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Home > Research Articles > Deep brain stimulation is a promising new treatment

NewsRx.com

Tuesday, May 20, 2003

NewsRx.com - May 15, 2003

Obsessive compulsive disorder (OCD) affects people of all ethnic groups, and both males and females are equally affected. A new study, "Deep Brain Stimulation (DBS) for the Treatment of Obsessive Compulsive Disorder (OCD): Preliminary Results from a Multicenter Prospective Trial," highlights bilateral DBS as a treatment of refractory OCD.

The study was presented during the 71st Annual Meeting of the American Association of Neurological Surgeons (AANS) in San Diego.

An estimated 20% of patients with OCD are intractable, and 50% of these patients are severely ill. OCD occurs in a spectrum from mild to severe, but if severe and left untreated, it can destroy a person's ability to function at work, at school or even at home.

The authors of the study wanted to test a new treatment option for people suffering from OCD. As part of the study, 15 severely disabled OCD patients (7 male, 8 female) refractory to prolonged medication and behavioral therapy were enrolled in the study from 1998-2002. The average age of onset of OCD was 14 years old, with DBS implantation occurring at an average age of 36 years.

Patients exhibited symptoms that included checking/incompleteness, touching, contamination fears, perfectionism, pervasive rituals, arranging, washing, counting, fear of harming, and intrusive obsessions.

Patients were operated on at the University of Leuven, Belgium, Brown University/Rhode Island Hospital, and the Cleveland Clinic Foundation. The operations involved implantation of bilateral deep brain stimulators in the part of the brain known as the anterior limb of the internal capsule. The primary team of caregivers included psychiatrists, neuropsychologists, neurosurgeons, neurologists, neuroradiologists, neurophysiologists and ethicists. In addition, each of the medical centers involved in the study obtained approval from their institutional review boards and an independent review committee comprising health care professionals.

Overall, patients reported an improved quality of life following DBS treatment, even though not all effects could be considered an improvement to their lives. Some effects of the DBS included mood elevation (although sometimes acute depression or a "sadness sensation"), hypomania (a mild mania), anxiety reduction, decreased OCD symptoms, increased alertness and energy, memory flashbacks, irritability, muscle contraction, epigastric (stomach) and olfactory (sense of smell) sensations, nausea, vomiting, visual changes (blurring), paresthesisas (facial) and tachycardia (abnormal heart rhythms).

"Deep brain stimulation has the advantage of being reversible and adjustable and is now routinely used for the treatment of refractory movement disorders," said Ali R. Rezai, MD, the Cleveland Clinic Foundation. "This treatment holds promise for the ongoing treatment of intractable obsessive compulsive disorder." This article was prepared by Health & Medicine Week editors from staff and other reports.

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ęCopyright 2003, Health & Medicine Week via NewsRx.com & NewsRx.net