Deep brain stimulation in the ALIC-BNST region targeting the bed nucleus of stria terminalis in patients with obsessive-compulsive disorder : effects on cognition after 12 months
© 2022. The Author(s)..
PURPOSE: The aim of this study was to evaluate cognitive effects 12 months after Deep Brain Stimulation (DBS) of the Bed Nucleus of Stria Terminalis (BNST) in patients with refractory Obsessive-Compulsive Disorder (OCD).
METHODS: Eight patients (5 female; mean ± SD age 36 ± 15) with OCD were included. A neuropsychological test battery covering verbal and spatial episodic memory, executive function, and attention was administered preoperatively and 12 months after surgery. Medical records were used as a source for descriptive data to probe for any changes not covered by standardized checklists and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the primary outcome measure.
RESULTS: At 12 months, seven patients showed response to DBS: three were full responders (i.e., Y-BOCS ≥ 35% improvement), and four were partial responders (Y-BOCS 25-34% improvement). Relative to baseline, there was a slight decline on visuo-spatial learning (p = 0.027), and improved performance on the Color-Word Interference inhibition/switching subtest (p = 0.041), suggesting improvement in cognitive flexibility.
CONCLUSIONS: DBS in the BNST for treatment refractory OCD generates very few adverse cognitive effects and improves cognitive flexibility after 12 months of stimulation. The improvement in Y-BOCS and the absence of major cognitive side effects support the BNST as a potential target for DBS in severe OCD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:165 |
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| Enthalten in: |
Acta neurochirurgica - 165(2023), 5 vom: 02. Mai, Seite 1201-1214 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Philipson, Johanna [VerfasserIn] |
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| Links: |
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| Themen: |
Bed nucleus of stria terminalis, BNST |
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| Anmerkungen: |
Date Completed 01.05.2023 Date Revised 24.05.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00701-022-05351-2 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM345734718 |
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| 100 | 1 | |a Philipson, Johanna |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Deep brain stimulation in the ALIC-BNST region targeting the bed nucleus of stria terminalis in patients with obsessive-compulsive disorder |b effects on cognition after 12 months |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 01.05.2023 | ||
| 500 | |a Date Revised 24.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a PURPOSE: The aim of this study was to evaluate cognitive effects 12 months after Deep Brain Stimulation (DBS) of the Bed Nucleus of Stria Terminalis (BNST) in patients with refractory Obsessive-Compulsive Disorder (OCD) | ||
| 520 | |a METHODS: Eight patients (5 female; mean ± SD age 36 ± 15) with OCD were included. A neuropsychological test battery covering verbal and spatial episodic memory, executive function, and attention was administered preoperatively and 12 months after surgery. Medical records were used as a source for descriptive data to probe for any changes not covered by standardized checklists and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the primary outcome measure | ||
| 520 | |a RESULTS: At 12 months, seven patients showed response to DBS: three were full responders (i.e., Y-BOCS ≥ 35% improvement), and four were partial responders (Y-BOCS 25-34% improvement). Relative to baseline, there was a slight decline on visuo-spatial learning (p = 0.027), and improved performance on the Color-Word Interference inhibition/switching subtest (p = 0.041), suggesting improvement in cognitive flexibility | ||
| 520 | |a CONCLUSIONS: DBS in the BNST for treatment refractory OCD generates very few adverse cognitive effects and improves cognitive flexibility after 12 months of stimulation. The improvement in Y-BOCS and the absence of major cognitive side effects support the BNST as a potential target for DBS in severe OCD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Bed nucleus of stria terminalis, BNST | |
| 650 | 4 | |a Cognition | |
| 650 | 4 | |a Deep brain stimulation, DBS | |
| 650 | 4 | |a Obsessive–compulsive disorder, OCD | |
| 700 | 1 | |a Naesstrom, Matilda |e verfasserin |4 aut | |
| 700 | 1 | |a Johansson, Johannes D |e verfasserin |4 aut | |
| 700 | 1 | |a Hariz, Marwan |e verfasserin |4 aut | |
| 700 | 1 | |a Blomstedt, Patric |e verfasserin |4 aut | |
| 700 | 1 | |a Jahanshahi, Marjan |e verfasserin |4 aut | |
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