Article
Modulation of oscillatory neuronal activity by high frequency deep brain stimulation in the bed nucleus of the stria terminalis/internal capsule in obsessive compulsive disorder
Modulation der oszillatorischen neuronalen Aktivität durch hochfrequente tiefe Hirnstimulation im Bed nucleus der Stria terminalis/internen Kapsel bei Zwangsstörung
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Published: | May 8, 2019 |
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Objective: Deep brain stimulation (DBS) of the bed nucleus of the stria terminalis/internal capsule (BNST/IC) is successfully used for treatment of patients with obsessive compulsive disorder (OCD). The mechanisms of action of DBS in OCD remain unclear. We here investigate the effect of stimulation of the BNST/IC on oscillatory neuronal activity in patients with OCD implanted with DBS electrodes.
Methods: We recorded the oscillatory activity of local field potentials (LFPs) from DBS electrodes (contact +0/-3; bipolar configuration; both hemispheres) from the BNST/IC parallel with frontal cortical electroencephalogram (EEG) one day after DBS surgery in four patients with OCD. BNST/IC and frontal cortical EEG oscillatory activities were analysed before stimulation as baseline and after three periods of stimulation with different voltage amplitudes (1V, 2V and 3.5V) at 130Hz.
Results: Overall, high frequency DBS suppressed theta (4–8Hz) and increased beta (12–30Hz) LFP oscillatory power both in BNST/IC and in the frontal cortex (P<0.01). Stimulation increased the percentage of alpha band (8–12Hz) LFP oscillatory power differently on the left (2V and 3.5V; P<0.05) and the right side (1V and 2V; P<0.01) without changes in the frontal cortex. Further, after stimulation the percentage of gamma band (30–100Hz) LFP oscillatory power in the left BNST/IC was increased with 1V (P<0.05) and 2V (P<0.01), and in the frontal cortex with 1V, 2V and 3.5V (P<0.01).
Conclusion: Our findings indicate that stimulation of the BNST/IC in OCD modulates oscillatory activity in brain regions that are thought to be involved in the pathomechanisms of OCD.