Deep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives

Maud Tastevin,1 Giorgio Spatola,2,3 Jean Régis,2,3 Christophe Lançon,1 Raphaëlle Richieri1,41Department of Psychiatry, Addictions and Psychiatry for Children, Public Assistance Marseille Hospitals, 13005 Marseille, France; 2Department of Functional and Stereotactic Neu...

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Autores principales:	Tastevin M, Spatola G, Régis J, Lançon C, Richieri R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	deep brain stimulation obsessive compulsive disorder treatment-refractory Yale-Brown Obsessive-Compulsive Scale cortico-striato-thalamo-cortical circuitry Research Domain Criteria Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
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spelling	oai:doaj.org-article:9b4d6c8c47a9451c9898e516609200052021-12-02T08:28:22ZDeep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives1178-2021https://doaj.org/article/9b4d6c8c47a9451c9898e516609200052019-05-01T00:00:00Zhttps://www.dovepress.com/deep-brain-stimulation-in-the-treatment-of-obsessive-compulsive-disord-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Maud Tastevin,1 Giorgio Spatola,2,3 Jean Régis,2,3 Christophe Lançon,1 Raphaëlle Richieri1,41Department of Psychiatry, Addictions and Psychiatry for Children, Public Assistance Marseille Hospitals, 13005 Marseille, France; 2Department of Functional and Stereotactic Neurosurgery, Public Assistance Marseille Hospitals, 13005 Marseille, France; 3Institut de Neurosciences des Systèmes, Aix Marseille University, Inserm UMR1106, France; 4Faculté des Sciences de Saint Jérôme, Aix Marseille University, Institut Fresnel - UMR 7249, Marseille, FranceAbstract: Deep brain stimulation (DBS) is a neuro-psychosurgical technique widely accepted in movement disorders, such as Parkinson’s disease. Since 1999, DBS has been explored for severe, chronic and treatment-refractory psychiatric diseases. Our review focuses on DBS in obsessive-compulsive disorder (OCD), considered as a last treatment resort by most of learned societies in psychiatry. Two main stimulation areas have been studied: the striatal region and the subthalamic nucleus. But, most of the trials are open-labeled, and the rare controlled ones have failed to highlight the most efficient target. The recent perspectives are otherwise encouraging. Indeed, clinicians are currently considering other promising targets. A case series of 2 patients reported a decrease in OCD symptoms after DBS in the medial forebrain bundle and an open-label study is exploring bilateral habenula stimulation. New response criteria are also investigating such as quality of life, or subjective and lived-experience. Moreover, first papers about cost-effectiveness which is an important criterion in decision making, have been published. The effectiveness of tractography-assisted DBS or micro-assisted DBS is studying with the aim to improve targeting precision. In addition, a trial involving rechargeable pacemakers is undergoing because this mechanism could be efficient and have a positive impact on cost-effectiveness. A recent trial has discussed the possibility of using combined cognitive behavioral therapy (CBT) and DBS as an augmentation strategy. Finally, based on RDoc Research, the latest hypotheses about the understanding of cortico-striato-thalamo-cortical circuits could offer new directions including clinical predictors and biomarkers to perform adaptive closed-loop systems in the next future.Keywords: deep brain stimulation, obsessive compulsive disorder, treatment-refractory, Yale-Brown obsessive-compulsive scale, cortico-striato-thalamo-cortical circuitry, Research Domain CriteriaTastevin MSpatola GRégis JLançon CRichieri RDove Medical Pressarticledeep brain stimulationobsessive compulsive disordertreatment-refractoryYale-Brown Obsessive-Compulsive Scalecortico-striato-thalamo-cortical circuitryResearch Domain CriteriaNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1259-1272 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	deep brain stimulation obsessive compulsive disorder treatment-refractory Yale-Brown Obsessive-Compulsive Scale cortico-striato-thalamo-cortical circuitry Research Domain Criteria Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	deep brain stimulation obsessive compulsive disorder treatment-refractory Yale-Brown Obsessive-Compulsive Scale cortico-striato-thalamo-cortical circuitry Research Domain Criteria Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Tastevin M Spatola G Régis J Lançon C Richieri R Deep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives
description	Maud Tastevin,1 Giorgio Spatola,2,3 Jean Régis,2,3 Christophe Lançon,1 Raphaëlle Richieri1,41Department of Psychiatry, Addictions and Psychiatry for Children, Public Assistance Marseille Hospitals, 13005 Marseille, France; 2Department of Functional and Stereotactic Neurosurgery, Public Assistance Marseille Hospitals, 13005 Marseille, France; 3Institut de Neurosciences des Systèmes, Aix Marseille University, Inserm UMR1106, France; 4Faculté des Sciences de Saint Jérôme, Aix Marseille University, Institut Fresnel - UMR 7249, Marseille, FranceAbstract: Deep brain stimulation (DBS) is a neuro-psychosurgical technique widely accepted in movement disorders, such as Parkinson’s disease. Since 1999, DBS has been explored for severe, chronic and treatment-refractory psychiatric diseases. Our review focuses on DBS in obsessive-compulsive disorder (OCD), considered as a last treatment resort by most of learned societies in psychiatry. Two main stimulation areas have been studied: the striatal region and the subthalamic nucleus. But, most of the trials are open-labeled, and the rare controlled ones have failed to highlight the most efficient target. The recent perspectives are otherwise encouraging. Indeed, clinicians are currently considering other promising targets. A case series of 2 patients reported a decrease in OCD symptoms after DBS in the medial forebrain bundle and an open-label study is exploring bilateral habenula stimulation. New response criteria are also investigating such as quality of life, or subjective and lived-experience. Moreover, first papers about cost-effectiveness which is an important criterion in decision making, have been published. The effectiveness of tractography-assisted DBS or micro-assisted DBS is studying with the aim to improve targeting precision. In addition, a trial involving rechargeable pacemakers is undergoing because this mechanism could be efficient and have a positive impact on cost-effectiveness. A recent trial has discussed the possibility of using combined cognitive behavioral therapy (CBT) and DBS as an augmentation strategy. Finally, based on RDoc Research, the latest hypotheses about the understanding of cortico-striato-thalamo-cortical circuits could offer new directions including clinical predictors and biomarkers to perform adaptive closed-loop systems in the next future.Keywords: deep brain stimulation, obsessive compulsive disorder, treatment-refractory, Yale-Brown obsessive-compulsive scale, cortico-striato-thalamo-cortical circuitry, Research Domain Criteria
format	article
author	Tastevin M Spatola G Régis J Lançon C Richieri R
author_facet	Tastevin M Spatola G Régis J Lançon C Richieri R
author_sort	Tastevin M
title	Deep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives
title_short	Deep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives
title_full	Deep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives
title_fullStr	Deep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives
title_full_unstemmed	Deep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives
title_sort	deep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/9b4d6c8c47a9451c9898e51660920005
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Deep brain stimulation in the treatment of obsessive-compulsive disorder: current perspectives

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