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Tractography-Based Modeling Explains Treatment Outcomes in Patients Undergoing Deep Brain Stimulation for Obsessive-Compulsive Disorder. | LitMetric

AI Article Synopsis

  • Deep brain stimulation (DBS) is a growing treatment for severe obsessive-compulsive disorder (OCD), targeting specific brain circuits related to the condition.
  • Researchers conducted a study on 10 OCD patients to see if predictive modeling could accurately forecast their clinical improvements after undergoing DBS, even without prior knowledge of the targeted brain areas.
  • The results showed a strong correlation between the predicted improvements from the modeling and the actual clinical outcomes measured on the Yale-Brown Obsessive Compulsive Scale after six months, highlighting the potential of using tractography-based modeling in DBS treatment planning.

Article 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387502PMC
http://dx.doi.org/10.1016/j.biopsych.2023.01.017DOI Listing

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