Deep Brain Stimulation (DBS) for the Treatment of Refractory Obsessive-compulsive Disorder (OCD)

Not Applicable

Active, not recruiting

• Conditions: Obsessive-Compulsive Disorder
• Interventions: Device: Deep brain stimulation

• Registration Number: NCT04217408
• Lead Sponsor: Sunnybrook Health Sciences Centre

Brief Summary

Deep brain stimulation for treatment resistant deep brain stimulation

Detailed Description

Subjects will receive bilateral deep brain stimulation to the ventral capsule/ventral striatum. They will receive standard follow-up and device programming over the span of 52 weeks. After that, they will enter a 5 week double blinded crossover phase consisting of 2 weeks of ON or OFF stimulation, separated by 1 week of 'washout', during which stimulation will be OFF.

Study Timeline

• Study Start: 2019-09-01
• Study First Submitted: 2020-01-02
• Study First Submitted QC: 2020-01-02
• Study First Posted: 2020-01-03
• Status Verified: 2023-12
• Last Update Submitted: 2023-12-01
• Last Update Posted: 2023-12-08
• Primary Completion: 2024-12-19
• Study Completion: 2024-12-19

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 10

Inclusion Criteria

1. Female or Male patients between age 18-70

2. DSM-V diagnosis of Obsessive Compulsive Disorder (OCD), at least 5-year illness history with a minimum score of 24 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).

3. SF-36<40

4. Medication-refractoriness as determined by an adequate dose and duration of psychiatric treatments (including psychotherapy and/or pharmacology) as determined by two psychiatrists associated with the study. Including specifically:

   1. Failed adequate trial of two or more medications accepted as first line in the treatment of OCD
   2. Attempted augmentation, if tolerated, by at least 1 medications known to be first line treatments for OCD

5. An adequate trial of cognitive behavioural therapy

6. Ability to provide informed consent and comply with all testing, follow-ups and study appointments and protocols

Exclusion Criteria

1. Any past or current evidence of psychosis or mania (patients with co-morbid depression will not be excluded from the study)
2. Active neurologic disease, such as epilepsy
3. Alcohol or substance dependence or abuse in the last 6 months, excluding caffeine and nicotine
4. Current suicidal ideation
5. Any contraindication to MRI scanning
6. No contraindication for DBS surgery
7. Presence of significant cognitive impairment
8. Likely to relocate or move out of the country during the study's duration
9. Presence of clinical and/or neurological conditions that may significantly increase the risk of the surgical procedure.
10. Currently pregnant (as determined by history and serum HCG) or lactating; for females of reproductive potential: use of highly effective contraception for at least 1 month prior to screening and agreement to use such a method during study participation

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
OFF stimulation followed by ON stimulation	Deep brain stimulation	All patients complete the same 52 week open-label phase with active stimulation. After this, they enter a blinded randomized crossover phase of 2 weeks of OFF (sham) stimulation, followed by 2 weeks of ON (active) stimulation
ON stimulation followed by OFF stimulation	Deep brain stimulation	All patients complete the same 52 week open-label phase with active stimulation. After this, they enter a blinded randomized crossover phase of 2 weeks of ON (active) stimulation, followed by 2 weeks of OFF (sham) stimulation

Primary Outcome Measures

Name	Time	Method
Quality of Life as measured by the Short-Form 36	12 months compared to baseline	Measured by the short form 36 (SF-36). The scores range from 0-100 with lower numbers indicating a worse quality of life.

Secondary Outcome Measures

Name	Time	Method
Obsessive compulsive symptoms as measured by the Yale-Brown Obsessive Compulsive Scale during randomization	Recorded at the end of the 2 week ON and OFF stimulation periods, which occur immediately after the 52 week open-label period	Yale-Brown Obsessive Compulsive Scale score during active ON stimulation compared to during OFF stimulation. The scores range from 0-40, with high scores indicating more severe obsessions and compulsions.
Obsessive compulsive symptoms as measured by the Yale-Brown Obsessive Compulsive Scale	12 months	Change in Yale-Brown Obsessive Compulsive Scale score at 12 months compared to baseline. The scores range from 0-40, with high scores indicating more severe obsessions and compulsions.

Trial Locations

Locations (1)

Sunnybrook Health Sciences Centre; 🇨🇦 Toronto, Ontario, Canada