The current state, challenges, and future directions of deep brain stimulation for obsessive compulsive disorder

Expert Rev Med Devices. 2023 Aug 29. doi: 10.1080/17434440.2023.2252732. Online ahead of print.ABSTRACTINTRODUCTION: Obsessive-compulsive disorder (OCD) is clinically and pathologically heterogenous, with symptoms often refractory to first line treatments. Deep brain stimulation (DBS) for the treatment of refractory OCD provides opportunity to adjust and individualize neuromodulation targeting aberrant circuitry underlying OCD. The tailoring of DBS therapy may allow precision in symptom control based on patient specific pathology. Progress has been made in understanding the potential targets for DBS intervention, however, a consensus on an optimal target has not been agreed upon.AREAS COVERED: A literature review of DBS for OCD was performed by querying the PubMed database. The following topics were covered: the evolution of DBS targeting in OCD, the concept of an underlying unified connectomic network, current DBS targets, challenges facing the field, and future directions which could advance personalized DBS in this challenging population.EXPERT OPINION: To continue increasing efficacy of DBS for OCD, we must further explore optimal DBS response across clinical profiles and neuropsychiatric domains of OCD as well as how interventions targeting multiple points in an aberrant circuit, multiple aberrant circuits, or a connectivity hub impacts clinical response. Additionally, biomarkers would be invaluable in programming adjustments and creating a closed-loop paradigm to addres...
Source: Expert Review of Medical Devices - Category: Medical Devices Authors: Source Type: research