PRELIMINARY STUDY IN PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER TREATED WITH ELECTRICAL STIMULATION IN THE INFERIOR THALAMIC PEDUNCLE
PRELIMINARY STUDY IN PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER TREATED WITH ELECTRICAL STIMULATION IN THE INFERIOR THALAMIC PEDUNCLE
复制标题
DOI：
10.1227/01.neu.0000345938.39199.90
复制
发表时间：
2009-12-01
期刊：
影响因子：
4.8
通讯作者：
Luis Criales, Jose
中科院分区：
文献类型：
--
作者：
Jimenez-Ponce, Fiacro;Velasco-Campos, Francisco;Luis Criales, Jose
目的：脑深部电刺激已被用于治疗难治性强迫症（OCD）。我们的主要目的是确定的安全性和有效性的丘脑下脚脑深部电刺激治疗难治性OCD.METHODS：开放协议进行了2003年3月至2007年4月5例强迫症难治性常规治疗。双侧立体定向植入四极电极的目的是丘脑下脚和证实的电生理反应和磁共振成像。所有患者在植入后1个月停止刺激。在刺激期间，在双极和连续模式下将参数设置为5 V、450微秒、130 Hz。每3个月用Yale-Brown强迫症量表和整体功能评估量表评估一次临床变化，共12个月。结果：Yale-Brown强迫量表评分从35分下降到17.8分（P < 0.001），总体功能评定量表评分从20%提高到70%（P < 0.0001）。的神经心理电池没有显示出显着的变化，并有没有相关的电刺激在慢性period.CONCLUSION副作用：我们得出结论，丘脑下脚刺激是一个安全的程序，并可能是一个有效的替代治疗那些强迫症的情况下，传统的治疗方法难治性。
OBJECTIVE: Deep brain stimulation has been used in the treatment of refractory obsessive-compulsive disorder (OCD). Our principal objective was to determine the safety and effectiveness of deep brain stimulation of the inferior thalamic peduncle in the treatment of refractory OCD.METHODS: An open protocol was performed from March 2003 to April 2007 in 5 patients with OCD refractory to conventional treatments. Bilateral stereotactic implantation of tetrapolar electrodes was aimed at the inferior thalamic peduncle and corroborated by electrophysiological responses and magnetic resonance imaging. All patients were off stimulation for 1 month after implantation. In the on-stimulation period, parameters were set at 5 V, 450 microseconds, 130 Hz in bipolar and continuous mode. Clinical changes were evaluated every 3 months for 12 months by means of the Yale-Brown Obsessive Compulsive Scale and the Global Assessment of Functioning scale. Statistical significance was assessed by the Friedman and Wilcoxon tests.RESULTS: The mean Yale-Brown Obsessive Compulsive Scale score decreased from 35 to 17.8 (P < 0.001), and the mean Global Assessment of Functioning scale score improved from 20% to 70% (P < 0.0001). The neuropsychological battery did riot show significant changes, and there were no side effects related to electrical stimulation in the chronic period.CONCLUSION: We conclude that inferior thalamic peduncle stimulation is a safe procedure and may be an effective alternative in the treatment of those OCD cases refractory to conventional treatments.