Original articlesDeep brain stimulation for refractory obsessive-compulsive disorder
Section snippets
Entry criteria and measures
This study was reviewed and approved by the University of Michigan Institutional Review Board. In addition, the protocol was granted an Investigational Device Exemption by the U.S. Food and Drug Administration. Entry criteria included Yale-Brown Obsessive Compulsive Scale (Y-BOCS; Goodman et al 1989a, 1989b) score of at least 25; Global Assessment of Function (GAF; Endicott et al 1976) score of no more than 44; multiple unsuccessful attempts at treatment with antiobsessional medication at
Subjects
Subject characteristics are presented in Table 1. Nonessential details have been changed to shield identity.
Exploratory testing
Side effects and symptom responses during exploratory testing are presented in Table 2. along with parameter settings chosen for the blinded test phase. Side effects were most prominent at high amplitudes and monopolar settings. The only acute symptom responses noted occurred in subject 3. She experienced a striking episode of elevated mood and increased activity, occurring at both
Discussion
This preliminary effort at a double-blind, controlled trial of DBS for treatment-refractory OCD produced favorable results. One of four patients (25%) showed a greater than 35% improvement in OCD symptoms during the double-blind testing phase. Two of four (50%) showed this level of improvement during the open phase. These results are comparable to those achieved with ablative, anterior capsulotomy (Mindus et al 1994), which has not been amenable to study in blinded protocols. These results
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