Deep brain stimulation has been shown to help people with severe obsessive compulsive disorder (OCD) who have not responded to other treatments, in a clinical trial conducted by researchers at the University of Queensland.
Lead author of the study, Dr Philip Mosley of the Queensland Brain Institute, CSIRO and QIMR Berghofer Medical Research Institute, said the trial produced remarkable results given the lifespan of the disability experienced by the participants.
“For example, one participant got married, started a business, and now has a young family after participating in the study,” said Dr Mosley.
“We have shown that deep brain stimulation is a promising treatment, and our ultimate goal is for it to become an approved therapy for people with extreme and treatment resistant OCD.”
People with OCD – a psychiatric disorder affecting between one and two percent of the population – experience intrusive and anxiety-provoking thoughts (obsessions) that may be accompanied by mental acts or behaviors (compulsions).
The time spent managing these behaviors deeply interferes with their daily lives and reduces professional and social functioning.
Dr Mosley said the team photographed participants’ brains to understand exactly how deep brain stimulation provides therapeutic benefit.
“Brain imaging has provided valuable information that will help us repeat these positive results in the future.”
This trial was a first for Australia, was randomized and double-blind placebo-controlled, enhancing the reliability of the results.
It targeted a region of the brain involved in mediating sustained stress and anxiety – and involved nine participants with severe OCD who had not responded to years of extensive pharmaceutical or psychological treatment.
The implantations were performed by QBI Associate Professor Terry Coyne (neurosurgeon) and Professor Peter Silburn (neurologist), world leaders in deep brain stimulation.
In the first part of the trial, half of the participants received active stimulation and the other half received placebo stimulation for three months.
The clinical trial showed further gains in the second phase of the trial, when all participants received active stimulation for an additional nine months, and a course of cognitive behavioral therapy once they responded to the stimulation. .
QBI Director Professor Pankaj Sah said deep brain stimulation delivered by implanted electrodes is well established for treating movement disorders like Parkinson’s disease.
“Deep brain stimulation is like a pacemaker for the brain – the electrodes deliver a continuous electrical impulse to a targeted region of the brain, a treatment that is both adjustable and reversible,” said Professor Sah.
“The trial showed a statistically and clinically significant reduction in OCD symptoms during active stimulation compared to placebo.”
The researchers gratefully acknowledge the commitment of participants who contributed their time to the study, which was funded by QBI in partnership with Medtronic.
The results of clinical trials are published in the Nature Journal, Translational psychiatry (doi.org/10.1038/s41398-021-01307-9).