[Frontiers in Bioscience 14, 1880-1890, January 1, 2009]

[Frontiers in Bioscience 14, 1880-1890, January 1, 2009]

Deep brain stimulation for refractory obsessive-compulsive disorder

Adam Burdick¹, Wayne K. Goodman², Kelly D. Foote¹

1University of Florida, Department of Neurosurgery, PO Box 100265, Gainesville, FL, 32610, ²University of Florida, Department of Psychiatry, 100 S. Newell Drive, Suite L4-100, Gainesville, FL 32611

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. Historical precedents: 3.1. Subcaudate tractotomy; 3.2. Cingulotomy; 3.3. Limbic leucotomy; 3.4. Anterior capsulotomy; 3.5. Comparisons and side effects
4. Pathophysiology: 4.1. Theory of parallel basal ganglia circuitry; 4.2. Neuroimaging evidence
5. Deep brain stimulation for OCD: 5.1. Background of DBS; 5.2. DBS for OCD; 5.3. Battery life; 5.4. Refining the target for OCD; 5.5. Programming; 5.6. Ethics
6. Perspective
7. Acknowledgments
8. REFERENCES

1. ABSTRACT

The use of deep brain stimulation (DBS) for obsessive compulsive disorder (OCD) is reviewed, including a brief discussion of historical groundwork in the surgical treatment of psychiatric disorders, and the rationale for the current practice. The theoretical neuroanatomic circuitry underlying the pathophysiology of OCD is presented, along with supporting neuroimaging and clinical evidence. The promising early results of DBS for OCD are summarized, including a discussion of current targets and programming issues. Finally, the ethical implications of the procedure are briefly discussed.