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Long-term electrical stimulation of bed nucleus of stria terminalis for obsessive-compulsive disorder

Published online by Cambridge University Press:  23 March 2020

S. Raymaekers*
Affiliation:
Catholic university of Leuven, neurosciences, Leuven, Belgium
V. Kristof
Affiliation:
Catholic university of Leuven, neurosciences, Leuven, Belgium
C. Bervoets
Affiliation:
University psychiatric centre of KU Leuven, pscyhiatry, Leuven, Belgium
L. Gabriëls
Affiliation:
University psychiatric centre of KU Leuven, psychiatry, Leuven, Belgium
L. Luyten
Affiliation:
Catholic university of Leuven, centre for psychology of learning and experimental psychopathology, Leuven, Belgium
K. Demyttenaere
Affiliation:
Catholic university of Leuven, neurosciences, Leuven, Belgium
B. Nuttin
Affiliation:
Catholic university of Leuven, neurosciences, Leuven, Belgium
*
*Corresponding author.

Abstract

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Introduction

We previously reported that deep brain stimulation (DBS) in the anterior limb of the internal capsule/bed nucleus of the stria terminalis (IC/BST) is effective in reducing symptoms in severe treatment-resistant obsessive-compulsive disorder patients.

Objective

To examine the long-term evolution of obsessive compulsive disorder (OCD) symptoms in 24 patients treated with chronic electrical stimulation in IC/BST.

Aims

We aimed to examine the evolution of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and to determine if a number of predictors assessed before surgery are significantly related to this evolution.

Methods

We used a linear mixed model to investigate the evolution of the Y-BOCS in 24 patients. Data was collected in a naturalistic manner. Seven hundred measurements, taken during a total of 1836 follow-up months, are included in this analysis.

Results

Our analysis showed a long-term, sustained effect of electrical stimulation in the IC/BST. After a fast initial decline of OCD symptoms, these symptoms stay relatively stable. In addition, results show a strong ON/OFF effect of stimulation (e.g., due to battery depletion). Beside the ON/OFF effect of stimulation, the surgery itself has no additional effect on OCD symptoms. The Beck Depression Inventory (BDI) at baseline was the only predictor significantly related to the evolution of the Y-BOCS. A higher BDI at baseline seemed to be related to a smaller decrease of the Y-BOCS over time.

Conclusion

Electrical stimulation in the IC/BST has a fast and sustained effect on OCD symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EW459
Copyright
Copyright © European Psychiatric Association 2014
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