Deep brain stimulation-its practical procedures, risks and benefits

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  • Sugiyama Kenji
    Department of Neurosurgery, Hamamatsu University School of Medicine
  • Namba Hiroki
    Department of Neurosurgery, Hamamatsu University School of Medicine
  • Nozaki Takao
    Department of Neurosurgery, Hamamatsu University School of Medicine
  • Itoh Tae
    Department of Neurosurgery, Hamamatsu University School of Medicine

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Other Title
  • DBSの実際─リスクとベネフィット
  • DBSの実際 : リスクとベネフィット
  • DBS ノ ジッサイ : リスク ト ベネフィット

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Abstract

Deep brain stimulation (DBS) has started from the therapy for intractable pain or involuntary movement, recognized as a therapy for cortico-striato-thalamo-cortical loop circuit in CNS, and has recently applied to some psychiatric disorders, such as treatment- refractory obsessive compulsive disorder (OCD) and depression. DBS therapy for intractable OCD obtained FDA approval in USA and CE mark approval in Europe. 94 DBS cases for intractable OCD have been reported. The average overall response rate is 64% (63.8±21.9%) . Three different target have mainly been reported. Case numbers (1) and the responded cases YBOCS less than 15 points (2), or 20 points (.) were as follows ; 1) anterior limb of internal capsule/ ventral striatum : 1. 42 cases, 2. 12 cases, 3. 15 cases, 2) nucleus accumbence ; 1. 33 cases, 2. 8-11 cases, 3. 13 cases, 3) subthalamic nucleus ; 1. 19 cases, 2. 7 cases, 3. 11 cases. We hope these DBS therapy for intractable OCD are recognized as a alternative adjuvant treatment for intractable OCD by Japanese psychiatrists, OCD patients and their families.

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