Severe obsessive compulsive disorder with very disabling and highly resistant to treatment. Other studies have noted that OCD may be associated with overly active neurons in a region of the brain called the caudate nucleus. A study in Biol Psychiatry 2008 Mar 15; 63:557 sheds some light on this issue. This study was reviewed in Journal Watch Psychiatry in the June 2008 Vol. 14 No. 6. Three patients, all of whom had a long history of severe OCD with repeated failures on the standard psychiatric medications and in psychotherapy, had electrodes implanted in their brain in order to deliver deep brain stimulation (DBS). “One year after surgery, scores in all patients on a standard OCD scale were 35% to 60% lower than the presurgery scores.” Unfortunately, the sample size is very small making it difficult to come to any meaningful conclusions about the use of DBS in patients with severe OCD.
The Bottom Line: The results of this study appear to support the idea that deep brain stimulation may help patients with severe obsessive compulsive disorder but the very small sample size makes it difficult to come to any meaningful conclusions about the use of DBS in patients with severe OCD. Nevertheless, this study does seem to support the theory that overly active neurons in the caudate nucleus may be, at least, one of the causes of OCD.
Dr. Tanya Korkosz
Dr. Jeffrey Speller
Psychopharmacology Associates
of New England
www.psychopharmassociates.com