Deep Brain Stimulation of the Nucleus Accumbens for Treatment-Refractory Obsessive-Compulsive Disorder
Deep Brain Stimulation of the Nucleus Accumbens for Treatment-Refractory Obsessive-Compulsive Disorder
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DOI：
10.1001/archgenpsychiatry.2010.122
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发表时间：
2010-10-01
影响因子：
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通讯作者：
Schuurman, Rick
中科院分区：
文献类型：
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作者：
Denys, Damiaan;Mantione, Mariska;Schuurman, Rick
背景：强迫症(OCD)是一种慢性精神障碍，影响2%的总人口。目的：确定双侧伏隔核脑深部刺激对难治性强迫症是否是有效和安全的治疗。设计：该研究包括开放的8个月的治疗阶段，然后是随机分配的2周的积极或虚假刺激的双盲交叉阶段，以开放的12个月的维持期结束。研究对象包括符合DSM-IV标准的强迫症患者，年龄18-65岁，符合严格的治疗难治标准。干预：双侧脑深部电刺激治疗的核团准确性。主要观察指标：根据YaleBrown强迫量表(Y-BOCS)基线的评分变化来评估主要疗效。结果：在开放阶段，平均(SD)Y-BOCS评分下降了46%，从基线的33.7(3.6)分下降到8个月后的18.0(11.4)分(P
Context: Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that affects 2% of the general population. Even when the best available treatments are applied, approximately 10% of patients remain severely afflicted and run a long-term deteriorating course of OCD.Objective: To determine whether bilateral deep brain stimulation of the nucleus accumbens is an effective and safe treatment for treatment-refractory OCD.Design: The study consisted of an open 8-month treatment phase, followed by a double-blind crossover phase with randomly assigned 2-week periods of active or sham stimulation, ending with an open 12-month maintenance phase.Setting: Academic research.Patients: Sixteen patients (age range, 18-65 years) with OCD according to DSM-IV criteria meeting stringent criteria for refractoriness to treatment were included in the study.Interventions: Treatment with bilateral deep brain stimulation of the nucleus accurnbens.Main Outcome Measures: Primary efficacy was assessed by score change from baseline on the YaleBrown Obsessive Compulsive Scale (Y-BOCS). Responders were defined by a score decrease of at least 35% on the Y-BOCS.Results: In the open phase, the mean (SD) Y-BOCS score decreased by 46%, from 33.7 (3.6) at baseline to 18.0 (11.4) after 8 months (P