Deep brain stimulation of the anterior limb of the internal capsule for treatment of therapy-refractory obsessive compulsive disorder (OCD): a case study highlighting neurocognitive and psychiatric changes

Neurocase. 2017 Apr;23(2):138-145. doi: 10.1080/13554794.2017.1319958. Epub 2017 May 1.

Abstract

Obsessive compulsive disorder (OCD) is an anxiety disorder characterized by repeated, unwanted thoughts and behaviors. Individuals with this condition often experience significant emotional distress secondary to their symptoms. Additionally, impairments in attention/concentration, processing speed, and executive functions are typically observed. The exact pathology of OCD remains unknown; consequently, it can be difficult to treat patients with severe symptomatology. Deep brain stimulation (DBS) may be a viable treatment option for individuals who do not respond to medication and/or cognitive behavioral therapy. The following case discusses DBS of the anterior limb of the internal capsule for a patient with severe, therapy-refractory OCD, including pre- to postoperative neurocognitive and psychiatric changes.

Keywords: Obsessive compulsive disorder; cognition; deep brain stimulation; internal capsule; neuropsychology.

MeSH terms

  • Activities of Daily Living
  • Attention / physiology
  • Cognition Disorders / etiology*
  • Cognition Disorders / therapy
  • Deep Brain Stimulation / methods*
  • Emotions / physiology
  • Female
  • Humans
  • Internal Capsule / physiology*
  • Magnetic Resonance Imaging
  • Male
  • Memory, Short-Term / physiology
  • Obsessive-Compulsive Disorder / complications*
  • Obsessive-Compulsive Disorder / therapy*
  • Personality
  • Verbal Learning / physiology
  • Young Adult