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Deep brain stimulation of the subthalamic nucleus in obsessive-compulsive disorder: Neuroanatomical and pathophysiological considerations.
Mulders, A E P; Plantinga, B R; Schruers, K; Duits, A; Janssen, M L F; Ackermans, L; Leentjens, A F G; Jahanshahi, A; Temel, Y.
Afiliación
  • Mulders AEP; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: a.mulders@maastrichtuniversity.nl.
  • Plantinga BR; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Biomedical Image Analysis, Eindhoven University of Technology, Eindhoven, The Neth
  • Schruers K; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Duits A; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Janssen MLF; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Ackermans L; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Leentjens AFG; Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Jahanshahi A; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Temel Y; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: y.temel@maastrichtuniversity.nl.
Eur Neuropsychopharmacol ; 26(12): 1909-1919, 2016 12.
Article en En | MEDLINE | ID: mdl-27838106
Obsessive-compulsive disorder (OCD) is among the most disabling chronic psychiatric disorders and has a significant negative impact on multiple domains of quality of life. For patients suffering from severe refractory OCD, deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been applied. Reviewing the literature of the last years we believe that through its central position within the cortico-basal ganglia-thalamocortical circuits, the STN has a coordinating role in decision-making and action-selection mechanisms. Dysfunctional information-processing at the level of the STN is responsible for some of the core symptoms of OCD. Research confirms an electrophysiological dysfunction in the associative and limbic (non-motor) parts of the STN. Compared to Parkinson׳s disease patients, STN neurons in OCD exhibit a lower firing rate, less frequent but longer bursts, increased burst activity in the anterior ventromedial area, an asymmetrical left-sided burst distribution, and a predominant oscillatory activity in the δ-band. Moreover, there is direct evidence for the involvement of the STN in both checking behavior and OCD symptoms, which are both related to changes in electrophysiological activity in the non-motor STN. Through a combination of mechanisms, DBS of the STN seems to interrupt the disturbed information-processing, leading to a normalization of connectivity within the cortico-basal ganglia-thalamocortical circuits and consequently to a reduction in symptoms. In conclusion, based on the STN׳s strategic position within cortico-basal ganglia-thalamocortical circuits and its involvement in action-selection mechanisms that are responsible for some of the core symptoms of OCD, the STN is a mechanism-based target for DBS in OCD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Núcleo Subtalámico / Estimulación Encefálica Profunda / Trastorno Obsesivo Compulsivo Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Eur Neuropsychopharmacol Asunto de la revista: PSICOFARMACOLOGIA Año: 2016 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Núcleo Subtalámico / Estimulación Encefálica Profunda / Trastorno Obsesivo Compulsivo Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Eur Neuropsychopharmacol Asunto de la revista: PSICOFARMACOLOGIA Año: 2016 Tipo del documento: Article Pais de publicación: Países Bajos