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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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Long-term deep brain stimulation in treatment-resistant obsessive-compulsive disorder – outcome and quality of life at 4–8-year follow-up

Langzeitergebnisse nach Tiefenhirnstimulation bei Zwangserkrankung – klinische Befunde und Lebensqualität nach 4–8 Jahren

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  • presenting/speaker Assel Saryyeva - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Lotta Winter - Medizinische Hochschule Hannover, Psychiatrie, Sozialpsychiatrie und Psychotherapie, Hannover, Deutschland
  • Kerstin Schwabe - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Hans E. Heissler - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Joachim Runge - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Mesbah Alam - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland
  • Ivo Heitland - Medizinische Hochschule Hannover, Psychiatrie, Sozialpsychiatrie und Psychotherapie, Hannover, Deutschland
  • Kai Kahl - Medizinische Hochschule Hannover, Psychiatrie, Sozialpsychiatrie und Psychotherapie, Hannover, Deutschland
  • Joachim K. Krauss - Medizinische Hochschule Hannover, Neurochirurgie, Hannover, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP207

doi: 10.3205/20dgnc493, urn:nbn:de:0183-20dgnc4935

Published: June 26, 2020

© 2020 Saryyeva et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Deep brain stimulation (DBS) has been proposed as a promising treatment for patients with treatment refractory obsessive-compulsive disorder (trOCD). However, the optimal site for stimulation is still a matter of debate, and clinical longterm follow-up observations including data on quality of life are sparse. We here present 6 trOCD patients who underwent DBS with electrodes placed in the bed nucleus of the stria terminalis/anterior limb of the internal capsule (BNST/ALIC), followed for 4-8 years after lead implantation.

Methods: In this prospective observational study, 6 patients (4 men, 2 women) aged 32-51 years suffering from severe to extreme trOCD underwent DBS of the BNST/ALIC. Symptom severity was assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and quality of life using the World Health Organization Quality of Life assessment scale (WHO-QoL BREF). Follow-up was obtained at least for 4 years in all patients.

Results: With chronic DBS for 4 - 8 years 4/6 patients had sustained improvement. Two patients remitted, and two patients responded (defined as > 35% symptom reduction), while the other two patients were considered non-responders on longterm. Quality of life markedly improved in remitters and responders. We did not observe periinterventional side effects or adverse effects of chronic stimulation.

Conclusion: Chronic DBS of BNST/ALIC provides longterm benefit up to 4 - 8 years in trOCD, although not all patients take profit. Quality of life improves in DBS responders, documented by improved QoL scores and, even more important, by regaining of autonomy and improving psychosocial functioning.