Acute effects of deep brain stimulation on brain function in obsessive-compulsive disorder

Objective: Deep brain stimulation (DBS) is an effective treatment for refractory obsessive-compulsive disorder (OCD) yet neural markers of optimized stimulation parameters are largely unknown. We aimed to describe (sub-)cortical electrophysiological responses to acute DBS at various voltages in OCD.Methods: We explored how DBS doses between 3-5 V delivered to the ventral anterior limb of the inter-nal capsule of five OCD patients affected electroencephalograms and intracranial local field potentials (LFPs). We focused on theta power/ phase-stability, given their previously established role in DBS for OCD.Results: Cortical theta power and theta phase-stability did not increase significantly with DBS voltage. DBS-induced theta power peaks were seen at the previously defined individualized therapeutic voltage. Although LFP power generally increased with DBS voltages, this occurred mostly in frequency peaks that overlapped with stimulation artifacts limiting its interpretability. Though highly idiosyncratic, three sub-jects showed significant acute DBS effects on electroencephalogram theta power and four subjects showed significant carry-over effects (pre-vs post DBS, unstimulated) on LFP and electroencephalogram theta power.Conclusions: Our findings challenge the presence of a consistent dose-response relationship between stimulation voltage and brain activity. Significance: Theta power may be investigated further as a neurophysiological marker to aid personalized DBS voltage optimization in OCD.(c) 2023 Published by Elsevier B.V. on behalf of International Federation of Clinical Neurophysiology.

Automated summary

Objective: To investigate the neural markers of optimized deep brain stimulation (DBS) for refractory obsessive-compulsive disorder (OCD) at different voltages. Methods: The study observed the electroencephalograms and intracranial local field potentials (LFPs) of five OCD patients under DBS doses between 3-5 V. Results: Theta power and phase-stability did not show significant increase with DBS voltage, challenging the consistent dose-response relationship. However, individualized therapeutic voltage did induce theta power peaks. Some subjects showed acute DBS effects on theta power and carry-over effects on LFP and theta power. Conclusions: Theta power may be a neurophysiological marker for personalized DBS voltage optimization in OCD.