Connectomic Deep Brain Stimulation for Obsessive-Compulsive Disorder

J.C. Baldermann*, T. Schuller, S. Kohl, V. Voon, N.F. Li, B. Hollunder, M. Figee, S.N. Haber, S.A. Sheth, P.E. Mosley, D. Huys, K.A. Johnson, C. Butson, L. Ackermans, T.B. van der Vlis, A.F.G. Leentjens, M. Barbe, V. Visser-Vandewalle, J. Kuhn, A. Horn

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

Abstract

Obsessive-compulsive disorder is among the most disabling psychiatric disorders. Although deep brain stimulation is considered an effective treatment, its use in clinical practice is not fully established. This is, at least in part, due to ambiguity about the best suited target and insufficient knowledge about underlying mechanisms. Recent advances suggest that changes in broader brain networks are responsible for improvement of obsessions and compulsions, rather than local impact at the stimulation site. These findings were fueled by innovative methodological approaches using brain connectivity analyses in combination with neuromodulatory interventions. Such a connectomic approach for neuromodulation constitutes an integrative account that aims to characterize optimal target networks. In this critical review, we integrate findings from connectomic studies and deep brain stimulation interventions to characterize a neural network presumably effective in reducing obsessions and compulsions. To this end, we scrutinize methodologies and seemingly conflicting findings with the aim to merge observations to identify common and diverse pathways for treating obsessive-compulsive disorder. Ultimately, we propose a unified network that-when modulated by means of cortical or subcortical interventions-alleviates obsessive-compulsive symptoms. https://doi.org/10.1016/j.biopsych.2021.07.010
Original languageEnglish
Pages (from-to)678-688
Number of pages11
JournalBiological Psychiatry
Volume90
Issue number10
DOIs
Publication statusPublished - 15 Nov 2021

Keywords

  • TERM-FOLLOW-UP
  • TRANSCRANIAL MAGNETIC STIMULATION
  • STEREOTACTIC ANTERIOR CAPSULOTOMY
  • SUBTHALAMIC NUCLEUS
  • ELECTRICAL-STIMULATION
  • CINGULATE CORTEX
  • DOUBLE-BLIND
  • LONG
  • CINGULOTOMY
  • ACCUMBENS

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