By Stephen Beech via SWNS
Deep brain stimulation could be the best way to treat obsessive-compulsive disorder, according to new research from Baylor College, Texas.
The study suggests that it can halve the symptoms of the debilitating mental health condition, known as OCD.
OCD is characterized by intrusive and persistent obsessive thoughts along with repeated behavior patterns. It is thought to affect up to three percent of people.
It often begins early in life and is frequently accompanied by severe depression or anxiety.
Justin Timberlake, Jessica Alba and David Beckham are among celebrities who have told of their struggles with OCD. Those affected often find it difficult to go to school or work.
Two-thirds of those affected experienced substantial improvement within two years, according to the analysis of pooled data published online in the BMJ Journal of Neurology Neurosurgery and Psychiatry.
Drugs and cognitive behavioral therapy (CBT) can be very effective in treating OCD, but in around one in 10 cases, those approaches don’t work.
Deep brain stimulation, which involves implanting electrodes in certain areas of the brain to regulate abnormal electrical impulses, has emerged in recent years as a potential treatment for those with severe symptoms.
While various studies have suggested that the technique can be effective in treating OCD patients, they have not always quantified the impact of potentially influential factors.
In a bid to account for this, the researchers systematically reviewed and pooled the results of 34 clinical trials published between 2005 and 2021, with the aim of critically assessing how well deep brain stimulation alleviates OCD and associated depressive symptoms in adults.
The 34 studies included 352 adults with an average age of 40, and severe to extreme OCD, the symptoms of which had not improved despite treatment.
In 23 of the studies, the participants were required to have had persistent symptoms for five or more years before consideration for surgery.
Of the remaining 11 studies, one had a requirement of more than a decade of symptoms and two or more years of failed treatment; another required at least one year of failed treatment; and five didn’t specify any requirements. On average, symptoms had persisted for 24 years.
Coexisting mental health issues were reported in 23 studies and included major depression, anxiety disorder, and personality disorder. The average monitoring period after deep brain stimulation was two years.
The final pooled data analysis, which included 31 studies, involving 345 participants, showed that deep brain stimulation reduced symptoms by 47 percent, and two-thirds of participants experienced substantial improvement within the monitoring period.
Secondary analysis revealed a reduction in reported depressive symptoms, with complete resolution in nearly half of the participants and partial response in a further 16 percent.
More than 20 of the studies reported complete data on serious side effects, including infections; seizures; suicide attempts; stroke; and the development of new obsessions associated with stimulation. Overall, 78 participants experienced at least one serious side-effect.
The findings prompt the researchers to conclude that there is “a strong evidence base” in support of the use of deep brain stimulation for the treatment of severe persistent OCD and associated depression.
Study author Dr. Sameer Sheth said: “While these results are encouraging, it is important to remember that deep brain stimulation is not without its limitations.
“First and foremost, it requires chronic implantation of hardware and carries the associated risk of complications.
"Furthermore, although we report a less than one percent incidence of de novo obsessions involving the deep brain stimulation patient programmer or the device itself, it remains a significant barrier to the effective implementation of deep brain stimulation for OCD in certain patients.”
Dr. Sheth, Associate Professor in the Department of Neurosurgery at Baylor College of Medicine in Houston, TX, added: “Successful application of deep brain stimulation requires a close therapeutic alliance between patient, neurosurgical and expert psychiatrist teams in centers that specialize in implantation and programming of the device.”
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