According to new research published in the journal Biological Psychiatry, targeted deep brain stimulation (DBS) may substantially improve symptoms of severe obsessive compulsive disorder (OCD), particularly debilitating behaviours and all-consuming thoughts.
The repetitive and compulsive behaviour in patients with OCD is known to be associated with cognitive rigidity or impaired cognitive flexibility. OCD is conventionally treated with a type of cognitive behavioural therapy known as 'exposure and response prevention' or with selective serotonin reuptake inhibitors. Despite this, about 40 per cent of patients with OCD are unresponsive to treatment.
Researchers at the University College London and the University of Cambridge evaluated the effectiveness of DBS for severe OCD in 6 patients. They compared the effects of DBS at two different locations of the brain: the subthalamic nucleus (STN) and ventral capsule (VC).
The findings showed that both sites were significantly effective in lowering the symptoms of OCD but on distinct aspects: while VC stimulation enhanced mood, STN stimulation enhanced cognitive flexibility. The two sites are believed to work on separate brain circuits, one involving the medial prefrontal cortex and the other involving the lateral prefrontal cortex.
Professor Barbara Sahakian from the University of Cambridge said: "While DBS is only used when medication and specific psychological treatments have been tried and failed, for some patients it may provide them with the opportunity to regain well-being and quality of life."