TY - JOUR
T1 - Effectiveness and safety of deep brain stimulation for patients with refractory obsessive compulsive disorder and comorbid autism spectrum disorder; A case series
AU - Graat, Ilse
AU - Balke, Sofie
AU - Prinssen, Janine
AU - de Koning, Pelle
AU - Vulink, Nienke
AU - Mocking, Roel
AU - van Rooijen, Geeske
AU - Munckhof, Pepijn van den
AU - Schuurman, Rick
AU - Denys, Damiaan
N1 - Funding Information: R.J.T. Mocking is funded by an unrestricted ABC Talent Grant. P.R. Schuurman acts as independent advisor for Medtronic and Boston. The other authors have no disclosures to report. Publisher Copyright: © 2021 The Authors
PY - 2022/2/15
Y1 - 2022/2/15
N2 - Background: Deep brain stimulation (DBS) is effective for patients with treatment refractory obsessive-compulsive disorder (OCD). Autism spectrum disorder (ASD) is present in up to a third of all patients with OCD, but it is unknown whether effectiveness of DBS for OCD also applies for patients with comorbid ASD. The present case series is the first to examine effectiveness on OCD symptoms and safety of DBS in patients with OCD and ASD specifically. Methods: Six consecutive patients with treatment-refractory OCD and comorbid ASD received DBS of the ventral anterior limb of the internal capsule (vALIC) or medial forebrain bundle (MFB). We examined effectiveness of DBS on symptoms of OCD and depression with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Hamilton Depression Rating Scale (HAM-D), respectively. We included qualitative data to describe the course of treatment in individual patients with OCD and ASD. Results: We found that DBS significantly decreased symptoms of OCD (p < .001) and depression (p = .007). Four out of six patients with OCD and comorbid ASD were responders (decrease ≥ 35% in Y-BOCS), one patient was partial-responder (decrease 25–35% in Y-BOCS) and one patient did not respond (decrease ≤ 25% in Y-BOCS). Serious adverse events were an infection of the DBS system, and a suicide attempt. Conclusions: Though present results are preliminary, DBS reduced symptoms of OCD and depression in patients with OCD and comorbid ASD. Comorbid ASD should therefore not be seen as a contra-indication for DBS in OCD.
AB - Background: Deep brain stimulation (DBS) is effective for patients with treatment refractory obsessive-compulsive disorder (OCD). Autism spectrum disorder (ASD) is present in up to a third of all patients with OCD, but it is unknown whether effectiveness of DBS for OCD also applies for patients with comorbid ASD. The present case series is the first to examine effectiveness on OCD symptoms and safety of DBS in patients with OCD and ASD specifically. Methods: Six consecutive patients with treatment-refractory OCD and comorbid ASD received DBS of the ventral anterior limb of the internal capsule (vALIC) or medial forebrain bundle (MFB). We examined effectiveness of DBS on symptoms of OCD and depression with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Hamilton Depression Rating Scale (HAM-D), respectively. We included qualitative data to describe the course of treatment in individual patients with OCD and ASD. Results: We found that DBS significantly decreased symptoms of OCD (p < .001) and depression (p = .007). Four out of six patients with OCD and comorbid ASD were responders (decrease ≥ 35% in Y-BOCS), one patient was partial-responder (decrease 25–35% in Y-BOCS) and one patient did not respond (decrease ≤ 25% in Y-BOCS). Serious adverse events were an infection of the DBS system, and a suicide attempt. Conclusions: Though present results are preliminary, DBS reduced symptoms of OCD and depression in patients with OCD and comorbid ASD. Comorbid ASD should therefore not be seen as a contra-indication for DBS in OCD.
KW - Autism spectrum disorder
KW - Deep brain stimulation
KW - Effectiveness
KW - Obsessive compulsive disorder
KW - Safety
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85121619429&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jad.2021.12.089
DO - https://doi.org/10.1016/j.jad.2021.12.089
M3 - Article
C2 - 34952108
SN - 0165-0327
VL - 299
SP - 492
EP - 497
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -