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Deep Brain Stimulation for Intractable OCD 

Deep Brain Stimulation for Intractable OCD
Deep Brain Stimulation for Intractable OCD

Wayne K. Goodman

, Nigel Kennedy

, Kyle Lapidus

, and Brian H. Kopell

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date: 26 June 2022

This chapter discusses the use of deep brain stimulation (DBS) for intractable OCD. In contrast to ablative procedures, DBS has the advantages of being reversible (explantable) and adjustable. In 2010, the FDA approved a Humanitarian Device Exemption (HDE) for ventral capsule/ventral striatum DBS in intractable OCD, based upon the device’s safety and its probable benefit, for up to 4,000 people a year in the US. DBS is only suitable for adult patients who remain severely ill despite multiple medication trials and adequate treatment with cognitive behavioral therapy. Further research is needed to further test the efficacy of DBS in OCD, compare targets, identify predictors of response, and optimize programming. Future DBS systems may take advantage of closed loop technology in which feedback from the brain is used to adjust stimulation automatically according to the patient’s changing needs.

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