Archival ReportDecrease of Prefrontal Metabolism After Subthalamic Stimulation in Obsessive-Compulsive Disorder: A Positron Emission Tomography Study
Section snippets
Participants
One group of patients with refractory OCD and one healthy control (HC) group took part in the study. The patient group comprised a series of 10 patients with refractory OCD, all of whom had undergone bilateral STN DBS in the STOC study. All the patients met the clinical DSM-IV criteria for OCD as a primary diagnosis. Standard selection and exclusion criteria for surgery of the patients have been described in detail in the clinical study (8). There were five men and five women. Mean (± SD) age
Clinical and Neuropsychological Effect of STN Stimulation
No significant differences were found between the On-Stimulation and Off-Stimulation conditions for the neuropsychologic background tests and the Montgomery–Åsberg Depression Scale score ranging from 0 to 60.
The median YBOCS scores for all 10 patients taken together were 31 (minimum = 18, maximum = 36) with Off-Stimulation status and 19 (minimum = 0, maximum = 30) with On-Stimulation status. The difference was statistically significant (p = .05). We found neither a carryover effect (p = .16)
Discussion
To our knowledge, this study is the first to describe the metabolic effects of STN DBS in refractory OCD patients. It is also the first to have used a double-blind randomized PET investigation to assess patients suffering from refractory OCD conducted within the framework of the STOC study. This study allowed us to investigate refractory OCD patients using functional neuroimaging. Whereas other techniques, such as functional MRI, require specific conditions for acquisitions in stimulated
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2020, EncephaleCitation Excerpt :Years thereafter, this project led to the first randomized crossover study showing the effectiveness of this therapeutic approach in highly resistant OCD patients. Consistently, an ancillary FDG-PET study in patients included in the STOC study [13] showed during STN stimulation decreases in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores, which as hypothesized, proved significantly correlated with decreases in their OFC metabolism. Studies combining DBS with FDG-PET supported the notion that OCD could be related to the combined dysfunction of the basal ganglia and the PFC regions.