Cyclic versus continuous deep brain stimulation in patients with obsessive compulsive disorder: A randomized controlled trial

Cyclic versus continuous deep brain stimulation in patients with obsessive compulsive disorder: A randomized controlled trial

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Background: Deep brain stimulation (DBS) of the ventral anterior limb of the internal capsule (vALIC) is effective for refractory obsessive-compulsive disorder (OCD), but patients typically require high stimulation voltages and DBS comes with a risk for adverse events (AE).Objective: The aim of the present study was to advance DBS for OCD by optimizing energy efficiency and minimize adverse events using a cyclic form of stimulation Methods: This double blind, randomized crossover trial compares 2 weeks of continuous versus cyclic DBS (0.1 s ON, 0.2 s OFF) in 16 patients with OCD.We compared OCD symptoms (Yale-Brown Obsessive-Compulsive Scale, Y-BOCS), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Scale (HAM-A), AEs, battery life, cognitive performance and quality of life.

Results: Outdoor Sectional with Ottoman Average Y-BOCS scores at baseline increased significantly with 5.5 points (p = 0.006) in the cyclic condition.Average HAM-D and HAM-A scores increased with 2.2 (p = Rooster 0.

088) and 2.8 points (p = 0.018).The overall health scale of quality of life worsened during cyclic DBS (p = 0.044).

Patients reported on average 3.3 AEs during continuous stimulation and 4.4 AEs during cyclic stimulation (p = 0.175), though stimulation-related AEs such as headache and concentration problems reduced during cyclic DBS.Battery usage during continuous DBS was 0.

021 V per hour compared to 0.008 V per hour during cyclic DBS.Conclusion: Though specific stimulation-related AEs improved, cyclic stimulation (0.1 s ON, 0.2 s OFF) comes with a high relapse risk in patients with DBS for OCD.

Cyclic DBS is no alternative for standard DBS treatment, but applicable in case of debilitating AEs.