Artikel
First results of deep brain stimulation in patients with therapy resistant obsessive compulsive disorder
Erste Ergebnisse der Tiefenhirnstimulation bei therapieresistenten Zwangserkrankungen
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Permanent high frequency stimulation in relevant brain regions can be a new therapeutical option in severe therapy resistant obsessive compulsive disorder. In this indication deep brain stimulation has the same advantages as in movement disorder treatment, which is reversibility at any time. The fact that deep brain stimulation can be inactivated at any time during therapy, provides many advantages for experimental research on the mechanisms of action of different targets in the brain as well as neurobiological circuits.
Methods
We have started together with our department of psychiatry a prospective randomised study to evaluate the effects of deep brain stimulation of the right nucleus accumbens in therapy resistant obsessive compulsive disorder. The study is a randomised double blind therapy study with follow-up-examinations over two years. After evaluation of all inclusion and exclusion criteria, the patients undergo stereotactic implantation of DBS electrodes into the shell of the right nucleus accumbens with connection to a subcutaneously implanted pacemaker.
Results
The effects of deep brain stimulation on symptom predominance and quality of life are measured. Therefore several clinical and psychometric tests at different time points are applied. Additional intraoperative f-MRI is used to show the functional role of the nucleus accumbens in the neurobiological circuit of obsessive compulsive disorder.
Conclusions
So far first results of our ongoing study are very promising. No adverse effects have occurred.