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Deep Brain Stimulation in Obsessive–Compulsive Disorder Targeted at the Nucleus Accumbens

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Deep Brain Stimulation

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Abstract

The nucleus accumbens (NAc) was selected as a target for deep brain stimulation (DBS) in therapy-resistant obsessive–compulsive disorder (OCD) because of its predominant role in the corticostriatothalamocortical circuitry. To date, five efficacy studies have reported on NAc DBS for the treatment of OCD with a total of 34 subjects. These small studies (N = 2–16), with various designs, indicate an overall Yale–Brown Obsessive–Compulsive Scale score decrease ranging from 6.8 to 17.5 points. The average overall responder rate was ±50 %. The frequency of adverse events appears to be limited and generally reversible by readjusting the stimulation. Since our understanding of the mode of action of NAc DBS for the treatment of OCD is still limited, larger prospective studies including neuroimaging are needed to adequately estimate its true potential and to elucidate its underlying mechanism of action and optimal location of stimulation administration. We conclude that DBS targeted at the NAc is a promising and safe therapy for treatment-resistant OCD.

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Authors and Affiliations

  1. University of Amsterdam, Amsterdam, The Netherlands

    Pelle P. de Koning, Pepijn van den Munckhof, Martijn Figee, Rick Schuurman & Damiaan Denys

Authors
  1. Pelle P. de Koning
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  2. Pepijn van den Munckhof
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  3. Martijn Figee
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  4. Rick Schuurman
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  5. Damiaan Denys
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Corresponding author

Correspondence to Pelle P. de Koning .

Editor information

Editors and Affiliations

  1. , Department of Psychiatry, Academic Medical Center, University of A, PO Box 75867, Amsterdam, 1070 AW, Netherlands

    Damiaan Denys

  2. , Neuromodulation and Behaviour, Netherlands Institute for Neuroscience, Meibergdreef 47, Amsterdam, 1105 BA, Netherlands

    Matthijs Feenstra

  3. , Department of Neurosurger, Academic Medical Center, University of A, Meibergdreef 9, Amsterdam, 1070 AW, Netherlands

    Rick Schuurman

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© 2012 Springer-Verlag Berlin Heidelberg

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de Koning, P.P., van den Munckhof, P., Figee, M., Schuurman, R., Denys, D. (2012). Deep Brain Stimulation in Obsessive–Compulsive Disorder Targeted at the Nucleus Accumbens. In: Denys, D., Feenstra, M., Schuurman, R. (eds) Deep Brain Stimulation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30991-5_5

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