Deep Brain Stimulation (DBS) for Obsessive-Compulsive Disorder (OCD)

Deep Brain Stimulation (DBS) for Obsessive-Compulsive Disorder (OCD)

Deep Brain Stimulation (DBS) for Obsessive-Compulsive Disorder (OCD)


Description: 
A 40-year-old male presents with treatment-resistant OCD to Mount Sinai. His symptoms began as tics in childhood, which progressed into fears of self-harm and harming others, and later, compulsive urges to poke his eyes. He would spend hours consumed with intrusive thoughts to neutralize these urges. In such severe cases, surgical neuromodulation is considered.

With a Yale-Brown OCD score of 30/40, his failed treatments included clomipramine, transcranial magnetic stimulation, electroconvulsive therapy, exposure and response prevention, and other pharmacological therapy. DBS for OCD has been approved since 2009 by the U.S. Food and Drug Administration under a humanitarian device exemption.

Brian H. Kopell, MD, Director of Mount Sinai’s Center for Neuromodulation, collaborated on this case with Martijn Figee, MD, PhD, Director of the Mount Sinai Interventional Psychiatry Program. They are part of a large team working within the Nash Center for Advanced Circuit Therapeutics (C-ACT), which was established as a hub to bring neurosurgeons, neurologists, psychiatrists, and psychologists together with neuroimaging specialists, electrophysiologists, data scientists, engineers, and basic neuroscientists to specifically rethink the way neuromodulation treatments are developed, personalized, and delivered to patients. Its founding director Helen S. Mayberg, MD, is internationally renowned for her study of brain circuits and her pioneering research into DBS.

In a narrated video, Drs. Kopell and Figee describe the preoperative planning, the surgical approach, the postoperative programming, and the outcome, which shows at 6-month follow-up the patient is almost free of OCD and has no eye-poking compulsions. Residual habitual rituals persist, they report, but they are shorter and unrelated to obsessions or strong urges.

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Featured Faculty

 

Brian H. Kopell, MD

Director, Center for Neuromodulation
Professor of Neurosurgery, Neurology, Psychiatry, and Neuroscience
Mount Sinai West

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Martijn Figee, MD, PhD

Director, Interventional Psychiatry Program
Mount Sinai West

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Published

February 1, 2023

Created by

Physician's Channel - Mount Sinai New York