WEDNESDAY, Oct. 6 (HealthDay News) -- Bilateral deep brain stimulation (DBS) of the nucleus accumbens appears to be a safe and effective treatment for refractory obsessive-compulsive disorder (OCD), according to a study in the October issue of the Archives of General Psychiatry.
Damiaan Denys, M.D., of the University of Amsterdam in the Netherlands, and colleagues initially treated 16 subjects with treatment-resistant OCD with bilateral DBS (Soletra, Medtronic Inc.) using optimal stimulation until improvement was observed on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), then added cognitive behavior therapy. After eight months of this open treatment phase, there was a double-blind crossover phase, in which subjects were randomly assigned to two weeks of active or sham stimulation. There was then an open 12-month maintenance phase.
In the open phase, the researchers found that the mean Y-BOCS score decreased 46 percent. Among the nine responders (defined as a decrease of at least 35 percent on the Y-BOCS), there was a mean decrease of 72 percent on the Y-BOCS. In the active/sham stimulation phase, the mean Y-BOCS score difference between active and sham stimulation phases was 25 percent. Mild forgetfulness and word-finding problems were the only permanent adverse events reported, and anxiety and depression significantly decreased.
"Further research is necessary to optimize this therapy with respect to patient selection and management, target location, and investigation of new potential indications," the authors write.
The study was financially supported by Medtronic Inc., which also provided the devices used. One study author disclosed financial ties to Medtronic.
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