Removing and reimplanting deep brain stimulation therapy devices in resistant OCD (when the patient does not respond)

Journal article


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Publication Details

Subtitle: case report
Author list: Soriano-Mas C
Publisher: BMC (part of Springer Nature)
Publication year: 2016
Journal: BMC Psychiatry (1471-244X)
Volume number: 16
Start page: 26
Number of pages: 7
ISSN: 1471-244X
Languages: English-Great Britain (EN-GB)


Deep brain stimulation (DBS) is emerging as a promising tool in the
treatment of refractory obsessive-compulsive disorder (OCD) but the
search for the best target still continues. This issue is especially
relevant when particularly resistant profiles are observed in some
patients, which have been ascribed to individual responses to DBS
according to differential patterns of connectivity. As patients have
been implanted, new dilemmas have emerged, such as what to do when the
patient does not respond to surgery.Here we describe a 22-year-old male
with extremely severe OCD who did not respond to treatment with DBS in
the nucleus accumbens, but who did respond after explanting and
reimplanting leads targeting the ventral capsule-ventral striatum
region. Information regarding the position of the electrodes for both
surgeries is provided and possible brain structures affected during
stimulation are reviewed. To our knowledge this case is the first in the
literature reporting the removal and reimplantation of DBS leads for
therapeutical benefits in a patient affected by a mental disorder.The
capability for explantation and reimplantation of leads should be
considered as part of the DBS therapy reversibility profile in resistant
mental disorders, as it allows application in cases of non-response to
the first surgery.


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Last updated on 2019-13-08 at 00:45