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Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder
Clinical outcome of deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) shows robust effects in terms of a mean Yale-Brown Obsessive-Compulsive Scale (YBOCS) reduction of 47.7 % and a mean response percentage (minimum 35 % YBOCS reduction) of 58.2 %. It appears that most patients re...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544542/ https://www.ncbi.nlm.nih.gov/pubmed/26317062 http://dx.doi.org/10.1007/s40473-015-0036-3 |
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author | van Westen, Maarten Rietveld, Erik Figee, Martijn Denys, Damiaan |
author_facet | van Westen, Maarten Rietveld, Erik Figee, Martijn Denys, Damiaan |
author_sort | van Westen, Maarten |
collection | PubMed |
description | Clinical outcome of deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) shows robust effects in terms of a mean Yale-Brown Obsessive-Compulsive Scale (YBOCS) reduction of 47.7 % and a mean response percentage (minimum 35 % YBOCS reduction) of 58.2 %. It appears that most patients regain a normal quality of life (QoL) after DBS. Reviewing the literature of the last 4 years, we argue that the mechanisms of action of DBS are a combination of excitatory and inhibitory as well as local and distal effects. Evidence from DBS animal models converges with human DBS EEG and imaging findings, in that DBS may be effective for OCD by reduction of hyperconnectivity between frontal and striatal areas. This is achieved through reduction of top-down-directed synchrony and reduction of frontal low-frequency oscillations. DBS appears to counteract striatal dysfunction through an increase in striatal dopamine and through improvement of reward processing. DBS affects anxiety levels through reduction of stress hormones and improvement of fear extinction. |
format | Online Article Text |
id | pubmed-4544542 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-45445422015-08-25 Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder van Westen, Maarten Rietveld, Erik Figee, Martijn Denys, Damiaan Curr Behav Neurosci Rep Neuromodulation (D Dougherty, Section Editor) Clinical outcome of deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) shows robust effects in terms of a mean Yale-Brown Obsessive-Compulsive Scale (YBOCS) reduction of 47.7 % and a mean response percentage (minimum 35 % YBOCS reduction) of 58.2 %. It appears that most patients regain a normal quality of life (QoL) after DBS. Reviewing the literature of the last 4 years, we argue that the mechanisms of action of DBS are a combination of excitatory and inhibitory as well as local and distal effects. Evidence from DBS animal models converges with human DBS EEG and imaging findings, in that DBS may be effective for OCD by reduction of hyperconnectivity between frontal and striatal areas. This is achieved through reduction of top-down-directed synchrony and reduction of frontal low-frequency oscillations. DBS appears to counteract striatal dysfunction through an increase in striatal dopamine and through improvement of reward processing. DBS affects anxiety levels through reduction of stress hormones and improvement of fear extinction. Springer International Publishing 2015-03-11 2015 /pmc/articles/PMC4544542/ /pubmed/26317062 http://dx.doi.org/10.1007/s40473-015-0036-3 Text en © The Author(s) 2015 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Neuromodulation (D Dougherty, Section Editor) van Westen, Maarten Rietveld, Erik Figee, Martijn Denys, Damiaan Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder |
title | Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder |
title_full | Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder |
title_fullStr | Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder |
title_full_unstemmed | Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder |
title_short | Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder |
title_sort | clinical outcome and mechanisms of deep brain stimulation for obsessive-compulsive disorder |
topic | Neuromodulation (D Dougherty, Section Editor) |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544542/ https://www.ncbi.nlm.nih.gov/pubmed/26317062 http://dx.doi.org/10.1007/s40473-015-0036-3 |
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