208 Inferior Thalamic Peduncle Deep Brain Stimulation for Treatment-Refractory Obsessive-Compulsive Disorder: A Phase 1 Pilot Trial. Issue Volume 65:Issue CN(2018)Supplement 1 (16th August 2018)

• Record Type: Journal Article
• Authors: Lee, Darrin J; Dallapiazza, Robert; Vloo, Philippe De; Elias, Gavin; Fomenko, Anton; Giacobbe, Peter; Lozano, Andres M
• Is Part Of: Neurosurgery. Volume 65:Issue CN(2018)Supplement 1
• Page Start: 118
• Page End: 118
• Publication Date: 2018-08-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyy303.208
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Treatment-resistant obsessive-compulsive disorder can be treated with a number of different surgical procedures targeting the limbic circuitry; however, within this circuit, there are unexplored targets. The objective of this study is to determine the safety and initial efficacy of inferior thalamic peduncle deep brain stimulation in patients with severe obsessive-compulsive disorder. METHODS: We performed an open-label, unblinded phase 1 pilot study examining the effects of bilateral inferior thalamic peduncle deep brain stimulation for severe treatment-refractory obsessive-compulsive disorder. The primary outcome was safety, as reported in intraoperative and postoperative visits. The initial efficacy was determined by Y-BOCs scores. Component Y-BOCs scores, Hamilton Depression Severity Scale, Quality of Life Assessment (SF-36), Oxford Happiness Questionnaire, Warwick-Edinburgh Mental Well-Being Scale, and Sheehan Disability Scale were also analyzed for a minimum of 2 yr after implantation. RESULTS: Five patients (2 males, 3 females; age range: 25-48 yr) were implanted with bilateral inferior thalamic peduncle deep brain stimulation. At 2 yr follow-up, there were no mortalities; however, there were 3 adverse events. One patient had the DBS system removed after 1 yr due to the device becoming part of the obsession. The other 2 adverse events occurred in 1 patient and were not related to the device. All 5 patients were considered responders (52% improvement in Y-BOCs scores compared to baseline (range: 39-73%), P < .01). CONCLUSION: Inferior thalamic peduncle deep brain stimulation is a safe and potentially efficacious treatment for severe obsessive-compulsive disorder. Further studies are necessary to determine efficacy.