Use of electrodes to stimulate areas deep in the brain has been uncovered as an alternative therapy for OCD sufferers who are resistant to other treatment types. It is a third means of treatment with pre-existing means being medication and cognitive behavioural therapy.
The two types of treatment mentioned are only effective for the bare majority of patients with 60% of sufferers experiencing a benefit by this means.
It is estimated that 10% of patients are severely affected by OCD despite using both of these treatment options. A reassessment of the safety of electrode use has been enacted by Damianna Denys of the University of Amsterdam. Also assessed was the effectiveness of the treatment type.
16 Study Participants
16 patients were taken who had symptoms of OCD, yet had not been cured after being in receipt of the other treatments for an extended time.
There were three treatment phases in the study, with the study taking place over an eight month period. Electrodes were implanted in the nucleus accumbens of the patients. This area of the brain is critical for our reward systems. Once implanted,
All participants received active stimulation to these electrodes. An assessment of their OCD symptoms was made every two weeks.
After this eight month period (Open Phase) all of the participants were invited to partake in a double blind phase lasting one month. This double blind phase meant, that there was a random assignment made to have the electrodes turned on or off in blocks lasting two weeks.
Assessment occurred prior to the double blind phase, and at the end of each of these two week blocks. A 12 month maintenance phase followed.
In this maintenance phase, stimulation resumed with assessment only now occurring every three months.
The ranking of OCD symptoms comes in the range of 0 to 40. If there was a score that showed a drop of more than 35% then these patients were classified as having responded to treatment. During the (open phase) of this study there was much improvement in symptoms noted, with the average score seeing a decrease of 46% of symptoms.
9 of the 16 participants showed a drop in symptom presentation of around 72%. It was found that depressive symptoms decreased by one half, with the stimulation being well received and tolerated by the participants.
Still Adverse Effects
There were however some permanent adverse effects of the OCD still present in these people, most notably word finding problems and mild forgetfulness.
It was uncovered during the double blind phase in which 14 of the patients were included, that there was a difference in the rate of response to the placebo stimulation and the real stimulation.
Here there was a decrease in the presence of symptoms of between 8.3 and 25%. It was found that the improvements made were sustained during the maintenance phase of the study.
The research authors have noted that in summary there is an indication as a result of the study that bilateral stimulation of the nucleus accumbens may be an effective and also a safe treatment in patients whose OCD is highly refractory. Safe is the key detail in this instance and what the scientists are delving to unearth. With any degree of stimulation being emitted into the body there is the potential for harm and stimulating particular regions of the brain through direct contact with electrodes is dangerous for obvious reasons.
It was found also that there is a support mechanism here for patients and doctors, another means of treatment beyond the cognitive techniques and the medication. There is in other words therapeutic potential in patients with incapacitating chronic psychiatric disorders such as OCD.
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