Deep Brain Stimulation of Medial Dorsal and Ventral Anterior Nucleus of the Thalamus in OCD: A Retrospective Case Series

Autor: Faycal El Majdoub, Clemens Neudorfer, Mohammad Maarouf, Doris Lenartz, Volker Sturm, Jens H. Kuhn
Jazyk: angličtina
Rok vydání: 2016
Předmět:
0301 basic medicine
Male
Obsessive-Compulsive Disorder
Physiology
medicine.medical_treatment
Deep Brain Stimulation
Emotions
Ventral anterior nucleus
Social Sciences
lcsh:Medicine
Anxiety
0302 clinical medicine
Thalamus
Medicine and Health Sciences
Medicine
Psychology
lcsh:Science
Brain Mapping
Multidisciplinary
Depression
Cognitive Neurology
Brain
Ventral Thalamic Nucleus
Middle Aged
Anxiety Disorders
Electrophysiology
medicine.anatomical_structure
Bioassays and Physiological Analysis
surgical procedures
operative
Brain Electrophysiology
Neurology
Thalamic Nuclei
Female
Neuropsychological testing
Anatomy
Research Article
Dorsum
Adult
medicine.medical_specialty
Deep brain stimulation
Mediodorsal Thalamic Nucleus
Cognitive Neuroscience
Neurophysiology
Neuropsychiatric Disorders
Surgical and Invasive Medical Procedures
Neuroses
Research and Analysis Methods
behavioral disciplines and activities
03 medical and health sciences
Neuropsychology
Mental Health and Psychiatry
mental disorders
Humans
ddc:610
Psychiatry
Quality of Health Care
Retrospective Studies
Neuropsychological Testing
Ventral Thalamic Nuclei
Behavioral Disorders
business.industry
Mood Disorders
Electrophysiological Techniques
lcsh:R
Biology and Life Sciences
030104 developmental biology
nervous system
Mediodorsal thalamic nucleus
Cognitive Science
lcsh:Q
business
Neuroscience
Nucleus
Deep-Brain Stimulation
030217 neurology & neurosurgery
Zdroj: PLoS ONE, Vol 11, Iss 8, p e0160750 (2016)
PLoS ONE
ISSN: 1932-6203
Popis: Background The current notion that cortico-striato-thalamo-cortical circuits are involved in the pathophysiology of obsessive-compulsive disorder (OCD) has instigated the search for the most suitable target for deep brain stimulation (DBS). However, despite extensive research, uncertainty about the ideal target remains with many structures being underexplored. The aim of this report is to address a new target for DBS, the medial dorsal (MD) and the ventral anterior (VA) nucleus of the thalamus, which has thus far received little attention in the treatment of OCD. Methods In this retrospective trial, four patients (three female, one male) aged 31–48 years, suffering from therapy-refractory OCD underwent high-frequency DBS of the MD and VA. In two patients (de novo group) the thalamus was chosen as a primary target for DBS, whereas in two patients (rescue DBS group) lead implantation was performed in a rescue DBS attempt following unsuccessful primary stimulation. Results Continuous thalamic stimulation yielded no significant improvement in OCD symptom severity. Over the course of thalamic DBS symptoms improved in only one patient who showed “partial response” on the Yale-Brown Obsessive Compulsive (Y-BOCS) Scale. Beck Depression Inventory scores dropped by around 46% in the de novo group; anxiety symptoms improved by up to 34%. In the de novo DBS group no effect of DBS on anxiety and mood was observable. Conclusion MD/VA-DBS yielded no adequate alleviation of therapy-refractory OCD, the overall strategy in targeting MD/VA as described in this paper can thus not be recommended in DBS for OCD. The magnocellular portion of MD (MDMC), however, might prove a promising target in the treatment of mood related and anxiety disorders.
Databáze: OpenAIRE
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