Johanna Philipson1, Matilda Naesstrom2, Johannes D Johansson3, Marwan Hariz4,5, Patric Blomstedt4, Marjan Jahanshahi5. 1. Department of Clinical Sciences, Neuroscience, Umeå University, 901 85, Umeå, Sweden. johanna.philipson@umu.se. 2. Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden. 3. Department of Biomedical Engineering, Linköping University, Linköping, Sweden. 4. Department of Clinical Sciences, Neuroscience, Umeå University, 901 85, Umeå, Sweden. 5. Unit of Functional Neurosurgery, Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, 33 Queen Square, London, UK.
Abstract
PURPOSE: The aim of this study was to evaluate cognitive effects 12 months after Deep Brain Stimulation (DBS) of the Bed Nucleus of Stria Terminalis (BNST) in patients with refractory Obsessive-Compulsive Disorder (OCD). METHODS: Eight patients (5 female; mean ± SD age 36 ± 15) with OCD were included. A neuropsychological test battery covering verbal and spatial episodic memory, executive function, and attention was administered preoperatively and 12 months after surgery. Medical records were used as a source for descriptive data to probe for any changes not covered by standardized checklists and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the primary outcome measure. RESULTS: At 12 months, seven patients showed response to DBS: three were full responders (i.e., Y-BOCS ≥ 35% improvement), and four were partial responders (Y-BOCS 25-34% improvement). Relative to baseline, there was a slight decline on visuo-spatial learning (p = 0.027), and improved performance on the Color-Word Interference inhibition/switching subtest (p = 0.041), suggesting improvement in cognitive flexibility. CONCLUSIONS: DBS in the BNST for treatment refractory OCD generates very few adverse cognitive effects and improves cognitive flexibility after 12 months of stimulation. The improvement in Y-BOCS and the absence of major cognitive side effects support the BNST as a potential target for DBS in severe OCD.
PURPOSE: The aim of this study was to evaluate cognitive effects 12 months after Deep Brain Stimulation (DBS) of the Bed Nucleus of Stria Terminalis (BNST) in patients with refractory Obsessive-Compulsive Disorder (OCD). METHODS: Eight patients (5 female; mean ± SD age 36 ± 15) with OCD were included. A neuropsychological test battery covering verbal and spatial episodic memory, executive function, and attention was administered preoperatively and 12 months after surgery. Medical records were used as a source for descriptive data to probe for any changes not covered by standardized checklists and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the primary outcome measure. RESULTS: At 12 months, seven patients showed response to DBS: three were full responders (i.e., Y-BOCS ≥ 35% improvement), and four were partial responders (Y-BOCS 25-34% improvement). Relative to baseline, there was a slight decline on visuo-spatial learning (p = 0.027), and improved performance on the Color-Word Interference inhibition/switching subtest (p = 0.041), suggesting improvement in cognitive flexibility. CONCLUSIONS: DBS in the BNST for treatment refractory OCD generates very few adverse cognitive effects and improves cognitive flexibility after 12 months of stimulation. The improvement in Y-BOCS and the absence of major cognitive side effects support the BNST as a potential target for DBS in severe OCD.
Authors: Juan A Barcia; Josué M Avecillas-Chasín; Cristina Nombela; Rocío Arza; Julia García-Albea; José A Pineda-Pardo; Blanca Reneses; Bryan A Strange Journal: Brain Stimul Date: 2018-12-20 Impact factor: 8.955
Authors: James L Abelson; George C Curtis; Oren Sagher; Ronald C Albucher; Mark Harrigan; Stephan F Taylor; Brian Martis; Bruno Giordani Journal: Biol Psychiatry Date: 2005-03-01 Impact factor: 13.382