Deep Brain Stimulation for Obsessive-Compulsive Disorder
Obsessive-compulsive disorderr, or OCD, is a challenge to treat. Many medications used to treat this mental problem have significant side effects, and psychological therapies take time to work - when they even have an effect. Not surprisingly, there’s a great deal of interest in new treatments for OCD. One of the more promising therapies researchers are investigating is deep brain stimulation for obsessive-compulsive disorder. What is this treatment and does it really work?
What is Deep Brain Stimulation?
Deep brain stimulation isn’t a treatment designed specifically for OCD. It has been seen to be beneficial for treating people with Parkinson’s disease and is approved by the FDA for this purpose. Because of modest success in treating cases of Parkinson’s that hadn’t responded to medications, scientists are investigating its role in treating other disorders including Tourette syndrome, major depression, phantom limb pain, and, of course, obsessive-compulsive disorder.
How Does Deep Brain Stimulation Work?
Deep brain stimulation for obsessive-compulsive disorder involves surgically placing removable electrodes into certain areas of the brain. Implantable neurostimulators are placed in the chest, and wires are inserted under the skin and lead to the brain. Once placed, these electrodes are used to stimulate discrete brain areas. The degree of deep stimulation can be adjusted up or down based on the patient’s clinical response. One of the biggest advantages of this form of therapy for OCD is it is completely reversible and isn’t extremely risky.
Most people who receive deep brain stimulation tolerate it well, although there are reports of some individuals experiencing psychiatric symptoms including hallucinations, memory problems, and depression after undergoing the procedure. Some of these symptoms are temporary and are related to transient brain swelling. Of course, any type of surgical procedure involves some risks including the risk of infection or bleeding.
Does Deep Brain Stimulation Help with Obsessive-Compulsive Disorder?
According to research published in the Cleveland Clinic Journal of Medicine, stimulation of the portion of the brain called the ventral striatum resulted in improvement in the symptoms of obsessive-compulsive disorder. Another small study published in the New England Journal of Medicine also looks promising. Eighteen patients with obsessive-compulsive disorder who didn’t respond to conventional treatment underwent deep brain stimulation to the subthalamic nucleus of the brain. Most experienced a significant decrease in OCD symptoms and an improved quality of life.
There’s another ongoing study looking at deep brain stimulation for obsessive-compulsive disorder at Brown University. So far, the results have been positive with anywhere from 25% to 50% of OCD patients who underwent deep brain stimulation showing improvement.
Despite these encouraging results, deep brain stimulation for OCD is still in its infancy and isn’t approved by the FDA as a treatment for this disorder. At this point, no one even knows exactly how or why it works.
Deep Brain Stimulation for Obsessive-Compulsive Disorder: The Bottom Line?
This procedure shows promise for treating obsessive-compulsive disorder, but more research is needed before it can be used on a widespread basis. Stay tuned for future developments in the use of deep brain stimulation to treat people with OCD.
Cleve Clin J Med. 2010 Jul;77 Suppl 3:S77-80.
New England Journal of Medicine. 2008. j359: 2121-2134.
John Hopkins Medicine website. “Promising New Treatments for Severe OCD”