Who Qualifies for Deep Brain Stimulation for OCD? Data From a Naturalistic Clinical Sample

Garnaat, Sarah L.; Greenberg, Benjamin D.; Sibrava, Nicholas J.; Goodman, Wayne K.; Mancebo, Maria C.; Eisen, Jane L.; Rasmussen, Steven A.

doi:10.1176/appi.neuropsych.12090226

Cited by 52 publications

(30 citation statements)

References 17 publications

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“…Beyond the implications for neurosurgical entry criteria, candidates for which are few 35 , these findings also have important implications for treatment planning for OCD patients more broadly. Clinicians who assess for a history of impairment significant enough to result in houseboundedness will quickly learn a key predictor of prognosis which may allow them to plan treatment more appropriately and aggressively.…”

Section: Discussionmentioning

confidence: 94%

Predicting Course of Illness in Patients With Severe Obsessive-Compulsive Disorder

Garnaat

Boisseau

Yip

et al. 2015

J. Clin. Psychiatry

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Objective Little data is available to inform clinical expectations about course and prognosis of severe OCD. This information is necessary to guide clinicians and to inform criteria for invasive interventions for severe and intractable OCD. This study sought to examine course and prospective predictors of a chronic course in patients with severe OCD over five years. Method A selected subset of adults in the Brown Longitudinal Obsessive-Compulsive Study (BLOCS) was included. Adult BLOCS participants were enrolled between 2001 and 2006. All participants in the current study had DSM-IV OCD diagnosis, severe OCD symptoms at baseline, and at least one year of follow-up data. Results Cox proportional hazard models were used to examine the general pattern of course in the severe OCD sample based on Longitudinal Interval Follow-Up Evaluation (LIFE) psychiatric status ratings, as well as test predictors of chronically severe course. Results indicated that approximately half of patients with severe OCD at baseline drop to a moderate or lower range of severity during five-years of follow-up (50.4%) and that marked improvement is rare after three years of severe illness. The only unique predictor of a more chronically severe course was patient report of ever having been housebound for a week or more due to OCD symptoms (p < .05). Conclusion Findings of this study were threefold: 1) half of participants with severe OCD have symptom improvement over five years of follow-up, 2) the majority of participants that drop-out of the severe range of symptom severity do so within the first three years of follow-up, and 3) patient-reported history of being housebound for one week or more due to OCD is a significant predictor of remaining severe over the five-year follow-up.

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Section: Discussionmentioning

confidence: 94%

Predicting Course of Illness in Patients With Severe Obsessive-Compulsive Disorder

Garnaat

Boisseau

Yip

et al. 2015

J. Clin. Psychiatry

Self Cite

View full text Add to dashboard Cite

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“…Second, multiple groups have identified abnormal cortical and subcortical beta rhythms in PD (4), whereas there is no robust or well-replicated EEG signature of OCD in any frequency band. Finally, psychiatric diagnoses have profound internal heterogeneity, and this may be specifically worse in DBS cases given how rare and treatment-resistant these patients are (5,6). The observed effect of Bahramisharif et al (1) may be driven by specific DBS settings or by unmodeled patient characteristics, including patients’ level of occipital CFC before surgery.…”

Section: To the Editormentioning

confidence: 99%

Ventral Capsule/Ventral Striatum Deep Brain Stimulation Does Not Consistently Diminish Occipital Cross-Frequency Coupling

Widge

Zorowitz

Link

et al. 2016

Biological Psychiatry

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“…VC/VS DBS for obsessive-compulsive disorder has worked in open-label studies, 7 and the number of patients with obsessive-compulsive disorder who qualify for DBS is small. 11 This result led to an approval by the U.S. Food and Drug Administration for VC/VS DBS in obsessive-compulsive disorder under a Humanitarian Device Exemption.…”

mentioning

confidence: 99%

Predictors of Hypomania During Ventral Capsule/Ventral Striatum Deep Brain Stimulation

Widge¹,

Licon²,

Zorowitz³

et al. 2016

JNP

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Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is a novel therapy for neuropsychiatric disorders. Hypomania is a known complication of VC/VS DBS, but who is at risk is less understood. Factors such as family history, combined with details of DBS programming, might quantify that risk. The authors performed an iterative modeling procedure on a VC/VS DBS patient registry to identify key predictors. Hypomania was less common for men and for patients stimulated on the ventral right contact. It was more common with right monopolar stimulation. These findings may help to establish decision rules to reduce complications of VC/VS DBS.

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Who Qualifies for Deep Brain Stimulation for OCD? Data From a Naturalistic Clinical Sample

Cited by 52 publications

References 17 publications

Predicting Course of Illness in Patients With Severe Obsessive-Compulsive Disorder

Predicting Course of Illness in Patients With Severe Obsessive-Compulsive Disorder

Ventral Capsule/Ventral Striatum Deep Brain Stimulation Does Not Consistently Diminish Occipital Cross-Frequency Coupling

Predictors of Hypomania During Ventral Capsule/Ventral Striatum Deep Brain Stimulation

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