Deep Brain Stimulation in the Bed Nucleus of Stria Terminalis in Obsessive-compulsive Disorder
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Obsessive-Compulsive Disorder
- Sponsor
- University Hospital, Umeå
- Enrollment
- 11
- Primary Endpoint
- Measuring the effect on obsessive-compulsive symptoms after treatment with DBS in the bed nucleus of stria terminalis using YBOCS
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
Deep brain stimulation is an established treatment for movement disorders. New indications for deep brain stimulation are under investigation, among them severe and treatment-resistant obsessive-compulsive disorder. Here, the investigators investigate clinical outcomes, safety and mechanism of action of DBS in the BNST in a series of 11 participants with severe therapy-refractory OCD.
Investigators
Matilda Naesström
Principal investigator
University Hospital, Umeå
Eligibility Criteria
Inclusion Criteria
- •Severe OCD according to the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV
- •YBOCS score of at least 25/40
- •Disease duration of ≥5 years with persistent disabling symptoms despite adequate trials with at least 3 different serotonergic acting antidepressants, augmentation with antipsychotics, and CBT
- •Only patients between 18 and 65 years of age who could understand and comply with instructions and provide their own written consent.
Exclusion Criteria
- •Current psychotic or substance abuse disorder
- •Clinically significant medical disorder, or previous brain surgery
Outcomes
Primary Outcomes
Measuring the effect on obsessive-compulsive symptoms after treatment with DBS in the bed nucleus of stria terminalis using YBOCS
Time Frame: 1 year
The primary outcome measure was the psychiatrist-rated YBOCS at one year, with response defined as ≥ 35% decrease in YBOCS score and partial response as a 25-34% decrease. In YBOCS is a 10-item clinically rated scale where the items are divided by obsessions and compulsions. The scale measures the severity of OCD by time spent on obsessions/compulsions, level of anxiety and decrease of functioning caused by OCD symptoms and ability to control obsessions and compulsions. Maximum points on the scale are 40, where 0-7 points indicates subclinical, 8-15 mild, 16-23 moderate, 24 - 32 severe and 33- 40 extreme OCD symptoms
Secondary Outcomes
- Measuring the effect on depressive symptoms after treatment with DBS in the bed nucleus of stria terminalis using the Montgomery-Asberg Depressive Rating Scale(1 year)
- Measuring the effect on functioning after treatment with DBS in the bed nucleus of stria terminalis using the Global Assessment of Functioning scale(1 year)