hagai Bergman,Peter Brown,Stephan Chabardes,Jin Woo Chang,Keith Matthews,Cameron C. McIntyre,Thomas E. Schlaepfer,Michael Schulder,Yasin Temel,Jens Volkmann,Joachim K. Krauss +12 more
TL;DR: How DBS has facilitated advances in the authors' understanding of how circuit malfunction can lead to brain disorders is considered and the key unmet challenges and future directions in the DBS field are outlined.
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The Nucleus Accumbens: A Comprehensive Review
TL;DR: The NAc is a fascinating and potentially rich target for stereotactic neuros surgical intervention, and analysis of existing information regarding all aspects of this structure should help potentiate therapeutic advances and reduce complications from future studies of neurosurgical intervention in this region for a variety of disorders.
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Probing and regulating dysfunctional circuits using deep brain stimulation.
Andres M. Lozano,Nir Lipsman +1 more
TL;DR: Recent advances in the DBS field are reviewed and potential future directions in targeted intracranial neuromodulation are discussed, making it a powerful tool to study the human brain.
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Resting-state networks link invasive and noninvasive brain stimulation across diverse psychiatric and neurological diseases.
Michael D. Fox,Randy L. Buckner,Hesheng Liu,M. Mallar Chakravarty,M. Mallar Chakravarty,Andres M. Lozano,Andres M. Lozano,Alvaro Pascual-Leone +7 more
TL;DR: It is found that although different types of brain stimulation are applied in different locations, targets used to treat the same disease most often are nodes within the same brain network as defined by resting-state functional-connectivity MRI.
References
More filters
Journal ArticleDOI
A rating scale for depression
TL;DR: The present scale has been devised for use only on patients already diagnosed as suffering from affective disorder of depressive type, used for quantifying the results of an interview, and its value depends entirely on the skill of the interviewer in eliciting the necessary information.
Journal ArticleDOI
The Yale-Brown Obsessive Compulsive Scale: I. Development, Use, and Reliability
Wayne K. Goodman,Lawrence H. Price,Steven A. Rasmussen,Carolyn M. Mazure,Roberta L. Fleischmann,Candy L. Hill,George R. Heninger,Dennis S. Charney +7 more
TL;DR: In a study involving four raters and 40 patients with obsessive-compulsive disorder at various stages of treatment, interrater reliability for the total Yale-Brown Scale score and each of the 10 individual items was excellent, with high degree of internal consistency among all item scores demonstrated with Cronbach's alpha coefficient.
Book
Structured clinical interview for DSM-IV axis I disorders : SCID-I : clinical version : scoresheet
TL;DR: The SCID-I is an efficient, user-friendly instrument that covers those DSM-IV diagnoses most commonly seen by clinicians and includes the diagnostic criteria for these disorders with corresponding interview questions and provides extensive documentation of the diagnostic process.
Journal ArticleDOI
The Yale-Brown Obsessive Compulsive Scale: II. Validity
Wayne K. Goodman,Lawrence H. Price,Steven A. Rasmussen,Carolyn M. Mazure,Pedro L. Delgado,George R. Heninger,Dennis S. Charney +6 more
TL;DR: Results from a previously reported placebo-controlled trial of fluvoxamine in 42 patients with obsessive-compulsive disorder showed that the Yale- Brown Scale was sensitive to drug-induced changes and that reductions in Yale-Brown Scale scores specifically reflected improvement in obsessive- compulsive disorder symptoms.
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