Six-Nine Year Follow-Up of Deep Brain Stimulation for Obsessive-Compulsive Disorder.
Six-Nine Year Follow-Up of Deep Brain Stimulation for Obsessive-Compulsive Disorder.
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DOI：
10.1371/journal.pone.0167875
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Ward HE
中科院分区：
文献类型：
--
作者：
Fayad SM;Guzick AG;Reid AM;Mason DM;Bertone A;Foote KD;Okun MS;Goodman WK;Ward HE
腹侧囊/腹侧纹状体（VC/VS）区域的脑深部电刺激（DBS）已显示出作为严重治疗难治性强迫症（OCD）成人的神经外科干预的前景。初步研究显示，DBS后强迫症状和次要结局得到改善。我们试图确定VC/VS DBS治疗成人强迫症的长期安全性和有效性。对6名入选国家精神卫生研究所原始DBS治疗强迫症试点研究的患者进行了长期随访研究（73-112个月）。收集了定性和定量数据。强迫症症状的减少反映了一年的随访数据。同样的四名参与者在治疗一年后表现出一致的强迫症反应（耶鲁布朗强迫症量表（YBOCS）降低超过35%）。另一例被归类为非应答者的受试者在长期随访时YBOCS评分降低了26%。唯一一名YBOCS未减少25%或以上的患者不再接受主动DBS治疗。次要结局通常与1年随访结果相匹配，但抑郁症状除外，其在随访期间显著增加。定性反馈表明受试者对DBS耐受良好。这些数据表明，DBS是安全的，并在减少强迫症症状方面具有长期益处。在初步诊断为强迫症的患者中，VC/VS区域的DBS没有显示出对共病抑郁症状的持续反应。
Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) region has shown promise as a neurosurgical intervention for adults with severe treatment-refractory obsessive-compulsive disorder (OCD). Pilot studies have revealed improvement in obsessive-compulsive symptoms and secondary outcomes following DBS. We sought to establish the long-term safety and effectiveness of DBS of the VC/VS for adults with OCD. A long term follow-up study (73–112 months) was conducted on the six patients who were enrolled in the original National Institute of Mental Health pilot study of DBS for OCD. Qualitative and quantitative data were collected. Reduction in OCD symptoms mirrored the one-year follow-up data. The same four participants who were treatment responders after one year of treatment showed a consistent OCD response (greater than 35% reduction in Yale Brown Obsessive Compulsive Scale (YBOCS)). Another subject, classified as a non-responder, achieved a 26% reduction in YBOCS score at long term follow-up. The only patient who did not achieve a 25% or greater reduction in YBOCS was no longer receiving active DBS treatment. Secondary outcomes generally matched the one-year follow-up with the exception of depressive symptoms, which significantly increased over the follow-up period. Qualitative feedback indicated that DBS was well tolerated by the subjects. These data indicate that DBS was safe and conferred a long-term benefit in reduction of obsessive-compulsive symptoms. DBS of the VC/VS region did not reveal a sustained response for comorbid depressive symptoms in patients with a primary diagnosis of OCD.
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影响因子：
10.6
作者：
Goodman WK;Foote KD;Greenberg BD;Ricciuti N;Bauer R;Ward H;Shapira NA;Wu SS;Hill CL;Rasmussen SA;Okun MS
通讯作者：
Okun MS
影响因子：
7.6
作者：
Greenberg, Benjamin D.;Malone, Donald A.;Rasmussen, Steven A.
通讯作者：
Rasmussen, Steven A.
影响因子：
6.6
作者：
Zimmerman, Mark;Martinez, Jennifer H.;Dalrymple, Kristy
通讯作者：
Dalrymple, Kristy
影响因子：
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作者：
KARNO, M;GOLDING, JM;BURNAM, MA
通讯作者：
BURNAM, MA
影响因子：
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作者：
Pine, DS;Cohen, P;Ma, YJ
通讯作者：
Ma, YJ