9. Deep Brain Stimulation in Obsessive Compulsive Disorders

  1. Sam Eljamel3 and
  2. Konstantin V. Slavin4
  1. David Christmas1 and
  2. Loes Gabriëls2

Published Online: 19 JUL 2013

DOI: 10.1002/9781118346396.ch9

Neurostimulation: Principles and Practice

Neurostimulation: Principles and Practice

How to Cite

Christmas, D. and Gabriëls, L. (2013) Deep Brain Stimulation in Obsessive Compulsive Disorders, in Neurostimulation: Principles and Practice (eds S. Eljamel and K. V. Slavin), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118346396.ch9

Editor Information

  1. 3

    Centre for Neurosciences, Ninewells Hospital & Medical School, Dundee, Scotland, UK

  2. 4

    Department of Neurosurgery, University of Illinois at Chicago. Chicago, Illinois, USA

Author Information

  1. 1

    Ninewells Hospital and Medical School, Dundee, UK

  2. 2

    University Hospitals, Leuven, Belgium

Publication History

  1. Published Online: 19 JUL 2013
  2. Published Print: 19 AUG 2013

ISBN Information

Print ISBN: 9781118346358

Online ISBN: 9781118346396

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Keywords:

  • deep brain stimulation;
  • inferior thalamic peduncle;
  • nucleus accumbens;
  • obsessive compulsive disorder (OCD);
  • psychiatric illness;
  • striatum;
  • subthalamic nucleus

Summary

Stimulation of key brain areas has been explored as an alternative to ablative surgery for psychiatric illness. Reversibility of deep brain stimulation (DBS) makes it an attractive alternative to ablative neurosurgery, although the risks arising from implantation of leads and neurostimulators may not be reversible. DBS was first used for the treatment of movement disorders where the functional anatomical pathways are well understood. With regards to obsessive compulsive disorder (OCD), there is convergent information pointing to dysfunction within cortico— striatal—thalamic—cortical (CSTC) loops in the pathogenesis of the symptoms. DBS of the internal capsule was derived empirically from experience with bilateral anterior capsulotomy. Stimulation of the subthalamic nucleus evolved serendipitously from treatment of patients with Parkinson's disease (PD) who suffered from comorbid obsessive compulsive disorder (OCD). Other targets have developed out of a greater understanding of the neuroanatomical pathways involved in OCD.