Deep Brain Stimulation for Refractory Obsessive-Compulsive Disorder

Who can take part

• Patients with a diagnosis of obsessive-compulsive disorder according to Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 criteria
• Severe OCD assessed by the Yale-Brown Obsessive-Compulsive Scale (YBOCS) with a score of more than 27
• Refractory OCD; severe symptoms and impairment for more than 5 years despite pharmacological and psychological treatment
• Have failed to improve following treatment with at least two serotonin transport inhibitors and one augmenting agent taken for an adequate time period
• Having failed to improve despite adequate cognitive behavioral therapy, as evaluated by the study psychiatrist
• Patients between 22 and 75
• Ability to understand and sign written informed consent by the patient

Who cannot take part

• Any clinically significant abnormality on preoperative MRI that would affect the safety of the surgical procedure in the opinion of the study neurosurgeon
• Diagnosis of severe major depression disorder (MDD) with psychotic features
• Comorbidity with any primary Psychotic Disorder, Post-Traumatic Stress Disorder (PTSD), or Eating Disorder
• History of substance or alcohol dependence or abuse in the preceding 12 months
• Any other current clinical significant neurological disorder or medical illness affecting brain function, other than a tic disorder
• Any DBS contraindication, infection, coagulopathy, significant cardiac risk factors, or other medical risk factors for surgery
• Significant suicidal risk [Hamilton Depression scale item 3 (suicide)>2]
• Significant cognitive decline, measured by Mini-Mental State Examination (MMSE <26) and Montreal Cognitive Assessment (MoCA; <24)
• Pregnancy