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Dr. Bob is Robert Hsiung, MD,
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Posted by ed_uk on December 15, 2004, at 8:58:39
.... or is anyone considering DBS for the treatment of intractable depression or OCD?
Deep brain stimulation of the ventral caudate nucleus in the treatment of obsessive-compulsive disorder and major depression. Case report.
Obsessive-compulsive disorder (OCD) is an anxiety disorder associated with recurrent intrusive thoughts and repetitive behaviors. Although conventional pharmacological and/or psychological treatments are well established and effective in treating OCD, symptoms remain unchanged in up to 30% of patients. Deep brain stimulation (DBS) of the anterior limb of the internal capsule has recently been proposed as a possible therapeutic alternative in treatment-resistant OCD. In the present study, the authors tested the hypothesis that DBS of the ventral caudate nucleus might be effective in a patient with intractable severe OCD and concomitant major depression. Psychiatric assessment included the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), and the Global Assessment of Functioning (GAF) Scale for determining the symptom severity of OCD, depression, and anxiety as well as the quality of pychosocial and occupational functioning, respectively. Neuropsychological assessment consisted of a wide range of tests primarily exploring memory and executive functions. Deep brain stimulation of the ventral caudate nucleus markedly improved symptoms of depression and anxiety until their remission, which was achieved at 6 months after the start of stimulation (HDRS < or = 7 and HARS < or = 10). Remission of OCD (Y-BOCS < 16) was also delayed after 12 or 15 months of DBS. The level of functioning pursuant to the GAF scale progressively increased during the 15-month follow-up period. No neuropsychological deterioration was observed, indicating that DBS of the ventral caudate nucleus could be a promising strategy in the treatment of refractory cases of both OCD and major depression.
Posted by bipolarspectrum on December 16, 2004, at 0:39:43
In reply to Has anyone ever had deep brain stimulation?, posted by ed_uk on December 15, 2004, at 8:58:39
Hi,
I've been battling with a bipolar depression for a couple years now.. I can't seem to tolerate medication... my psychopharm has been dropping hints all over the place about deep brain stimulation (I'm in canada)... and after thinking about it, I am all for it... its all experimental and I'm not sure if theres much evidence... but it seems to really help parkinsons patients and other movement disorders.. plus, it has a great benefit for ocd, which is inherently difficult to treat i understand... but the clincher for my interest in dbs was that its been put in 30-40000 parkinsons patients.. hence, the procedure itself is not experimental and potentially relatively safe... plus, the idea with remission with minimal bodily side effects and never having to take a pill again is a big plus... but its all speculation!!!
bps
Posted by ed_uk on December 16, 2004, at 6:33:07
In reply to MAY POSSIBILY DO SO SOON!!, posted by bipolarspectrum on December 16, 2004, at 0:39:43
Hi,
Thank you for your reply.
When do you think that you might be able to have it done?
Regards,
Ed.
Posted by bipolarspectrum on December 16, 2004, at 16:37:54
In reply to Re: MAY POSSIBILY DO SO SOON!! » bipolarspectrum, posted by ed_uk on December 16, 2004, at 6:33:07
Ed,
No idea when I can get it done.. they have very very stringest screening.. and i doubt i'll meet the requirements (more like 'failments') because I have been on many of the medications for 8-10 weeks.. the centre for me is Toronto.. but i understand they do dbs for depression in many of the large, academic centres like Mass Hospital, where i beleive they do 11-12 a year... so, i doubt mine will happen for a couple months but thoughts of it bring hope to my little world..
bps
Posted by denise1904 on December 19, 2004, at 12:20:43
In reply to Has anyone ever had deep brain stimulation?, posted by ed_uk on December 15, 2004, at 8:58:39
Hi,
Doestn't deep brain stimulation invole an operation and boring a hole into the brain? wouldn't it be better to try ect first?
Denise
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