PMID- 15481726
OWN - NLM
STAT- MEDLINE
DCOM- 20041116
LR  - 20231024
IS  - 0022-3085 (Print)
IS  - 0022-3085 (Linking)
VI  - 101
IP  - 4
DP  - 2004 Oct
TI  - Deep brain stimulation of the ventral caudate nucleus in the treatment of 
      obsessive-compulsive disorder and major depression. Case report.
PG  - 682-6
AB  - Obsessive-compulsive disorder (OCD) is an anxiety disorder associated with 
      recurrent intrusive thoughts and repetitive behaviors. Although conventional 
      pharmacological and/or psychological treatments are well established and 
      effective in treating OCD, symptoms remain unchanged in up to 30% of patients. 
      Deep brain stimulation (DBS) of the anterior limb of the internal capsule has 
      recently been proposed as a possible therapeutic alternative in 
      treatment-resistant OCD. In the present study, the authors tested the hypothesis 
      that DBS of the ventral caudate nucleus might be effective in a patient with 
      intractable severe OCD and concomitant major depression. Psychiatric assessment 
      included the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Hamilton 
      Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), and the 
      Global Assessment of Functioning (GAF) Scale for determining the symptom severity 
      of OCD, depression, and anxiety as well as the quality of pychosocial and 
      occupational functioning, respectively. Neuropsychological assessment consisted 
      of a wide range of tests primarily exploring memory and executive functions. Deep 
      brain stimulation of the ventral caudate nucleus markedly improved symptoms of 
      depression and anxiety until their remission, which was achieved at 6 months 
      after the start of stimulation (HDRS < or = 7 and HARS < or = 10). Remission of 
      OCD (Y-BOCS < 16) was also delayed after 12 or 15 months of DBS. The level of 
      functioning pursuant to the GAF scale progressively increased during the 15-month 
      follow-up period. No neuropsychological deterioration was observed, indicating 
      that DBS of the ventral caudate nucleus could be a promising strategy in the 
      treatment of refractory cases of both OCD and major depression.
FAU - Aouizerate, Bruno
AU  - Aouizerate B
AD  - Services de Psychiatrie A and B, Centre Hospitalier Charles Perrens, Bordeaux, 
      France.
FAU - Cuny, Emmanuel
AU  - Cuny E
FAU - Martin-Guehl, Corinne
AU  - Martin-Guehl C
FAU - Guehl, Dominique
AU  - Guehl D
FAU - Amieva, Helene
AU  - Amieva H
FAU - Benazzouz, Abdelhamid
AU  - Benazzouz A
FAU - Fabrigoule, Colette
AU  - Fabrigoule C
FAU - Allard, Michele
AU  - Allard M
FAU - Rougier, Alain
AU  - Rougier A
FAU - Bioulac, Bernard
AU  - Bioulac B
FAU - Tignol, Jean
AU  - Tignol J
FAU - Burbaud, Pierre
AU  - Burbaud P
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Neurosurg
JT  - Journal of neurosurgery
JID - 0253357
SB  - IM
CIN - J Neurosurg. 2004 Oct;101(4):574-5; discussion 575-6. PMID: 15481708
MH  - Caudate Nucleus/*physiology
MH  - Depressive Disorder/*therapy
MH  - *Electric Stimulation Therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obsessive-Compulsive Disorder/*therapy
MH  - Psychiatric Status Rating Scales
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2004/10/16 09:00
MHDA- 2004/11/17 09:00
CRDT- 2004/10/16 09:00
PHST- 2004/10/16 09:00 [pubmed]
PHST- 2004/11/17 09:00 [medline]
PHST- 2004/10/16 09:00 [entrez]
AID - 10.3171/jns.2004.101.4.0682 [doi]
PST - ppublish
SO  - J Neurosurg. 2004 Oct;101(4):682-6. doi: 10.3171/jns.2004.101.4.0682.