Stimulating deep brain areas effective for OCD patients
POSTED October 6, 2010 - 11:55 | POSTED BY neha gupta
Last edited by Silky Chandvani on October 6, 2010 - 12:55
The currently used treatments for OCD include cognitive behavioral therapy and medication.
However, the therapies work for only half of the patients and reduce symptoms by an average of 40 to 60 percent and approximately 10 percent of patients remain severely affected by OCD despite receiving the best available treatments, past studies reveal.
16 OCD patients studied
The study conducted by Damiaan Denys of the University of Amsterdam and colleagues looked at 16 patients whose OCD had not responded to previous rounds of treatment.
The safety and effectiveness of deep brain stimulation among the group of patients was analyzed by the researchers.
Initially, electrodes were implanted in the nucleus accumbens in the patients, a brain area critical to the reward system.
After implantation, they underwent an open phase of eight months during which they received active stimulation and were assessed for symptoms of OCD every two weeks.
Finally, the participants entered a one-month, double blind phase in which they were asked to have the electrodes turned on or off in two-week blocks.
The disorder symptoms of the patients were assessed both before and after this phase.
After this, all the participants were sent to a 12 month maintenance phase, wherein stimulation was resumed.
They were then evaluated at three-month intervals.
Obsessive compulsive symptoms of the participants were ranked on a scale of zero to 40; patients were classified as responding to treatment if they had a score decrease of at least 35 percent.
Revelations of the study
The average score among the participants decreased from 33.7 to 18.0, that is, 46 percent.
Among the nine patients classified as responders, scores decreased by an average of 23.7, or 72 percent, researchers revealed.
"Anxiety and depressive symptoms decreased by half.
"The surgical procedure and stimulation were well tolerated. Permanent adverse events were limited to mild forgetfulness and word-finding problems," wrote the authors.
During the double-blind phase of the study, in which 14 patients participated, the average difference in score between those receiving active stimulation and those receiving false stimulation was found to be 8.3, or 25 percent.
The improvements observed in the open phase were sustained over the 12-month maintenance phase.
The findings were published in the 'Archives of General Psychiatry,' one of the JAMA/Archives journals.
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