EP 20. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) in obsessive compulsive disorder (OCD): A clinical and neurophysiological observation

Abstract

Introduction One interesting target for DBS in OCD is the STN as it can be regarded as an important modulator of movement and behavior. Especially in comparison to Parkinson’s disease (PD) local and network oscillations of the STN in OCD are of interest. Methods We report clinical results of a female patient that underwent anterior-STN DBS for the treatment of severe medically refractory OCD. Furthermore, using resting intraoperative (local field potentials, LFP) and postoperative (LFP and magnetoencephalography, MEG) recordings we describe characteristics of both local and long-range oscillatory coherent networks. Results Over a follow-up of 3 years the patient showed a stable and even increasing effect of DBS on the Y-BOCS compared to baseline (3 vs 39). Due to slight hyperkinesia in the feet stimulation was set bipolar (bilateral 2.1 mA, 60 μ ses, 130 Hz). Local Theta-, Alpha-, Beta- and High-frequency oscillations were observed. High-beta was coherent to sonsomotor cortices, whereas theta-coupling was evident to the anterior cingulate cortex (ACC). Conclusions In line with clinical studies the anterior STN seems to be a suitable candidate for DBS in OCD. Beta- and High-frequency oscillations seem not to be restricted to PD. STN-ACC coupling in OCD points to a possible pathway via that DBS effects might be generated in this particular disease.