Objective: Deep brain stimulation (DBS) is an effective treatment option for patients with refractory obsessive-compulsive disorder (OCD). However, clinical experience with DBS for OCD remains limited. The authors examined the tolerability and effectiveness of DBS in an open study of patients with refractory OCD.
Methods: Seventy consecutive patients, including 16 patients from a previous trial, received bilateral DBS of the ventral anterior limb of the internal capsule between April 2005 and October 2017 and were followed for 12 months. Primary effectiveness was assessed by the change in scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) from baseline until the 12-month follow-up. Response was defined by a ≥35% decrease in Y-BOCS score, partial response was defined by a 25%−34% decrease, and nonresponse was defined by a <25% decrease. Secondary effectiveness measures were the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale.
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The participant will evaluate how deep brain stimulation may be used as a treatment for patients with refractory obsessive-compulsive disorder.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: March 1, 2020
End Date: February 28, 2022
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Title: Efficacy of Deep Brain Stimulation of the Ventral Anterior Limb of the Internal Capsule for Refractory Obsessive-Compulsive Disorder: A Clinical Cohort of 70 Patients
Authors: Damiaan Denys, M.D., Ph.D., Ilse Graat, M.D., Roel Mocking, M.D., Ph.D., Pelle de Koning, M.D., Ph.D., Nienke Vulink, M.D., Ph.D., Martijn Figee, M.D., Ph.D., Pieter Ooms, Ph.D., Mariska Mantione, Ph.D., Pepijn van den Munckhof, M.D., Ph.D., Rick Schuurman, M.D., Ph.D.
Affiliations: The Department of Psychiatry, University of Amsterdam (D.D., I.G., R.M., P.d.K., N.V., P.O.); the Department of Psychiatry, Mount Sinai Hospital, New York (M.F.); the Department of Neurosurgery, University of Amsterdam (P.v.d.M., R.S.); and the Department of Neurology and Neurosurgery, University of Amsterdam Utrecht, Utrecht, the Netherlands (M.M.).
Disclosures: Dr. Schuurman serves as an independent adviser for Boston Scientific, Elekta, and Medtronic. The other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Ned H. Kalin, M.D. (Editor-in-Chief, AJP); Carolyn Rodriguez, M.D., Ph.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals). Dr. Kalin has served as a consultant to the Board of Scientific Advisors, the Pritzker Neuropsychiatric Disorders Research Consortium, and the Skyland Trail Advisory Board and as Councilor, Society of Biological Psychiatry. Dr. Rodriguez has served as a consultant to Allergan, Blackthorn, Epiodyne, and Rugen. Mr. Roy and Mr. Pogachar report no financial relationships with commercial interests.
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