Deep Brain Stimulation Study for Obsessive Compulsive Disorder

Deep Brain Stimulation for Treatment-Refractory Obsessive-Compulsive Disorder: Understanding the Mechanism of Action.

About Deep Brain Stimulation Study for Obsessive Compulsive Disorder

Deep brain stimulation (DBS) involves the surgical implantation of two electrodes (one for each hemisphere of the brain) within the subcortex (the region of the brain below the cortical surface). These are connected by wires that run underneath the skin to a pulse generator (a brain pacemaker) that is implanted in the chest wall. A small (millimeters in diameter) electrical field is generated around the tip of the electrode and this changes local brain activity and activity in brain regions connected to the site of stimulation.

We recently published the first Australian, randomised, double-blind, sham-controlled trial of DBS for treatment-refractory obsessive-compulsive disorder (OCD). All cases were completed at St Andrew’s War Memorial Hospital in Brisbane, Australia. Amongst 9 participants, the average reduction in OCD symptoms after 12-months of stimulation was 50%, with 7 of those 9 showing a clinically-significant response resulting in an improved quality of life.

In this new trial funded by the National Health and Medical Research Council, we will implant a DBS device in a further 5 participants with treatment-refractory OCD. We will use a device that can record local neuronal activity as well as stimulate, and that is also approved for postoperative magnetic resonance (MR) neuroimaging. Therefore, this research will not only provide further evidence of the effectiveness of DBS for OCD, but it will also measure local and global changes in brain activity. These advances will help close a significant knowledge gap: how DBS changes brain network activity to reduce OCD symptoms. In turn, this will help us develop more effective stimulation paradigms for OCD.