Cargando…

Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond): case report

BACKGROUND: Deep brain stimulation (DBS) is emerging as a promising tool in the treatment of refractory obsessive-compulsive disorder (OCD) but the search for the best target still continues. This issue is especially relevant when particularly resistant profiles are observed in some patients, which...

Descripción completa

Detalles Bibliográficos
Autores principales: Real, Eva, Plans, Gerard, Alonso, Pino, Aparicio, Marco A., Segalàs, Cinto, Cardoner, Narcís, Soriano-Mas, Carles, López-Solà, Clara, Menchón, José M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744631/
https://www.ncbi.nlm.nih.gov/pubmed/26852116
http://dx.doi.org/10.1186/s12888-016-0730-z
_version_ 1782414504184774656
author Real, Eva
Plans, Gerard
Alonso, Pino
Aparicio, Marco A.
Segalàs, Cinto
Cardoner, Narcís
Soriano-Mas, Carles
López-Solà, Clara
Menchón, José M.
author_facet Real, Eva
Plans, Gerard
Alonso, Pino
Aparicio, Marco A.
Segalàs, Cinto
Cardoner, Narcís
Soriano-Mas, Carles
López-Solà, Clara
Menchón, José M.
author_sort Real, Eva
collection PubMed
description BACKGROUND: Deep brain stimulation (DBS) is emerging as a promising tool in the treatment of refractory obsessive-compulsive disorder (OCD) but the search for the best target still continues. This issue is especially relevant when particularly resistant profiles are observed in some patients, which have been ascribed to individual responses to DBS according to differential patterns of connectivity. As patients have been implanted, new dilemmas have emerged, such as what to do when the patient does not respond to surgery. CASE PRESENTATION: Here we describe a 22-year-old male with extremely severe OCD who did not respond to treatment with DBS in the nucleus accumbens, but who did respond after explanting and reimplanting leads targeting the ventral capsule-ventral striatum region. Information regarding the position of the electrodes for both surgeries is provided and possible brain structures affected during stimulation are reviewed. To our knowledge this case is the first in the literature reporting the removal and reimplantation of DBS leads for therapeutical benefits in a patient affected by a mental disorder. CONCLUSION: The capability for explantation and reimplantation of leads should be considered as part of the DBS therapy reversibility profile in resistant mental disorders, as it allows application in cases of non-response to the first surgery.
format Online
Article
Text
id pubmed-4744631
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-47446312016-02-08 Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond): case report Real, Eva Plans, Gerard Alonso, Pino Aparicio, Marco A. Segalàs, Cinto Cardoner, Narcís Soriano-Mas, Carles López-Solà, Clara Menchón, José M. BMC Psychiatry Case Report BACKGROUND: Deep brain stimulation (DBS) is emerging as a promising tool in the treatment of refractory obsessive-compulsive disorder (OCD) but the search for the best target still continues. This issue is especially relevant when particularly resistant profiles are observed in some patients, which have been ascribed to individual responses to DBS according to differential patterns of connectivity. As patients have been implanted, new dilemmas have emerged, such as what to do when the patient does not respond to surgery. CASE PRESENTATION: Here we describe a 22-year-old male with extremely severe OCD who did not respond to treatment with DBS in the nucleus accumbens, but who did respond after explanting and reimplanting leads targeting the ventral capsule-ventral striatum region. Information regarding the position of the electrodes for both surgeries is provided and possible brain structures affected during stimulation are reviewed. To our knowledge this case is the first in the literature reporting the removal and reimplantation of DBS leads for therapeutical benefits in a patient affected by a mental disorder. CONCLUSION: The capability for explantation and reimplantation of leads should be considered as part of the DBS therapy reversibility profile in resistant mental disorders, as it allows application in cases of non-response to the first surgery. BioMed Central 2016-02-06 /pmc/articles/PMC4744631/ /pubmed/26852116 http://dx.doi.org/10.1186/s12888-016-0730-z Text en © Real et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Real, Eva
Plans, Gerard
Alonso, Pino
Aparicio, Marco A.
Segalàs, Cinto
Cardoner, Narcís
Soriano-Mas, Carles
López-Solà, Clara
Menchón, José M.
Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond): case report
title Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond): case report
title_full Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond): case report
title_fullStr Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond): case report
title_full_unstemmed Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond): case report
title_short Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond): case report
title_sort removing and reimplanting deep brain stimulation therapy devices in resistant ocd (when the patient does not respond): case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744631/
https://www.ncbi.nlm.nih.gov/pubmed/26852116
http://dx.doi.org/10.1186/s12888-016-0730-z
work_keys_str_mv AT realeva removingandreimplantingdeepbrainstimulationtherapydevicesinresistantocdwhenthepatientdoesnotrespondcasereport
AT plansgerard removingandreimplantingdeepbrainstimulationtherapydevicesinresistantocdwhenthepatientdoesnotrespondcasereport
AT alonsopino removingandreimplantingdeepbrainstimulationtherapydevicesinresistantocdwhenthepatientdoesnotrespondcasereport
AT apariciomarcoa removingandreimplantingdeepbrainstimulationtherapydevicesinresistantocdwhenthepatientdoesnotrespondcasereport
AT segalascinto removingandreimplantingdeepbrainstimulationtherapydevicesinresistantocdwhenthepatientdoesnotrespondcasereport
AT cardonernarcis removingandreimplantingdeepbrainstimulationtherapydevicesinresistantocdwhenthepatientdoesnotrespondcasereport
AT sorianomascarles removingandreimplantingdeepbrainstimulationtherapydevicesinresistantocdwhenthepatientdoesnotrespondcasereport
AT lopezsolaclara removingandreimplantingdeepbrainstimulationtherapydevicesinresistantocdwhenthepatientdoesnotrespondcasereport
AT menchonjosem removingandreimplantingdeepbrainstimulationtherapydevicesinresistantocdwhenthepatientdoesnotrespondcasereport