In a new study, researchers have further refined the use of deep brain stimulation in the treatment of the obsessive-compulsive disorder.
By accurately localizing electrode placement in the brains of patients, they were able to identify a fiber tract linked to the best clinical outcomes following deep brain stimulation.
The researchers’ findings may be used to improve the treatment of the obsessive-compulsive disorder.
The research was conducted by a team from Charité–Universitätsmedizin Berlin.
A person with obsessive-compulsive disorder (OCD) experiences unwanted thoughts and behaviors, the urge for which they find difficult or impossible to resist.
More than 2% of people are affected by obsessive thoughts and compulsive behaviors which severely impair daily activities.
A treatment option for severe cases is deep brain stimulation, a technique that is also used in other disorders, such as Parkinson’s disease.
Deep brain stimulation involves the implantation of tiny electrodes into structures deep inside the brain. After implantation, these electrodes deliver very weak electric currents to help rebalance brain activity.
By stimulating different areas of the brain, such as a fiber tract within the internal capsule or the subthalamic nucleus, this technique can help improve clinical symptoms in some cases.
Treatment success depends on the accurate placement of electrodes and requires millimeter-level precision.
The optimal stimulation target for patients with obsessive-compulsive disorders had not previously been identified.
For the first time, the team has been able to identify a specific nerve bundle that appears to be the optimal target for stimulation.
The researchers studied 50 patients with obsessive-compulsive disorder who received treatment at a number of centers around the world.
Using MRI technology both before and after electrode placement, the researchers were able to visualize surrounding fiber tracts and test to see which of these the electrodes were selectively stimulating.
The researchers initially examined two groups of patients, both of which received deep brain stimulation to the internal capsule or the subthalamic nucleus.
These brain structures have a variety of connections to other areas of the brain.
And yet, a specific tract situated between the prefrontal cortex and the subthalamic nucleus was identified as a suitable target for stimulation in both of these groups.
Precise electrode localizations allowed the researchers to reliably predict treatment outcomes in both of these groups.
The team says the results do not alter the original target area, they simply helped us to define it more precisely.
All 3-D structural analysis data have been made publicly available to researchers around the world.
The participating research centers continue to share their knowledge and are developing protocols for additional studies to test the newly defined target areas.
One author of the study is Dr. Andreas Horn of Charité’s Department of Neurology with Experimental Neurology.
The study is published in which have been published in Nature Communications.
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