PILOT STUDY OF DBS FOR TREATMENT-REFRACTORY OCD

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者的研究机构。 该研究项目的目标是减轻症状的严重程度，提高生活质量的严重和顽固性强迫症（OCD）的主题。尽管在药理学和行为疗法方面取得了进展，但大量患者在经过多年的常规和实验性干预后未能显着改善。对于一些患者，立体定向神经外科手术是唯一有希望的选择。现有的证据表明，这些程序可能会导致持久的好处和相对较少的副作用，在大多数强迫症患者的顽固性疾病。然而，这些消融技术对脑组织和功能的影响是不可逆的。一个欧洲研究小组报告了四个顽固性强迫症病例中的三个使用内囊前肢的双侧脑深部电刺激（DBS）的积极结果。在它得到更广泛的应用之前，由一个合格的精神神经外科团队的独立确认是至关重要的;已经有迹象表明，全国各地的许多中心都在追求它。虽然DBS，像消融手术一样，是一种有创手术，不常见但风险严重，与消融技术不同，DBS是可调节的，部分可逆的。本项目旨在收集6例难治性强迫症受试者内囊前肢中通过双侧植入电极进行慢性刺激（DBS）的有效性、安全性和耐受性的初步数据，否则这些受试者将成为消融性神经外科手术的候选者。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The goal of this research project is to reduce symptom severity and enhance quality of life for subjects with severe and intractable obsessive-compulsive disorder (OCD). Despite advances in the pharmacological and behavioral therapies, a substantial number of patients fail to improve significantly following years of conventional as well as experimental interventions. For some patients, stereotactic neurosurgery is the only promising option left. The available evidence suggests that these procedures may lead to enduring benefits and relatively few side effects in the majority of OCD patients with intractable disease. However, the effects of these ablative techniques on brain tissue and function are irreversible. A team of European investigators reported positive results in three of four intractable cases of OCD using bilateral deep brain stimulation (DBS) of the anterior limb of the internal capsule. Independent confirmation by a qualified psychiatric-neurosurgical team is crucial before it gains more widespread use; there are already indications that numerous centers across the country are pursuing it. Although DBS, like ablative surgery, is an invasive procedure with infrequent but serious risks, unlike ablative techniques, DBS is adjustable and partially reversible. The current project is designed to gather preliminary data on the effectiveness, safety, and tolerability of chronic stimulation (DBS) via bilaterally implanted electrodes in the anterior limb of the internal capsules of 6 subjects with treatment-refractory OCD that would otherwise be candidates for ablative neurosurgery.