OBJECTIVE Deep brain stimulation (DBS) is an effective treatment option for patients with refractory obsessive-compulsive disorder (OCD). However, clinical experience with DBS for OCD remains limited. The authors examined the tolerability and effectiveness of DBS in an open study of patients with refractory OCD. METHODS Seventy consecutive patients, including 16 patients from a previous trial, received bilateral DBS of the ventral anterior limb of the internal capsule (vALIC) between April 2005 and October 2017 and were followed for 12 months. Primary effectiveness was assessed by the change in scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) from baseline until the 12-month follow-up. Response was defined by a ≥35% decrease in Y-BOCS score, partial response was defined by a 25%-34% decrease, and nonresponse was defined by a <25% decrease. Secondary effectiveness measures were the Hamilton Anxiety Rating Scale (HAM-A) and the Hamilton Depression Rating Scale (HAM-D). RESULTS Y-BOCS, HAM-A, and HAM-D scores all decreased significantly during the first 12 months of DBS. Twelve months of DBS resulted in a mean Y-BOCS score decrease of 13.5 points (SD=9.4) (40% reduction; effect size=1.5). HAM-A scores decreased by 13.4 points (SD=9.7) (55%; effect size=1.4), and HAM-D scores decreased by 11.2 points (SD=8.8) (54%; effect size=1.3). At the 12-month follow-up, 36 of the 70 patients were categorized as responders (52%), 12 patients as partial responders (17%), and 22 patients as nonresponders (31%). Adverse events included transient symptoms of hypomania, agitation, impulsivity, and sleeping disorders. CONCLUSIONS These results confirm the effectiveness and safety of DBS of the vALIC for patients with treatment-refractory OCD in a regular clinical setting.

中文翻译：

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脑深部刺激内囊前肢对顽固性强迫症的疗效：临床队列70例。

目的难治性强迫症（OCD）患者的深部脑刺激（DBS）是一种有效的治疗选择。但是，DBS for OCD的临床经验仍然有限。作者在一项难治性强迫症患者的开放性研究中检查了DBS的耐受性和有效性。方法自2005年4月至2017年10月，连续70例患者接受了内囊腹侧前肢（vALIC）的双侧DBS，其中包括16例来自先前试验的患者，并随访了12个月。从基线到12个月的随访，通过耶鲁-布朗强迫症量表（Y-BOCS）评分的变化来评估主要疗效。响应定义为Y-BOCS得分下降≥35％，部分响应定义为下降25％-34％，无响应定义为< 减少25％。次要疗效指标是汉密尔顿焦虑量表（HAM-A）和汉密尔顿抑郁量表（HAM-D）。结果在DBS的前12个月，Y-BOCS，HAM-A和HAM-D分数均显着下降。十二个月的DBS导致Y-BOCS得分平均下降了13.5分（SD = 9.4）（下降了40％；效应量= 1.5）。HAM-A得分降低了13.4分（SD = 9.7）（55％;效应值= 1.4），HAM-D得分降低了11.2分（SD = 8.8）（54％;效应值= 1.3）。在12个月的随访中，将70例患者中的36例归为有反应者（52％），将12例患者归为部分反应者（17％），将22例患者归为无反应者（31％）。不良事件包括轻躁狂，躁动，冲动和睡眠障碍的短暂症状。