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Scientists Pinpoint How Deep Brain Stimulation Eases OCD
Date:2/25/2013

approval in the United States to treat OCD that hasn't responded to other treatments.

But experts haven't been sure why the procedure worked.

This study involved 16 patients with OCD and 13 healthy controls, all of whom had electrodes implanted in the nucleus accumbens area of the brain. They then underwent functional MRI brain scans while performing a task that involved the anticipation of reward (the type of activity that might trigger OCD).

OCD symptoms improved an average of 50 percent while brain activity -- not only in the nucleus accumbens but also in a larger brain network -- was normalized, said Figee, who is a psychiatrist with the DBS psychiatry department at Academic Medical Center in Amsterdam, the Netherlands.

"This may explain why patients with DBS experience very fast changes in a wide array of motivational and behavioral problems," he added. "This is clinically important because it indicates that DBS could also help for other disorders that have similar network disturbances, like addiction or eating disorders."

Several centers in Europe and the United States now use DBS for psychiatric illnesses, said Figee.

Accessibility and insurance coverage vary greatly, although Medicaid sometimes covers it, said Goodman.

But choosing appropriate candidates for the procedure can be daunting, as they need to have failed multiple medications as well as cognitive behavioral therapy, said Snyder. Cognitive behavioral therapy is a treatment that helps patients try to change their thoughts, feelings and behaviors. The patients also need to be free of other psychiatric disorders.

Although benefits appear to be long lasting, the procedure is not a cure, Snyder noted.

"It provides significant symptomatic benefits," he said. "It could mean the difference between being able to go out of the house and going to a job and being stuck in the house or an institution all the time."

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