Obsessive-compulsive disorder (OCD) is a common and serious psychiatric disorder. Although subthalamic nucleus deep brain stimulation (DBS) has been studied as a treatment for OCD patients the underlying mechanism of this treatment and the optimal method of stimulation are unknown. To study the neural basis of subthalamic nucleus DBS in OCD patients we used a novel, implantable DBS system with long-term local field potential sensing capability. We focus our analysis on two patients with OCD who experienced severe treatment-resistant symptoms and were implanted with subthalamic nucleus DBS systems. We studied them for a year at rest and during provocation of OCD symptoms (46 recording sessions) and compared them to four Parkinson's disease (PD) patients implanted with subthalamic nucleus DBS systems (69 recording sessions). We show that the dorsal (motor) area of the subthalamic nucleus in OCD patients displays a beta (25-35 Hz) oscillatory activity similar to PD patients whereas the ventral (limbic-cognitive) area of the subthalamic nucleus displays distinct theta (6.5-8 Hz) oscillatory activity only in OCD patients. The subthalamic nucleus theta oscillatory activity decreases with provocation of OCD symptoms and is inversely correlated with symptoms severity over time. We conclude that beta oscillations at the dorsal subthalamic nucleus in OCD patients challenge their pathophysiologic association with movement disorders. Furthermore, theta oscillations at the ventral subthalamic nucleus in OCD patients suggest a new physiological target for OCD therapy as well as a promising input signal for future emotional-cognitive closed-loop DBS.
|State||Published - 1 Dec 2018|
Bibliographical noteFunding Information:
The Activa PC + S devices were generously provided by Medtronic Inc, MA, USA. The study was partially supported by grants from the NARSAD Young Investigator Grant (R.E.), the Israel Science Foundation-ISF no. 1129/12 (R.E. and H.B.), the Israel-US Binational Science Foundation–BSF no. 2011410 (R.E. and H. B.), the Magnet program of the Office of the Chief Scientist (OCS) of the Ministry of Economy of Israel (H.B.) and the Adelis foundation grant (Z.I. and H. B.). The remaining authors declare no competing interests.
© 2018 The Author(s).