Abstract
Background
Deep brain stimulation (DBS) is an established and expanding therapy for treatment-refractory
obsessive-compulsive disorder. Previous work has suggested that a white matter circuit
providing hyperdirect input from the dorsal cingulate and ventrolateral prefrontal
regions to the subthalamic nucleus could be an effective neuromodulatory target.
Methods
We tested this concept by attempting to retrospectively explain through predictive
modeling the ranks of clinical improvement as measured by the Yale-Brown Obsessive
Compulsive Scale (Y-BOCS) in 10 patients with obsessive-compulsive disorder who underwent
DBS to the ventral anterior limb of internal capsule with subsequent programming uninformed
by the putative target tract.
Results
Rank predictions were carried out using the tract model by a team that was completely
uninvolved in DBS planning and programming. Predicted Y-BOCS improvement ranks significantly
correlated with actual Y-BOCS improvement ranks at the 6-month follow-up (r = 0.75, p = .013). Predicted score improvements correlated with actual Y-BOCS score improvements
(r = 0.72, p = .018).
Conclusions
Here, we provide data in a first-of-its-kind report suggesting that normative tractography-based
modeling can blindly predict treatment response in DBS for obsessive-compulsive disorder.
Keywords
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Article info
Publication history
Published online: January 30, 2023
Accepted:
January 19,
2023
Received in revised form:
December 29,
2022
Received:
October 15,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Society of Biological Psychiatry.
