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Brain Sci. 2019 Aug 30;9(9). pii: E220. doi: 10.3390/brainsci9090220.

Local and Global Changes in Brain Metabolism during Deep Brain Stimulation for Obsessive-Compulsive Disorder.

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Department of Psychiatry and Psychotherapy, University of Cologne, Medical faculty, 50937 Cologne, Germany.
Department of Nuclear Medicine, University of Cologne, Medical faculty, 50937 Cologne, Germany.
Department of Psychiatry and Psychotherapy, University of Cologne, Medical faculty, 50937 Cologne, Germany.
Department of Stereotactic and Functional Neurosurgery, University of Cologne, 50937 Cologne, Germany.
Department of Psychiatry, Psychotherapy and Psychosomatic, Johanniter Hospital Oberhausen, 50937 Oberhausen, Germany.


Recent approaches have suggested that deep brain stimulation (DBS) for obsessive-compulsive disorder relies on distributed networks rather than local brain modulation. However, there is insufficient data on how DBS affects brain metabolism both locally and globally. We enrolled three patients with treatment-refractory obsessive-compulsive disorder with ongoing DBS of the bilateral ventral capsule/ventral striatum. Patients underwent resting-state 18F-fluorodeoxyglucose and positron emission tomography in both stimulation ON and OFF conditions. All subjects showed relative hypometabolism in prefronto-basal ganglia-thalamic networks compared to a healthy control cohort when stimulation was switched OFF. Switching the stimulation ON resulted in differential changes in brain metabolism. Locally, volumes of activated tissue at stimulation sites (n = 6) showed a significant increase in metabolism during DBS ON compared to DBS OFF (Mean difference 4.5 % ± SD 2.8; p = 0.012). Globally, differential changes were observed across patients encompassing prefrontal increase in metabolism in ON vs. OFF condition. Bearing in mind limitations of the small sample size, we conclude that DBS of the ventral capsule/ventral striatum for obsessive-compulsive disorder increases brain metabolism locally. Across distributed global networks, DBS appears to exert differential effects, possibly depending on localization of stimulation sites and response to the intervention.


18F-fluorodeoxyglucose; DBS; Deep brain stimulation; FDG-PET; OCD; Obsessive-Compulsive Disorder; Positron emission tomography

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Conflict of interest statement

V.V.-V. has received payments for traveling, lodging, and financial compensation for contributions to advisory boards or workshops (mostly 2/year) by Medtronic, Abbott, and St. Jude Medical. J.K. has received financial support for Investigator initiated trials from Medtronic GmbH.

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