Deep brain stimulation for obsessive compulsive disorder: A literature review

The success of deep brain stimulation (DBS) in treating medically refractory symptoms of Parkinson’s disease has inspired investigation into obsessive-compulsive disorder (OCD). Results for this therapy in refractory OCD have been promising however a consensus about the DBS optimal target has not yet been achieved. The objective of this article is to review the literature regarding long-term effects of DBS in OCD and to discuss the efficacy of its targets, mainly: anterior limb of the internal capsule-ventral capsule/ventral striatum (ALIC-VC/VS), subthalamic nucleus (STN), nucleus accumbens (NA) and inferior thalamic peduncle (IPT).We were able to identify 28 articles, with a total of 90 patients treated so far. Results obtained were similar with ALIC-VC/VS (n=32) and NA (n=36) stimulation, demonstrating a near 50% reduction of OCD related symptoms. These two areas might reflect a single target. Only one investigation team studied IPT target (n=5) and results presented may be enviesed. Because STN stimulation (n=17) only occurred for 3 months, no conclusions were made for this target. DBS is an effective and safe treatment in patients with highly refractory OCD, however further research is needed to optimize this treatment, regarding patient selection and management, target location and mechanism of action.