scholarly journals Deep brain stimulation modulates directional frontolimbic connectivity in obsessive‐compulsive disorder

2019 ◽  
Author(s):  
Egill Axfjord Fridgeirsson ◽  
Martijn Figee ◽  
Judy Luigjes ◽  
Pepijn van den Munckhof ◽  
P.Richard Schuurman ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Resting State ◽  
Connectivity Analysis ◽  
Imaging Data ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Impact ◽  
Deep Brain

AbstractDeep brain stimulation (DBS) is effective for patients with treatment‐refractory obsessive‐compulsive disorder. DBS of the ventral anterior limb of the internal capsule (vALIC) rapidly improves mood and anxiety with optimal stimulation parameters. To understand these rapid effects of vALIC‐DBS, we studied functional interactions within the affective amygdala circuit. We compared resting state functional magnetic resonance imaging data during chronic stimulation versus one week of stimulation discontinuation in patients, and obtained two resting state scans from matched healthy volunteers to account for test‐retest effects. Imaging data were analyzed using functional connectivity analysis and dynamic causal modelling. Improvement in mood and anxiety following DBS was associated with reduced amygdala‐insula functional connectivity. Directional connectivity analysis revealed that DBS increased the impact of the ventromedial prefrontal cortex on the amygdala, and decreased the impact of the amygdala on the insula. These results highlight the importance of the amygdala circuit in the pathophysiology of OCD, and suggest a neural systems model through which negative mood and anxiety are modulated by vALIC‐DBS for OCD and possibly other psychiatric disorders.One Sentence SummaryDeep brain stimulation improves mood and anxiety in obsessive‐compulsive disorder by altering connectivity between the amygdala, insula and prefrontal cortex.

scholarly journals Deep brain stimulation modulates directional limbic connectivity in obsessive-compulsive disorder

Brain ◽  
2020 ◽  
Vol 143 (5) ◽  
pp. 1603-1612 ◽  
Author(s):  
Egill Axfjord Fridgeirsson ◽  
Martijn Figee ◽  
Judy Luigjes ◽  
Pepijn van den Munckhof ◽  
P Richard Schuurman ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Internal Capsule ◽  
Connectivity Analysis ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Impact ◽  
Deep Brain ◽  
Stimulation Of

Abstract Deep brain stimulation is effective for patients with treatment-refractory obsessive-compulsive disorder. Deep brain stimulation of the ventral anterior limb of the internal capsule rapidly improves mood and anxiety with optimal stimulation parameters. To understand these rapid effects, we studied functional interactions within the affective amygdala circuit. We compared resting state functional MRI data during chronic stimulation versus 1 week of stimulation discontinuation in patients, and obtained two resting state scans from matched healthy volunteers to account for test-retest effects. Imaging data were analysed using functional connectivity analysis and dynamic causal modelling. Improvement in mood and anxiety following deep brain stimulation was associated with reduced amygdala-insula functional connectivity. Directional connectivity analysis revealed that deep brain stimulation increased the impact of the ventromedial prefrontal cortex on the amygdala, and decreased the impact of the amygdala on the insula. These results highlight the importance of the amygdala circuit in the pathophysiology of obsessive-compulsive disorder, and suggest a neural systems model through which negative mood and anxiety are modulated by stimulation of the ventral anterior limb of the internal capsule for obsessive-compulsive disorder and possibly other psychiatric disorders.

Comparative effectiveness of neuroablation and deep brain stimulation for treatment-resistant obsessive-compulsive disorder: a meta-analytic study

2019 ◽  
Vol 90 (4) ◽  
pp. 469-473 ◽  
Author(s):  
Kevin K Kumar ◽  
Geoffrey Appelboom ◽  
Layton Lamsam ◽  
Arthur L Caplan ◽  
Nolan R Williams ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Comparative Effectiveness ◽  
English Language ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Treatment Refractory ◽  
The Impact ◽  
Deep Brain

BackgroundThe safety and efficacy of neuroablation (ABL) and deep brain stimulation (DBS) for treatment refractory obsessive-compulsive disorder (OCD) has not been examined. This study sought to generate a definitive comparative effectiveness model of these therapies.MethodsA EMBASE/PubMed search of English-language, peer-reviewed articles reporting ABL and DBS for OCD was performed in January 2018. Change in quality of life (QOL) was quantified based on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the impact of complications on QOL was assessed. Mean response of Y-BOCS was determined using random-effects, inverse-variance weighted meta-analysis of observational data.FindingsAcross 56 studies, totalling 681 cases (367 ABL; 314 DBS), ABL exhibited greater overall utility than DBS. Pooled ability to reduce Y-BOCS scores was 50.4% (±22.7%) for ABL and was 40.9% (±13.7%) for DBS. Meta-regression revealed no significant change in per cent improvement in Y-BOCS scores over the length of follow-up for either ABL or DBS. Adverse events occurred in 43.6% (±4.2%) of ABL cases and 64.6% (±4.1%) of DBS cases (p<0.001). Complications reduced ABL utility by 72.6% (±4.0%) and DBS utility by 71.7% (±4.3%). ABL utility (0.189±0.03) was superior to DBS (0.167±0.04) (p<0.001).InterpretationOverall, ABL utility was greater than DBS, with ABL showing a greater per cent improvement in Y-BOCS than DBS. These findings help guide success thresholds in future clinical trials for treatment refractory OCD.

scholarly journals Elucidating neural network changes induced by deep brain stimulation for OCD

Brain ◽  
2020 ◽  
Vol 143 (5) ◽  
pp. 1293-1296
Author(s):  
Jens Kuhn ◽  
Juan Carlos Baldermann
Keyword(s):  
Neural Network ◽  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

This scientific commentary refers to ‘Deep brain stimulation modulates directional limbic connectivity in obsessive-compulsive disorder’, by Fridgeirsson etal. (doi:10.1093/brain/awaa100).

Improvements in Anorexia Symptoms After Deep Brain Stimulation for Intractable Obsessive-Compulsive Disorder

2013 ◽  
Vol 73 (9) ◽  
pp. e29-e31 ◽  
Author(s):  
Nicole C.R. McLaughlin ◽  
Elizabeth R. Didie ◽  
Andre G. Machado ◽  
Suzanne N. Haber ◽  
Emad N. Eskandar ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

scholarly journals Connectomic deep brain stimulation for obsessive-compulsive disorder

2021 ◽  
Author(s):  
Juan Carlos Baldermann ◽  
Thomas Schüller ◽  
Sina Kohl ◽  
Valerie Voon ◽  
Ningfei Li ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain
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