TY - JOUR
T1 - Acute effects of deep brain stimulation on brain function in obsessive–compulsive disorder
AU - Bangel, Katrin A.
AU - Bais, Melisse
AU - Eijsker, Nadine
AU - Schuurman, P. Richard
AU - van den Munckhof, Pepijn
AU - Figee, Martijn
AU - Smit, Dirk J. A.
AU - Denys, Damiaan
N1 - Funding Information:
We would like to thank Gaetano Leogrande for technical support, Isidoor Bergfeld for feedback on the manuscript, and Caroline de Booij, Eva S.A. Dijkstra, Maud Ottenheijm, Nora Runia, Victoria I. Visser, and Lara de Vries for their assistance with data collection. This work was supported by Medtronic Europe and Hersenstichting Nederland.
Funding Information:
We would like to thank Gaetano Leogrande for technical support, Isidoor Bergfeld for feedback on the manuscript, and Caroline de Booij, Eva S.A. Dijkstra, Maud Ottenheijm, Nora Runia, Victoria I. Visser, and Lara de Vries for their assistance with data collection. This work was supported by Medtronic Europe and Hersenstichting Nederland. DD and RS receive occasional fees from Medtronic for educational purposes. RS acts as consultant for Medtronic, Boston Scientific and Elekta. DD has until recently been a member of the advisory board of Lundbeck. These connections did in no way influence the decision to write and submit this manuscript. All remaining authors have no conflicts of interest to disclose.
Publisher Copyright:
© 2023
PY - 2023/4
Y1 - 2023/4
N2 - Objective: Deep brain stimulation (DBS) is an effective treatment for refractory obsessive–compulsive disorder (OCD) yet neural markers of optimized stimulation parameters are largely unknown. We aimed to describe (sub-)cortical electrophysiological responses to acute DBS at various voltages in OCD. Methods: We explored how DBS doses between 3–5 V delivered to the ventral anterior limb of the internal capsule of five OCD patients affected electroencephalograms and intracranial local field potentials (LFPs). We focused on theta power/ phase-stability, given their previously established role in DBS for OCD. Results: Cortical theta power and theta phase-stability did not increase significantly with DBS voltage. DBS-induced theta power peaks were seen at the previously defined individualized therapeutic voltage. Although LFP power generally increased with DBS voltages, this occurred mostly in frequency peaks that overlapped with stimulation artifacts limiting its interpretability. Though highly idiosyncratic, three subjects showed significant acute DBS effects on electroencephalogram theta power and four subjects showed significant carry-over effects (pre-vs post DBS, unstimulated) on LFP and electroencephalogram theta power. Conclusions: Our findings challenge the presence of a consistent dose–response relationship between stimulation voltage and brain activity. Significance: Theta power may be investigated further as a neurophysiological marker to aid personalized DBS voltage optimization in OCD.
AB - Objective: Deep brain stimulation (DBS) is an effective treatment for refractory obsessive–compulsive disorder (OCD) yet neural markers of optimized stimulation parameters are largely unknown. We aimed to describe (sub-)cortical electrophysiological responses to acute DBS at various voltages in OCD. Methods: We explored how DBS doses between 3–5 V delivered to the ventral anterior limb of the internal capsule of five OCD patients affected electroencephalograms and intracranial local field potentials (LFPs). We focused on theta power/ phase-stability, given their previously established role in DBS for OCD. Results: Cortical theta power and theta phase-stability did not increase significantly with DBS voltage. DBS-induced theta power peaks were seen at the previously defined individualized therapeutic voltage. Although LFP power generally increased with DBS voltages, this occurred mostly in frequency peaks that overlapped with stimulation artifacts limiting its interpretability. Though highly idiosyncratic, three subjects showed significant acute DBS effects on electroencephalogram theta power and four subjects showed significant carry-over effects (pre-vs post DBS, unstimulated) on LFP and electroencephalogram theta power. Conclusions: Our findings challenge the presence of a consistent dose–response relationship between stimulation voltage and brain activity. Significance: Theta power may be investigated further as a neurophysiological marker to aid personalized DBS voltage optimization in OCD.
KW - Artifact identification
KW - Obsessive–compulsive disorder (OCD)
KW - Oscillatory brain power
KW - Parameter optimization
KW - deep brain stimulation (DBS)
KW - intracranial EEG (iEEG)
UR - https://www.scopus.com/pages/publications/85147866778
U2 - 10.1016/j.clinph.2022.12.012
DO - 10.1016/j.clinph.2022.12.012
M3 - Article
C2 - 36774324
SN - 1388-2457
VL - 148
SP - 109
EP - 117
JO - Clinical neurophysiology
JF - Clinical neurophysiology
ER -