Deep brain stimulation (DBS) has been used effectively for both treatment-resistant
obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) (
1
,
2
). While DBS of the anterior limb of the internal capsule is Food and Drug Administration
approved for use in OCD under a Humanitarian Device Exemption, DBS for TS is still
considered investigational (
3
,
4
). Several DBS targets for TS have been studied, most prominently the globus pallidus
internus (GPi) and centromedian/parafascicular thalamus, though no single best target
has emerged (
2
,
5
). Up to two-thirds of patients with TS present with comorbid OCD (
6
). In many cases, treatment-resistant dual-diagnosis patients have been treated with
one pair of leads in the hope of improving both. In an attempt to optimize outcomes
for both disorders, and given the increasing utilization of multilead implantation
strategies (
7
,
- Oliveria S.F.
- Rodriguez R.L.
- Bowers D.
- Kantor D.
- Hilliard J.D.
- Monari E.H.
- et al.
Safety and efficacy of dual-lead thalamic deep brain stimulation for patients with
treatment-refractory multiple sclerosis tremor: A single-centre, randomised, single-blind,
pilot trial.
Lancet Neurol. 2017; 16: 691-700
8
,
9
,
10
), we opted for a dual-target strategy in 2 patients with severe TS and OCD. We also
utilized recently available sensing-capable implantable pulse generators (IPGs), which
present a unique opportunity to study the disease-modifying effects of DBS on OCD-
and TS-associated neurophysiology.To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 01, 2023
Accepted:
January 18,
2023
Received:
January 16,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Society of Biological Psychiatry.
