TY  - JOUR
T1  - DEep brain stimulation of the nucleus accumbens for treatment-refractory obsessive-compulsive disorder
AU  - Denys D, Mantione M, Figee M, et al
Y1  - 2010/10/04
N1  - 10.1001/archgenpsychiatry.2010.122
JO  - Archives of General Psychiatry
SP  - 1061
EP  - 1068
VL  - 67
IS  - 10
N2  - Context 
    Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that affects 2% of the general population. Even when the best available treatments are applied, approximately 10% of patients remain severely afflicted and run a long-term deteriorating course of OCD.Objective 
    To determine whether bilateral deep brain stimulation of the nucleus accumbens is an effective and safe treatment for treatment-refractory OCD.Design 
    The study consisted of an open 8-month treatment phase, followed by a double-blind crossover phase with randomly assigned 2-week periods of active or sham stimulation, ending with an open 12-month maintenance phase.Setting 
    Academic research.Patients 
    Sixteen patients (age range, 18-65 years) with OCD according to DSM-IV criteria meeting stringent criteria for refractoriness to treatment were included in the study.Interventions 
    Treatment with bilateral deep brain stimulation of the nucleus accumbens.Main Outcome Measures 
    Primary efficacy was assessed by score change from baseline on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Responders were defined by a score decrease of at least 35% on the Y-BOCS.Results 
    In the open phase, the mean (SD) Y-BOCS score decreased by 46%, from 33.7 (3.6) at baseline to 18.0 (11.4) after 8 months (P < .001). Nine of 16 patients were responders, with a mean (SD) Y-BOCS score decrease of 23.7 (7.0), or 72%. In the double-blind, sham-controlled phase (n = 14), the mean (SD) Y-BOCS score difference between active and sham stimulation was 8.3 (2.3), or 25% (P = .004). Depression and anxiety decreased significantly. Except for mild forgetfulness and word-finding problems, no permanent adverse events were reported.Conclusion 
    Bilateral deep brain stimulation of the nucleus accumbens may be an effective and safe treatment for treatment-refractory OCD.Clinical Trial Registration 
    isrctn.org Identifier: ISRCTN23255677
SN  - 0003-990X
M3  - doi: 10.1001/archgenpsychiatry.2010.122
UR  - http://dx.doi.org/10.1001/archgenpsychiatry.2010.122
ER  -